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"For chronic pain, reducing pain and improving the functionality are the main goals of the treatment. Transcutaneous Electrical Nerve Stimulation is an electrotherapy method for the inhibition of nociceptors, blockade transmission of pain at afferent nerves, sympathetic blockage and increasing the release of endogenous opioids. Reducing pain, inflammation, muscular symptomes and joint stiffness are the goals of the physical therapy for the symptomatic recovery.’’ According to a new study conducted at the University of Giresun, either with TENS or not, physical therapy was effective in chronic low back pain with lomber disc herniation. Also, effect of acupuncture-like TENS on pain, started later than other TENS modalities. ‘‘Having differences wouldn’t be surprising, because the analgesic mecanisms of TENS’ with lower and higher frequencies are different", Ilhanli said.
He stated that ‘‘the exercise is an effective component for pyhsical therapy and dynamic lomber stabilization exercises provide a physiologic bracing in neutral position and quicken the return to work in patients with lomber disc herniation.’’ Also, the superficial heater methods like hotpacks and the deep heater methods like ultrasound, short wave diathermy and microwave diathermy seem to be useful for their physiological effects in pain relief and spasm relaxation.
Lead author Dr. Ilker Ilhanli, who conducted the research at Giresun, analyzed data on 160 patients with chronic low back pain who were diagnosed as lomber disc herniation. Patients were randomized into 4 groups – conventional, brief-intense, acupuncture-like or sham TENS groups with physical therapy including hotpack, ultrasound and exercise program- and pain, functional capacity and quality of life were investigated. Patients were evaluated before the treatment, a week after the beginning of the treatment, at the end of the treatment and a month after the end of the treatment.
To reduce the pain, physicians can choose different TENS modalities for different patient models according to the character of complaints, but the final outcomes of the treatment regimens with or without TENS don’t differ, said Ilhanli, who currently is Asst. Prof. at the University of Giresun at the School of Medicine, Department of Physical Medicine and Rehabilitation.
A paper about the study appeared recently in Clinical Medicine and Research journal.