Electroanalgesia

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 electric 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. 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 electric 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. The first cases of electroanalgesia were documented by Greek scholars, Plutarch and Socrates, who noticed numbing effects of standing in pools of water on a beach that contained electric fish. The Chinese practice of acupuncture, dating back to 3000 BCE, also utilizes the properties of electroanalgesia by stimulating specific nerves to produce electrical signals which produce pleasurable responses in the brain. Another ancient analgesic method, aging back to 5000 BCE in Sumer, is to use natural minerals, vitamins, and herbs, usually in a mixture with other natural products. Technology invented specifically for electroanalgesia emerged at the beginning of the 1900s. Advancements in technology within the past fifteen years have created multiple forms of electroanalgesia. Doctors can target specific electrical signals caused by pain and cancel them out using electrical signals, optimally with alternating low and high frequencies. A theoretical explanation for the mechanism of pain reduction by transcranial electrostimulation, or TCES, suggests that the electrical stimulation activates the anti-nociceptive system in the brain, resulting in β-endorphin, serotonin and noradrenaline release. TCES can be used on people with cervical pain, chronic lower back syndrome, or migraines. It cannot be used on people with orthopedic or radiological potentially serious spinal conditions, hydrocephalus, epilepsy, glaucoma, malignant hypertension, pacemaker or other implanted electronic device; recent cerebral trauma, nervous system infection, skin lesions at sites of electrode placement; oncological disease; patients undergoing any other treatments for pain; any invasive therapy, e.g. surgery, within the last month. The equipment used is Pulse Mazor Instruments' Pulsatilla 1000, which consists of a headset with three electrodes, two that go behind the ears and one that goes on the forehead, that release set frequencies of electricity at set intervals. Deep brain stimulation, or DBS, was first evaluated as an electroanalgesic in the late 1950s. It works in some chronic pain patients. The mechanism of DBS is unknown. There is some evidence that it decreases pain transmission along sensory discriminative pathways although more recent studies have shown that it has central effects on other brain regions involved in the pain network (Pereira et al. 2007). This method has mainly been used for chronic pain patients after all other options have failed due to potential of intracranial complications (e.g., intracranial hemorrhage, infection, and oculomotor abnormalities). An electrode is 'stereotactically' guided to the site using magnetic resonance imaging and once in place, the electrode is activated by subcutaneous leads attached to a pulse generator under the skin. It is effective in treating refractory post-stroke pain, atypical face pain, anaesthesia dolorosa, and deafferentation and somatic pain such as in phantom limb or brachial plexus injury (Boccard et al. 2013). The use of peripheral nerve stimulation, or PNS, for the relief of chronic pain states was first reported over 30 years ago. Recent studies have demonstrated that electrical stimulation of nerves leads to inhibitory input to the pain pathways at the spinal cord level. PNS is most effective in the treatment of neuropathic pain (e.g., posttraumatic neuropathy, diabetic neuropathy) when the nerve lesion is distal to the site of stimulation. Percutaneous electrical nerve stimulation, or PENS, is used mainly in the treatment of intractable pain associated with chronic low back pain syndrome, cancer, and other disorders. It is a technique involving insertion of an ultra-fine acupuncture needle which probes into the soft tissues or muscles to electrically stimulate nerve fibers in the sclerotomal, myotomal, or dermatomal distribution corresponding to the patient's pain symptoms. PENS is related to both electroacupuncture and transcutaneous electrical nerve stimulation. PENS used to be a term to describe a neurosurgical procedure involving implantation of temporary stimulating electrodes before an SCS device. The term has recently been changed to percutaneous neuromodulation therapy, or PNT. The term PNT was chosen because it more accurately describes the neurophysiologic basis for PENS-induced analgesia. Transcutaneous electrical nerve stimulation, or TENS, involves the transmission of electrical energy from an external stimulator to the peripheral nervous system via cutaneously placed conductive gel pads. TENS can be subclassified into two variants: