Korean J Pain.  2020 Apr;33(2):121-130. 10.3344/kjp.2020.33.2.121.

Transcutaneous electrical nerve stimulation, acupuncture, and spinal cord stimulation on neuropathic, inflammatory and, noninflammatory pain in rat models

• Sato KL
• Sanada LS
• Silva MDd
• Okubo R
• Sluka KA

• KMID: 2502635
• DOI: http://doi.org/10.3344/kjp.2020.33.2.121

Abstract

Background
Transcutaneous electrical nerve stimulation (TENS), manual acupuncture (MA), and spinal cord stimulation (SCS) are used to treat a variety of pain conditions. These non-pharmacological treatments are often thought to work through similar mechanisms, and thus should have similar effects for different types of pain. However, it is unclear if each of these treatments work equally well on each type of pain condition. The purpose of this study was to compared the effects of TENS, MA, and SCS on neuropathic, inflammatory, and non-inflammatory pain models.
Methods
TENS 60 Hz, 200 μs, 90% motor threshold (MT), SCS was applied at 60 Hz, an intensity of 90% MT, and a 0.25 ms pulse width. MA was performed by inserting a stainless-steel needle to a depth of about 4-5 mm at the Sanyinjiao (SP6) and Zusanli (ST36) acupoints on a spared nerve injury (SNI), knee joint inflammation (3% carrageenan), and non-inflammatory muscle pain (intramuscular pH 4.0 injections) in rats. Mechanical withdrawal thresholds of the paw, muscle, and/or joint were assessed before and after induction of the pain model, and daily before and after treatment.
Results
The reduced withdrawal thresholds were significantly reversed by application of either TENS or SCS (P < 0.05). MA, on the other hand, increased the withdrawal threshold in animals with SNI and joint inflammation, but not chronic muscle pain.
Conclusions
TENS and SCS produce similar effects in neuropathic, inflammatory and non-inflammatory muscle pain models while MA is only effective in inflammatory and neuropathic pain models.

Keyword

Acupuncture Therapy; Inflammation; Knee Joint; Myalgia; Neuralgia; Pain; Spinal Cord Stimulation; Transcutaneous Electric Nerve Stimulation

Figure

• 

  Fig. 1 Average paw withdrawal thresholds in the SNI group (A), joint inflammation group (B), and the non-inflammatory muscle pain group (C). Each graph shows the effects before and after induction of the model, and before and after treatment on each day. A significant decrease in withdrawal thresholds occurred after induction of the models, and this reduced withdrawal thresholds was increased after treatment on each day for the SNI and the joint inflammation model. For the acid model, a significant decrease occurred in all groups, and this decreased threshold was reversed by TENS and SCS but not by MA. SNI: spared nerve injury, TENS: transcutaneous electrical nerve stimulation, SCS: spinal cord stimulation, MA: manual acupuncture. ***P < 0.001.

• 

  Fig. 2 (A) Average joint withdrawal thresholds before (baseline) and after induction of knee joint inflammation, and before and after treatment on each day with TENS, MA, or SCS. Significant increases occurred after treatment on each day. TENS was significantly higher than SCS and MA. (B) Average muscle withdrawal thresholds before (baseline) and after the second injection of acidic saline (pH 4.0), and before and after treatment on each day with TENS, MA, SCS. Significant increases occurred after treatment on each day. SCS and TENS were significantly greater than MA. TENS: transcutaneous electrical nerve stimulation, MA: manual acupuncture, SCS: spinal cord stimulation. ***P < 0.001.

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