As an alternative to pain-relieving drugs, a variety of back pain therapies that use electrical impulses to block pain can be prescribed for patients to use on an as-needed basis. Most often used in conjunction with other pain-relief treatments, including physical therapy and exercise, electrical stimulation works either by “short-circuiting” or redirecting the pain message; increasing the body’s ability to produce painkilling endorphins; or, in some cases, by relieving muscle spasm at its source, although exactly how they do this is not always known.
Electrical stimulation is not recommended for those with a history of cardiac problems or for those who wear a pacemaker, and because the effects on fetuses are not known, it should be avoided during pregnancy. Treatment outcome may be affected by the use of drugs or the user’s psychological state. Here are a few of the more common techniques.
Transcutaneous Electrical Nerve Stimulation (TENS)
Some say it works best for acute back pain such as that associated with a pinched nerve; others say it’s particularly well-suited to chronic back pain; some say it works only as well as a placebo; others say it’s among the best pain-easing options around. As inconclusive as the literature may be, one way or another, about 100,000 people use TENS each year for temporary back pain relief.
TENS works by sending low-voltage electrical impulses from the surface of the skin to the nerve fibers just below, blocking pain messages from the nerves to the brain. It does this via small electrodes placed on the surface of your skin, usually in the area of the pain, and attached to a small stimulator – about the size of a small personal cassette player – that you wear and control, turning the TENS unit on and off as needed to control back pain.
The doctor who prescribes the unit will teach you where to place the electrodes on your back and how to use the device, which can be rented or purchased. Interferential current is a similar approach.
Percutaneous Electrical Nerve Stimulation (PENS)
More invasive than TENS, PENS sends painless electrical impulses into muscles through fine needle electrodes. (It’s been called electrical acupuncture.) A study published in the Journal of the American Medical Association involving sixty men and women with long-term lower back pain caused by degenerative disk disease compared PENS with TENS and exercise therapies. Each approach was used for thirty minutes three times a week for three weeks. PENS was found “significantly more effective” in decreasing back pain after each treatment, as well as in improving physical activity, quality of sleep, and sense of well-being. Ninety-one percent of the patients reported it the most effective in decreasing their pain.
Spinal Cord Stimulation
Reserved for extreme cases of chronic back pain, this method involves having electrodes implanted under the skin near the spine, connected to a small receiver located either below the collar bone or in the abdominal area. Activation of a stimulation transmitter that you wear cues the receiver to send low-current electrical impulses to the spinal cord, short-circuiting pain signals.
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