| Bob McConnell 2005-04-24, 10:52 pm |
| On Thu, 21 Apr 2005 22:13:56 -0700, "Jack Sandweiss"
<sandweiss@dslextreme.com> wrote:
>I'm curious. What do you mean by "shut down"? Is this the same as
>habituation? Why wouldn't overstimulation result in sensitization (or
>increased sensitivity), or can this be avoided by using correct voltage and
>frequency settings in the TENS unit? Sensitization is sometimes discussed
>as a factor in chronic pain. It would seem to me, that adding stimulation to
>nerve fibers that are already transmitting pain impulses would be extremely
>painful, at least while the unit was being used.
>
>IF severe chronic pain is reflective of overstimulation of pain fibers, why
>doesn't chronic pain go away on its own? Of course, if I knew that answer,
>we wouldn't be having this discussion.
>Then again, chronic pain may not be due to hyperexcited nerve fibers.
>
>I've always been somewhat amazed at the success that some have with TENS,
>and I've yet to hear a good explanation of "exactly" how it provides
>relief. But, I will never argue with empiricism. Relief is relief.
>
>Jack
>
I can only relate it to my wife's situation, since that is the context
we were looking at. She has had two unsuccessful ulnar transpositions,
one by a semi-senile osteopath, the second by two competent
neuro-surgeons. The latter were unable to correct the damage done by
the former. So she has scar tissue in several locations around the
elbow trapping or rubbing the nerve bundle. The nerve fibers are
continuously being damaged and regenerating, causing several types of
pain. She gets temporary relief from a TENS, but it is too bulky to
use full time.
After a thorough nerve conduction test, which identified each point of
damage and what was causing each of her reported symptoms, another
neurosurgeon, brought in by the insurance company, suggested an
implanted TENS unit with a remote control. He said this would at least
control the pain so that she would be able to do basic housework and
rest comfortably. The device itself costs more than US$10,000. Of
course, since this was a workman's comp case, the insurance company
wouldn't discuss anything that didn't guarantee she could go back to
work full time. (She finally settled for a lump sum that was a
fraction of the income and benefits she lost. New York's WC laws
benefit the employer more than the emplyee.)
But, in the discussion, he also said that there are some forms of pain
that the TENS cannot help. I didn't pay a lot of attention to that
part, since we were focused on my wife's condition. It was his
explanation of the function of the TENS unit that I paraphrased
earlier. He made a distinction between the nerves from pain sensors,
pressure and temperature sensors and motor control. He instructed us
to adjust the unit up to the point where the pain subsided, but her
arm should not start shaking or twitching. She should still be able to
feel some pressure and even hot or cold at that point.
HTH,
Bob McConnell
N2SPP
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