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transcutaneous electrical nerve stimulation (TENS, Stimpod NMS460)

Indications: - relief of chronic pain - neurogenic pain - functional abdominal pain in patients 11-18 years of age with irritable bowel syndrome (IB-Stim) [3] - total hip arthroplasty (transcutaneous electrical acupoint stimulation) * pain relief slower than intra-articular glucocorticoid Contraindications: - not useful for lateral epicondylitis [1] - should not be used near cardiac pacemaker (i.e. TENS for shoulder) Procedure: - a small battery-operated device, worn by the patient, which provides continuous electrical pulses via surface electrodes applied to the skin with the goal of providing symptomatic relief by modifying pain perception (electroanalgesia) - Stimpod NMS460 applies pulsed radiofrequency waveform to the affected area transcutaneously [2] - IB-Stim [3] - prescription-only device - consist of a small single-use electrical nerve stimulator placed behind the patient's ear - device contains a battery-powered chip that emits low-frequency electrical pulses to stimulate branches of cranial nerves continuously for 5 days - device is replaced after 5 days - stimulating nerve bundles in & around the ear is thought to provide pain relief - patients can use the device for up to 3 consecutive weeks to reduce functional abdominal pain associated with IBS [3]

Specific

Cefaly transcutaneous electrical nerve stimulation (Cefaly) NSS-2 Bridge device trigeminal nerve stimulator; Monarch external trigeminal nerve stimulation (eTNS)

General

electroanalgesia

References

  1. Chesterton LS et al Transcutaneous electrical nerve stimulation as adjunct to primary care management for tennis elbow: pragmatic randomised controlled trial (TATE trial). BMJ 2013;347:f5160 PMID: 23999980 http://www.bmj.com/content/347/bmj.f5160
  2. Anderson P FDA Clears Noninvasive Device for Intractable Pain. Medscape. Aug 1, 2017 http://www.medscape.com/viewarticle/883653
  3. FDA News Release. June 7, 2019 FDA permits marketing of first medical device for relief of pain associated with irritable bowel syndrome in patients 11-18 years of age. https://www.fda.gov/news-events/press-announcements/fda-permits-marketing-first-medical-device-relief-pain-associated-irritable-bowel-syndrome-patients