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The Cleveland Clinic

Pain Management: TENS and Electrothermal Therapy

Electrical nerve stimulation and electrothermal therapy are used to relieve pain associated with various conditions including back pain. Transcutaneous electrical nerve stimulation (TENS) therapy provides short-term pain relief and is the most common form of electrical stimulation used in pain management. Intradiscal electrothermal therapy (IDET) is used as a treatment option for people with low back pain resulting from inter-vertebral disc problems.

TENS

In TENS therapy, a small, battery-operated device sends low-voltage electrical current through the skin via electrodes placed near the source of pain. The electricity from the electrodes stimulates the nerves in an affected area and sends signals to the brain that "scramble" normal pain signals. TENS is not painful and has been proven effective for some people capable of using the therapy to mask pain.

Intradiscal Electrothermal Therapy

Inter-vertebral discs act as cushions between the vertebrae. Sometimes the discs can become damaged and cause pain. IDET uses heat to modify the nerve fibers of a spinal disc and to destroy pain receptors in the area. In this procedure, a wire called an electrothermal catheter is placed through an incision in the disc. An electrical current passes through the wire, heating the disc to a temperature of 90 degrees Celsius.

IDET is performed as an outpatient procedure while the patient is awake and under a local anesthesia. Early studies indicate that some patients may have continued pain relief for up to six months or longer. The long-term effects of this procedure on the disc have not been determined.

Reviewed by the doctors at The Cleveland Clinic Spine Center.
Edited by Cynthia Haines, MD, WebMD, August 2004.

Portions of this page © The Cleveland Clinic 2000-2005


Last Editorial Review: 2/3/2005 10:19:36 PM




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Transcutaneous Electrical Nerve Stimulation

Introduction: The Universal Disorder

You know it at once. It may be the fiery sensation of a burn moments after your finger touches the stove. Or it's a dull ache above your brow after a day of stress and tension. Or you may recognize it as a sharp pierce in your back after you lift something heavy.

It is pain. In its most benign form, it warns us that something isn't quite right, that we should take medicine or see a doctor. At its worst, however, pain robs us of our productivity, our well-being, and, for many of us suffering from extended illness, our very lives. Pain is a complex perception that differs enormously among individual patients, even those who appear to have identical injuries or illnesses.

In 1931, the French medical missionary Dr. Albert Schweitzer wrote, "Pain is a more terrible lord of mankind than even death itself." Today, pain has become the universal disorder, a serious and costly public health issue, and a challenge...

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