Transcutaneous Electrical Nerve Stimulation

Pain Management: TENS and Electrothermal Therapy

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Electrical nerve stimulation and electrothermal therapy are used to relieve pain associated with various conditions including back pain. Transcutaneous electrical nerve stimulation (TENS) therapy provides short-term pain relief and is the most common form of electrical stimulation used in pain management. Intradiscal electrothermal therapy (IDET) is used as a treatment option for people with low back pain resulting from inter-vertebral disc problems.

TENS

In TENS therapy, a small, battery-operated device sends low-voltage electrical current through the skin via electrodes placed near the source of pain. The electricity from the electrodes stimulates the nerves in an affected area and sends signals to the brain that "scramble" normal pain signals. TENS is not painful and has been proven effective for some people capable of using the therapy to mask pain.

Intradiscal Electrothermal Therapy

Inter-vertebral discs act as cushions between the vertebrae. Sometimes the discs can become damaged and cause pain. IDET uses heat to modify the nerve fibers of a spinal disc and to destroy pain receptors in the area. In this procedure, a wire called an electrothermal catheter is placed through an incision in the disc. An electrical current passes through the wire, heating the disc to a temperature of 90 degrees Celsius.

IDET is performed as an outpatient procedure while the patient is awake and under a local anesthesia. Early studies indicate that some patients may have continued pain relief for up to six months or longer. The long-term effects of this procedure on the disc have not been determined.

Reviewed by the doctors at The Cleveland Clinic Spine Center.
Edited by Cynthia Haines, MD, WebMD, August 2004.

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