TENS Relieves Pain, Spasticity for Patients with Multiple Sclerosis

TENS for multiple sclerosis
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People with multiple sclerosis who are looking for non-drug approaches to dealing with pain and spasticity of the disease may find some relief from TENS (transcutaneous electrical nerve stimulation). A new review and previous research suggests TENS offers these benefits to patients with MS.

TENS is a treatment approach that sends extremely low levels of electrical currents to the body for the purpose of relieving pain. Two of the benefits of TENS are it can be done safely and easily at home using a small device and there are no drugs involved.

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Another advantage of TENS is that it has been shown to provide some relief for both neuropathic (nerve) and nociceptive (musculoskeletal) pain. Neuropathic pain occurs when there is damage to nerve connections within the nervous system, while nociceptive pain is the result of tissue damage. Both types of pain are common among people who have MS.

Explanations as to how and why TENS is believed to relieve pain are a bit complicated, but here’s a simplification:

  • The electrical currents reduce pain by inhibiting nociceptive receptors in the dorsal horn. Nociceptive receptors are substances that become irritated and cause nociceptive pain, which is the type of pain that occurs when you twist your ankle or burn yourself. The dorsal horn is one of the two roots of a spinal nerve that contains sensory fibers.
  • TENS also helps control pain by increasing levels of beta endorphin and met-enkephalin, which are the body’s natural pain killers

The reviewers looked at two studies that involved TENS compared with placebo in patients with MS and concluded that TENS “may be effective in reducing central neuropathic pain in MS.”

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TENS and spasticity
Spasticity management is a challenge for MS patients. One of the current treatments for this MS symptom is baclofen, so the study compared the two treatment options in 52 patients who suffered with lower limb spasticity.

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During the four-week study, half of the patients received 10 mg twice daily of baclofen (increasing to 25 mg over three weeks) while the other half used self-applied TENS. At the end of the four weeks, spasticity improved in both groups of patients.

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However, response was better among those who used TENS; that is, the mean difference in the modified Ashworth scale (used to measure spasticity) was significantly lower in the TENS group than in the baclofen group. Therefore, although both baclofen and TENS are effective in reducing spasticity related to MS, TENS can provider better results and without the side effects of the drug.

TENS also proved beneficial against nortriptyline when treating pain and spasticity in the upper extremities. The head-to-head comparison was done in 59 people with MS who were randomly assigned to receive TENS or nortriptyline (10 mg to 50 mg) over eight weeks.

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At the end of the study period, both TENS and nortriptyline resulted in similar improvements in pain and spasticity; that is, one method was not significantly better than the other. However, given the side effects associated with the drug (e.g., drowsiness, dry mouth, headache, weight gain, dizziness, taste problems), TENS seems to be safer choice.

If you have MS and have not tried TENS for pain or spasticity, you may want to talk to your healthcare provider. TENS for multiple sclerosis can be done at the doctor’s office, with a physical therapist, or at home with minimal instruction.

SOURCES
Chitsaz A et al. Sensory complaints of the upper extremities in multiple sclerosis: relative efficacy of nortriptyline and transcutaneous electrical nerve stimulation. Clinical Journal of Pain 2009 May; 25(4): 281-85
Jawahar R et al. Alternative approaches: a systematic review of non-pharmacological treatments for non-spastic and non-trigeminal pain in patients with multiple sclerosis. European Journal of Physical Rehabilitation Medicine 2014 Mar 4
Shaygannejad V et al. Comparison of the effect of baclofen and transcutaneous electrical nerve stimulation for the treatment of spasticity in multiple sclerosis. Neurological Research 2013 Jul; 35(6): 636-41

Image: Wikimedia Commons

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