Pain<unk>  is a commonly used treatment approach to alleviate acute and chronic pain by reducing the sensitization of dorsal horn neurons, elevating levels of gamma-aminobutyric acid and glycine, and inhibiting glial activation. However, many systematic reviews and meta analyses assessing clinical trials looking at the effectiveness of using<unk>  to reduce different sources of pain have been inconclusive due to a lack of high quality and unbiased evidence. Potential benefits of<unk>  treatment include the safety, relative low cost, the ability to self-administer, and availability over the counter without a prescription. In principle, an adequate intensity of<unk>  is necessary to achieve pain relief with<unk> . An analysis of treatment fidelity (meaning that the delivery of<unk>  in a trial was in accordance with current clinical advice, such as using "a strong but comfortable sensation" and suitable, frequent treatment durations) showed that higher fidelity trials tended to have a positive outcome. Acute pain For people with recent onset pain (less than three months) such as pain associated with surgery, trauma, and/or medical procedures,<unk>  may be better than placebo in some cases, however the evidence of benefit is very weak. Musculoskeletal and neck/back pain There is some evidence to support a benefit of using<unk>  in chronic musculoskeletal pain. Results from a task force on neck pain in 2008, found no clinically significant benefit to<unk>  for the treatment of neck pain when compared to a placebo treatment. A 2010 review did not find evidence to support the use of<unk>  for chronic low back pain. Another study examining Knee Osteoarthritis (KOA) patients supported that<unk>  demonstrated a better efficacy and safety profile than Weak Opiates. Given the age and comorbidities of the KOA population being generally older, often prone to polypharmacy and sensitive to adverse reactions,<unk>  could be a relevant non-pharmacological therapeutic alternative to pharmacological analgesics for the management of Knee Osteoarthritis pain. Neuropathy and phantom limb pain There is tentative evidence that it may be useful for painful diabetic neuropathy. As of 2015, the efficacy of<unk>  therapy for phantom limb pain is not known as no randomized controlled trials have been performed. A few studies have shown objective evidence that<unk>  may modulate or suppress pain signals in the brain. One used evoked cortical potentials to show that electric<unk>  of peripheral A-beta sensory fibers reliably suppressed A-delta fiber nociceptive (pain perception) processing. Two other studies used functional magnetic resonance imaging (fMRI): one showed that high-frequency<unk>  produced a decrease in pain-related cortical activations in patients with carpal tunnel syndrome, while the other showed that low-frequency<unk>  decreased shoulder impingement pain and modulated pain-induced activation in the brain. Labor and menstrual pain Earlier studies have stated that<unk>  "has been shown not to be effective in postoperative and labour pain." These studies also had questionable ability to truly blind the patients. However, more recent studies have shown that<unk>  was "effective for relieving labour pain, and they are well considered by pregnant participants." One study also showed that there was a significant change in how soon the laboring mothers took to request pharmacologic pain management, like the epidural. The group with the<unk>  waited five additional hours. Both groups were satisfied with the pain relief that they had from their choices. No maternal, infant, or labor problems were noted. There is tentative evidence that<unk>  may be helpful for treating pain from dysmenorrhoea, however further research is required. Cancer pain Non-pharmacological treatment options for people experiencing pain caused by cancer are much needed, however, it is not clear from the weak studies that have been published if<unk>  is an effective approach. Dentistry<unk>  has been extensively used in non-odontogenic orofacial pain relief. In addition,<unk>  and ultra low frequency-TENS (ULF-TENS) are commonly employed in diagnosis and treatment of temporomandibular joint dysfunction (TMD). Further clinical studies are required to determine its efficacy. Tremor A wearable neuromodulation device that delivers<unk><unk>  to nerves in the wrist is now available by prescription. Worn around the wrist, it acts as a non-invasive treatment for those living with essential tremor. The stimulator has electrodes that are placed circumferentially around a patient's wrist. Positioning the electrodes on generally opposing sides of the target nerve can result in improved<unk>  of the nerve. In clinical trials reductions in hand tremors were reported following noninvasive median and radial nerve<unk> .<unk>  Afferent Patterned<unk>  (TAPS) is a tremor-customized therapy, based on the patient's measured tremor frequency, and is delivered<unk> ly to the median and radial nerves of a patient's wrist. The patient specific TAPS<unk>  is determined through a calibration process performed by the accelerometer and microprocessor on the device. The Cala ONE delivers TAPS in a wrist-worn device that is calibrated to treat tremor symptoms. Cala ONE received de novo FDA clearance in April 2018 for the transient relief of hand tremors in adults with essential tremor and is currently marketed as Cala Trio.
Transcutaneous electrical nerve stimulation
Repetitive nerve stimulation
Percutaneous tibial nerve stimulation
Electrical muscle stimulation
Nerve conduction study
Nerve biopsy
Femoral nerve stretch test
Electromyography