Peripheral Nerve Block Injection For Chronic Pain Not Necessary with Electroanalgesia

 

      Nerve Blocks For Paraesthesia May Be Obsolete with Electroanalgesia High Frequency Stimulation

 

 

 What does the term mean, "electroanalgesia"?

 
Wikipedia describes this way:
 
   "Electroanalgesia is a form of analgesia, or pain relief, that uses electricity to ease pain. Electrical devices can be internal or external, at the site of pain (local) or delocalized throughout the whole body. It works by interfering with the electrical currents of pain signals, inhibiting them from reaching the brain and inducing a response; 
different from traditional analgesics, such as opiates which mimic natural endorphins and NSAIDS (non-steroidal anti-inflammatory drugs) that help relieve inflammation and stop pain at the source. Electroanalgesia has a lower addictive potential and poses less health threats to the general public, but can cause serious health problems, even death, in people with other electrical devices such as pacemakers or internal hearing aids, or with heart problems."
 
"Analgesia that is induced by the passage of an electric current."
.......The American Heritage® Medical Dictionary
 
"the reduction of pain by electrical stimulation of a peripheral nerve or the dorsal column of the spinal cord,"
...Miller-Keane Encyclopedia and Dictionary of Medicine, Nursing, and Allied Health
 
    Are those definitions correct?   
 
  Well not exactly sure, as the concept is not new, but is actually  very old.  Just so you know you may see these terms being used that imply a similar concept, "electroceutical" and "electroanalgesic".   What is becoming exciting about this form of electrotherapy is rather than do an invasive "nerve block" ( I'll let you check that out on Wikipedia!!), the new non invasive concept is to do an electroanalgesia nerve block using an external device.   The block does not have to occur in the spinal area but can be done on peripheral nerves. 
 
    A patient comes to the clinic, generally in pain, and while on a treatment table one, two or three electrodes are placed along the spine and the other electrode is place in the stomach area.    The power is turned up to a comfortable sensation and the patient is treated for approximately 20 minutes.   During the electroanalgesia procedure the pain sensation is lost and there is a general anesthesia felt in the area of stimulation.
 
   Upon completion of the treatment the patient no longer feels the pain,much like one experiences who has undergone a nerve block.   The results are very promising that chronic pain can be controlled by using external high frequency, interferential type stimulators for pain control.  
 
   Several of the companies producing the equipment are claiming the paraesthesia is due to the high frequency which seems to vary from 4,000 to 20,000 pulses per second (frequency).   Problem with that logic is for decades clinicians have been able to produce similar paresthesia effects with a tens unit, which is only 150 pulses per second.  Now for clarity I'm talking paraesthesia in a digit,  using a tens unit on high amplitude ( power) and 150 pps ( pulses per second or frequency). 
 
   With a tens unit ( transcutaneous electrical nerve stimulator)  one takes a finger, wraps two electrodes around the digit,  making sure they do not touch, and turns the power ( amplitude ) up to a point where it is somewhat uncomfortable for approximately 20 minutes.   After treatment most people can then have a pin/needle inserted into their finger that was stimulated,  and feel no or very little pain due to the paraesthesia of the tens stimulation.   "Pressure" is felt but not pain and that is generally due to the transmission of the pressure sensation is due to non pain fibers, not pain fibers. 
 
   Tens has not been able to produce a paraesthesia in the spinal area as does interferential high frequency, nor does Tens stimulation work effectively for any form of carryover or residual pain relief ( see video below) .  The question that is not answered is whether the electroanalgesia is due to the higher frequency, higher amplitude, or electrode placement or some other reason. 
 
   As the Functional Restoration clinics that are opening up continues the hope is for a more definitive answer, based upon patient - clinician experience and research by The American College of Physical Medicine.
 
   Electroanalgesia is real, it's the how we need to obtain more knowledge about.