Effects of two different intensities of transcutaneous electrical nerve stimulation on pain thresholds of contralateral muscles in healthy subjects

Katsuyoshi Tanaka, Masahiko Ikeuchi, Masashi Izumi, Koji Aso, Natsuki Sugimura, Hayato Enoki, Yasunori Nagano, Kenji Ishida, Toshikazu Tani, Katsuyoshi Tanaka, Masahiko Ikeuchi, Masashi Izumi, Koji Aso, Natsuki Sugimura, Hayato Enoki, Yasunori Nagano, Kenji Ishida, Toshikazu Tani

Abstract

[Purpose] This study aimed to investigate the differential effects of high-intensity and low-intensity transcutaneous electrical nerve stimulation on the contralateral side on the pain threshold in healthy subjects. [Subjects and Methods] Twenty-five healthy adults, volunteers received two intensity levels (motor-level, 1.5 times the muscle motor threshold; sensory-level, sensory threshold of the common peroneal nerve), for 30 s on separate days. Pressure pain threshold was recorded on the contralateral tibialis anterior and deltoid muscle before, during, and after stimulation. [Results] Motor-level stimulation significantly increased the pressure pain threshold at both muscle sites, while effects of sensory-level stimulation on pressure pain thresholds were significant only at the deltoid site. The percent change in pressure pain thresholds at both sites was significantly higher during motor-level stimulation. [Conclusion] Motor-level stimulation, applied unilaterally to one leg, produced immediate contralateral diffuse and segmental analgesic effects. This may be of therapeutic benefit in patients for whom transcutaneous electrical nerve stimulation cannot be directly used at the painful site.

Keywords: Motor-level stimulation; Pressure pain threshold; Transcutaneous electrical nerve stimulation.

Figures

Fig. 1.
Fig. 1.
Measurement protocol. Three PPT values were obtained, at 30 s intervals, before- and after-TENS application, with the average PPT of the three measures used in the analysis. A single PPT measurement was obtained during the 30 s duration of TENS application.

References

    1. Lauretti GR, Chubaci EF, Mattos AL: Efficacy of the use of two simultaneously TENS devices for fibromyalgia pain. Rheumatol Int, 2013, 33: 2117–2122.
    1. Silva JG, Santana CG, Inocêncio KR, et al. : Electrocortical analysis of patients with intercostobrachial pain treated with TENS after breast cancer surgery. J Phys Ther Sci, 2014, 26: 349–353.
    1. Bae YH, Lee SM: Analgesic effects of transcutaneous electrical nerve stimulation and interferential current on experimental ischemic pain models: frequencies of 50 Hz and 100 Hz. J Phys Ther Sci, 2014, 26: 1945–1948.
    1. Chen CC, Johnson MI: An investigation into the hypoalgesic effects of high- and low-frequency transcutaneous electrical nerve stimulation (TENS) on experimentally-induced blunt pressure pain in healthy human participants. J Pain, 2010, 11: 53–61.
    1. Ghoname ES, Craig WF, White PF, et al. : The effect of stimulus frequency on the analgesic response to percutaneous electrical nerve stimulation in patients with chronic low back pain. Anesth Analg, 1999, 88: 841–846.
    1. Bi X, Lv H, Chen BL, et al. : Effects of transcutaneous electrical nerve stimulation on pain in patients with spinal cord injury: a randomized controlled trial. J Phys Ther Sci, 2015, 27: 23–25.
    1. Ainsworth L, Budelier K, Clinesmith M, et al. : Transcutaneous electrical nerve stimulation (TENS) reduces chronic hyperalgesia induced by muscle inflammation. Pain, 2006, 120: 182–187.
    1. Somers DL, Clemente FR: Transcutaneous electrical nerve stimulation for the management of neuropathic pain: the effects of frequency and electrode position on prevention of allodynia in a rat model of complex regional pain syndrome type II. Phys Ther, 2006, 86: 698–709.
    1. Moran F, Leonard T, Hawthorne S, et al. : Hypoalgesia in response to transcutaneous electrical nerve stimulation (TENS) depends on stimulation intensity. J Pain, 2011, 12: 929–935.
    1. Leffler AS, Hansson P, Kosek E: Somatosensory perception in a remote pain-free area and function of diffuse noxious inhibitory controls (DNIC) in patients suffering from long-term trapezius myalgia. Eur J Pain, 2002, 6: 149–159.
    1. Leffler AS, Hansson P, Kosek E: Somatosensory perception in patients suffering from long-term trapezius myalgia at the site overlying the most painful part of the muscle and in an area of pain referral. Eur J Pain, 2003, 7: 267–276.
    1. Kemp J, Despres O, Dufour A: Unreliability of the visual analog scale in experimental pain assessment: a sensitivity and evoked potentials study. Pain Physician, 2012, 15: E693–E699.
    1. Johannesson U, de Boussard CN, Brodda Jansen G, et al. : Evidence of diffuse noxious inhibitory controls (DNIC) elicited by cold noxious stimulation in patients with provoked vestibulodynia. Pain, 2007, 130: 31–39.
    1. Claydon LS, Chesterton LS, Barlas P, et al. : Effects of simultaneous dual-site TENS stimulation on experimental pain. Eur J Pain, 2008, 12: 696–704.
    1. Le Bars D, Dickenson AH, Besson JM: Diffuse noxious inhibitory controls (DNIC). I. Effects on dorsal horn convergent neurones in the rat. Pain, 1979, 6: 283–304.
    1. Pud D, Sprecher E, Yarnitsky D: Homotopic and heterotopic effects of endogenous analgesia in healthy volunteers. Neurosci Lett, 2005, 380: 209–213.
    1. Lautenbacher S, Roscher S, Strian F: Inhibitory effects do not depend on the subjective experience of pain during heterotopic noxious conditioning stimulation (HNCS): a contribution to the psychophysics of pain inhibition. Eur J Pain, 2002, 6: 365–374.
    1. Kosek E, Lundberg L: Segmental and plurisegmental modulation of pressure pain thresholds during static muscle contractions in healthy individuals. Eur J Pain, 2003, 7: 251–258.
    1. Vierck CJ, Jr, Staud R, Price DD, et al. : The effect of maximal exercise on temporal summation of second pain (windup) in patients with fibromyalgia syndrome. J Pain, 2001, 2: 334–344.
    1. Ruble SB, Hoffman MD, Shepanski MA, et al. : Thermal pain perception after aerobic exercise. Arch Phys Med Rehabil, 2005, 86: 1019–1023.
    1. Staud R, Robinson ME, Price DD: Isometric exercise has opposite effects on central pain mechanisms in fibromyalgia patients compared to normal controls. Pain, 2005, 118: 176–184.
    1. Koltyn KF, Umeda M: Contralateral attenuation of pain after short-duration submaximal isometric exercise. J Pain, 2007, 8: 887–892.
    1. Koltyn KF, Trine MR, Stegner AJ, et al. : Effect of isometric exercise on pain perception and blood pressure in men and women. Med Sci Sports Exerc, 2001, 33: 282–290.
    1. Atlas LY, Wielgosz J, Whittington RA, et al. : Specifying the non-specific factors underlying opioid analgesia: expectancy, attention, and affect. Psychopharmacology (Berl), 2014, 231: 813–823.
    1. Bushnell MC, Duncan GH, Dubner R, et al. : Attentional influences on noxious and innocuous cutaneous heat detection in humans and monkeys. J Neurosci, 1985, 5: 1103–1110.
    1. Moont R, Pud D, Sprecher E, et al. : ‘Pain inhibits pain’ mechanisms: is pain modulation simply due to distraction? Pain, 2010, 150: 113–120.
    1. Lannersten L, Kosek E: Dysfunction of endogenous pain inhibition during exercise with painful muscles in patients with shoulder myalgia and fibromyalgia. Pain, 2010, 151: 77–86.
    1. Börsbo B, Liedberg GM, Wallin M, et al. : Subgroups based on thermal and pressure pain thresholds in women with chronic whiplash display differences in clinical presentation—an explorative study. J Pain Res, 2012, 5: 511–521.
    1. Lee YC, Lu B, Edwards RR, et al. : The role of sleep problems in central pain processing in rheumatoid arthritis. Arthritis Rheum, 2013, 65: 59–68.

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