Long term results of peripheral conditioning stimulation as an analgesic measure in chronic pain

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Abstract

In the present study 123 patients with chronic pain, consecutively referred for symptomatic pain treatment, were given peripheral conditioning stimulation as an analgesic measure and were followed for 2 years or till they terminated the treatment. The stimulation was either conventional transcutaneous nerve stimulation (TNS) [35] of mainly cutaneous afferents with high frequency (10–100 Hz) or acupuncture-like TNS [11] where muscle nerves are activated at a low repetition rate (1–4 Hz) with small trains of stimuli. The follow-up showed that 55, 41 and 31% of the patients continued the treatment after 3, 12 and 24 months, respectively. About 30% of the patients had to use acupuncture-like TNS to get useful analgesia, defined as a desire of the patient to continue stimulation treatment. Three-quarters of the successfully relieved patients reported more than 50% pain relief as measured from visual analogue scales and half of these reported an increased social activity and a decrease of analgesic drug intake by more than 50%. Psychogenic and visceral pains were less suitable for TNS treatment. It is concluded that peripheral conditioning stimulation is a valuaable theraphy in cases of chronic pain and that both conventional and acupuncture-like TNS should be tried before considering implantable devices or destructive surgery.

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