Transcutaneous Electrical Nerve Stimulation

By Larry Ready

At the last meeting I attended we had a brief discussion of TENS therapy and its role in treating pain in PPS patients. Since that time I have been promising Vera that I would write a brief article about TENS therapy. Procrastination being one of my more pronounced character flaws, I am only now submitting it.

Electrical stimulation for pain control was used in ancient Greece. In 63 A.D. it was reported that pain was relieved by standing on an electrical fish at the seashore. In the 16th through the 18th century various devices were used for headache and other pains. Benjamin Franklin was a proponent of this method for pain relief. In the 1900s a device called the electreat, along with numerous other devices were used for pain control and cancer cures. Only the electreat survived into the twentieth century, but was not portable, and had limited control of the stimulus.

Transcutaneous Electrical Nerve Stimulation, more commonly referred to as a "TENS," is defined by the American Physical Therapy Association as application of electrical current through the skin for pain control . The unit is usually connected to the skin using two or more electrodes.

TENS is a non-invasive, safe method to reduce pain, both acute and chronic. A number of systematic reviews have confirmed its effectiveness for postoperative pain, osteoarthritis, and chronic musculoskeletal pain. Recent clinical studies suggest that using adequate intensity of stimulation is necessary to obtain analgesia with TENS.

Basic science studies show that high and low frequency TENS produce their effects by activation of opioid receptors in the central nervous system. Specifically, high frequency TENS activates delta-opioid receptors both in the spinal cord and supraspinally (in the medulla) while low frequency TENS activates mu-opioid receptors both in the spinal cord and supraspinally. Further high frequency TENS reduces excitation of central neurons that transmit nociceptive information, reduces release of excitatory neurotransmitters (glutamate) and increases the release of inhibitory neurotransmitters (GABA) in the spinal cord, and activates muscarinic receptors centrally to produce analgesia. Low frequency TENS also releases serotonin and activates serotonin receptors in the spinal cord, releases GABA, and activates muscarinic receptors to reduce excitability of nociceptive neurons in the spinal cord.

TENS units are used in an attempt to alleviate pain due to neuropathy. Some patients benefit from this approach, while others may not, depending on individual differences , and pain threshold.

I have arranged with a local TENS supplier to offer demonstration of TENS therapy to members of MAPPSG if you are interested. They have offered to have me bring demo units to a meeting or they welcome any member stopping by to have Debbie Hannon, their TENS expert, show us the features and benefits. Debbie can be reached at 633-6235. Coastal Therapeutics is located at 1234A Hillcrest Road.

TENS units and supplies are fully covered by Medicare and most insurance plans if the unit is ordered by your treating physician.

MOBILE AREA POST-POLIO SUPPORT GROUP meets the 4th Saturday each month except November & December at 1 pm West Regional Branch Mobile Public Library	PENSACOLA POST-POLIO SUPPORT GROUP meets the 3rd Saturday every month at 10 am Baptist Towers Lobby 1717 North E and Avery Streets, Pensacola, Florida
Notes from the MAPPSG Meetings October Meeting - Patsy Adams reporting Sylvia Bern, facilitator, called the group of 12 from their greeting conversations and welcomed all to the final meeting of 2008. Everyone was encouraged to spend our regular meeting time with family and friends on the fourth Saturday in November and December. The Christmas party was scheduled for December 13 at The American Café. Everyone was delighted to meet Ed Weller’s mother. We are always happy to have family and friends attend our meeting. Attention was called to the article in Post-Polio Health International newsletter. Under the “We’re Still Here” campaign: Other great ideas in the works … Manuscript for Post-Polio Players – The brainchild of Vera Moore, Mobile Area Post-Polio Support Group, this fast-moving script of polio survivors chatting before their support group meeting raises post-polio issues in a personal way. The short script, which can be modified to fit any area's history, is easy and fun for groups to produce. Book the production for Rotary meetings, church and community action groups, school assemblies, social interest groups. Schedule a Q&A session after the skit. The script needs minimal props, set and characters. The script is available online at http://www.post-polio.org/WereStillHereFocus.html Attendance: Patsy Adams ~ Sylvia Bern ~ Betty Driscoll ~ John Driscoll ~ George Fassig ~ JoAnn Fassig ~ Julie Ford ~ Rus Ford ~ Clara Norsworthy ~ George Norsworthy ~ Ed Weller ~ Ed’s Mother. December Christmas Party - Patsy Adams reporting December 13th was a beautiful day and gave a good start to the holidays with our being together for lunch at the American Cafe. Even though we were late in being seated, the time gave us a chance to visit. The long, long table hindered conversation with those at the other end of the table once our private dining area was made available. We hope everyone had a nice and safe holiday and ready to make new “LAWS” for ourselves. Listen to our bodies and obey! Attendance: Patsy Adams ~ Mary Ellen Blankenship ~ Laurence Byrd ~ James Cheeseboro ~ John Driscoll ~ Betty Driscoll ~ JoAnn Fassig ~ George Fassig ~ Rus Ford ~ Julie Ford ~ Charles Gollott ~ Barbara Gollott ~ Dorcas Howard ~ Leland Jones ~ Carolyn Jones ~ George Norsworthy ~ Clara Norsworthy ~ Ed Weller.	Notes from the PPPSG Meetings October Meeting - Clara Norsworthy reporting Fourteen were present for our October 18th meeting. We were disappointed the scheduled speaker, Dr. Kenna Risola of Emerald Coast Center for Neurological Disorders, was not able to be with us. We understand the demands on medical presenters and will eager to reschedule her time with us at her convenience but hopefully very soon. We are excited and appreciative that the our group grows monthly. Pam Lett and Jo Ann McCoy were first timers this month and had much to give as we shared our mutual experiences. Attendance: Jane Clark ~ Carole Cofer ~ Leigh Dethlefs ~ George Dethlefs ~ Cyndee Ice ~ Pam Lett ~ Cliff Martin ~ Kay Martin ~ Jo Ann McCoy ~ Jim Neil ~ Shirley Neil ~ Clara Norsworthy ~ George Norsworthy ~ Crystal Shoemaker November Meeting - Clara Norsworthy reporting Eleven were present at the November 15th meeting. We again welcomed a new person, Michael Hammond. Michael is a wealth of information and shares with us new and innovative methods of enabling a healthy outlook as we continue to survive polio daily. We shared very best complete recovery wishes to Mary Warneck and Pat De Lorme. Attendance: Bill Bridenbrack ~ Tommie Bridenbrack ~ Chereyl Cooper ~ Leigh Dethlefs ~ Michael Hammond ~ Theresa Inge ~ Pat Kaderly ~ Ron Kaderly ~ Clara Norsworthy ~ Gail Page ~ Mary Warneck December Meeting - Clara Norsworthy reporting Seventeen people gathered on December 20th for a fun meeting/Christmas Party with the very best of holiday goodies. As has become tradition, we played Dirty Christmas. It was a real challenge to hang on to your favorite candle as really nice ones were taken away from you. Happy Holidays and come back in January when an interesting meeting will be held on the 17th. Attendance: Wayne Baggett ~ Carol Cofer ~ Chereyl Cooper ~ George Dethlefs ~ Leigh Dethlefs ~ Michael Hammond ~ Theresa Inge ~ Jo Ann Mc Coy ~ Margaret Nail ~ Robert Nail ~ Jim Neil ~ Shirley Neil ~ Clara Norsworthy ~ George Norsworthy ~ Zofia Sywak ~ Bill Way ~ Sally Way
Contact for additional information e-mail Vera Moore	Contact for additional information e-mail Leigh Dethlefs

These Post-Polio Supports Groups are supported by
Goodwill Easter Seals of the Gulf Coast
In Mobile - Chara Brown ~ 251-471-1581 ~ chara@gesgc.org
In Pensacola - Liz Cravatt ~ 850-434-0032 ~ liz@gesgc.org
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