Purpose of Review

Transcutaneous electrical nerve stimulation (TENS) is widely used as a non-pharmacological approach for pain relief in a variety of clinical conditions. This manuscript aimed to review the basic mechanisms and clinical applications regarding the use of TENS for alleviating the peripheral (PNP) and central neuropathic pain (CNP).

Recent Findings

Basic studies on animal models showed that TENS could alleviate pain by modulating neurotransmitters and receptors in the stimulation site and its upper levels, including the spinal cord, brainstem, and brain. Besides, many clinical studies have investigated the efficacy of TENS in patients with CNP (caused by spinal cord injury, stroke, or multiple sclerosis) and PNP (induced by diabetes, cancer, or herpes zoster). Most clinical trials have demonstrated the efficacy of TENS in attenuating neuropathic pain and suggested that appropriate stimulation parameters (e.g., stimulation frequency and intensity) were critical to improving the analgesic effects of TENS. However, there are some conflicting findings related to the efficacy of TENS in relieving neuropathic pain.

Summary

With optimized stimulation parameters, TENS would be effective in attenuating neuropathic pain. To obtain sufficient evidence to support the use of TENS in the clinic, researchers recommended performing multicenter clinical trials with optimized TENS protocols for the treatment of various CNP and PNP.

中文翻译：

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经皮神经电刺激缓解神经性疼痛：基本机制和临床应用。

审查目的

经皮电神经刺激（TENS）被广泛用作在各种临床情况下缓解疼痛的非药物方法。该手稿旨在回顾有关使用TENS缓解周围性（PNP）和中枢神经性疼痛（CNP）的基本机制和临床应用。

最近的发现

动物模型的基础研究表明，TENS可以通过调节刺激部位及其上层（包括脊髓，脑干和大脑）的神经递质和受体来减轻疼痛。此外，许多临床研究已经研究了TENS在CNP（由脊髓损伤，中风或多发性硬化症引起）和PNP（由糖尿病，癌症或带状疱疹诱发）中的疗效。大多数临床试验已经证明了TENS在减轻神经性疼痛方面的功效，并建议适当的刺激参数（例如刺激频率和强度）对于改善TENS的镇痛作用至关重要。但是，与TENS缓解神经性疼痛的功效相关的发现存在一些矛盾的发现。

概要

通过优化的刺激参数，TENS将有效减轻神经性疼痛。为了获得足够的证据支持在临床中使用TENS，研究人员建议使用优化的TENS方案进行多中心临床试验，以治疗各种CNP和PNP。