Transcutaneous electrical nerve stimulation for the management of neuropathic pain: the effects of frequency and electrode position on prevention of allodynia in a rat model of complex regional pain syndrome type II.
OBJECTIVE
Complex regional pain syndrome type II (CPSII) is a painful condition that develops following a nerve injury. Although transcutaneous electrical nerve stimulation (TENS) relieves the pain of CPSII, the stimulation parameters that would best prevent the development of the condition are not known. The purpose of this study was to compare the ability of several different stimulation strategies to reduce the development of allodynia.


METHODS
Sprague-Dawley rats were used in the study.


METHODS
A chronic constriction injury (CCI) to the right sciatic nerve was used to induce allodynia. Two groups of CCI rats received high-frequency TENS to the lumbar paravertebral region with electrodes positioned on the skin overlying either the right or left paraspinal musculature. Two additional groups of CCI rats received low-frequency TENS to acupuncture points in the right or left hind limbs. A fifth group of CCI rats received no TENS intervention. Thermal and mechanical pain thresholds were assessed in the right hind paw before and 12 days after the CCI surgery. The TENS was delivered 1 hour per day beginning on the day of surgery.


RESULTS
Daily high-frequency TENS reduced the development of mechanical allodynia in CCI rats, and low-frequency TENS reduced the development of thermal allodynia, but only when TENS was delivered on the left side.


CONCLUSIONS
The results indicate that TENS delivered contralateral to a nerve injury best reduces allodynia development. Comprehensive reduction of allodynia development would require a combination of high- and low-frequency TENS intervention.
Somers
David L
DL
Department of Physical Therapy, Duquesne University, 113 Health Sciences Bldg, Pittsburgh, PA 15282-0011, USA. somers@duq.edu
Clemente
F Richard
FR
D015669:Acupuncture Points; D000818:Animals; D002422:Causalgia / Q000517:prevention & control*; D003627:Data Interpretation, Statistical; D004195:Disease Models, Animal; D015671:Electroacupuncture; D004566:Electrodes; D008297:Male; D008962:Models, Theoretical; D010147:Pain Measurement; D051381:Rats; D017207:Rats, Sprague-Dawley; D012584:Sciatic Nerve / Q000293:injuries; D013997:Time Factors; D004561:Transcutaneous Electric Nerve Stimulation / Q000379:methods*