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An investigation of the development of analgesic tolerance to TENS in humans

Liebano, Richard E., Rakel, Barbara, Vance, Carol G.T., Walsh, Deirdre M. and Sluka, Kathleen A. (2011) An investigation of the development of analgesic tolerance to TENS in humans. PAIN, 152 (2). pp. 335-342. [Journal article]

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URL: http://dx.doi.org/10.1016/j.pain.2010.10.040

DOI: doi:10.1016/j.pain.2010.10.040


Transcutaneous electrical nerve stimulation (TENS) is a noninvasive modality used to control pain. Animal models show that repeated TENS application produces analgesic tolerance and cross-tolerance at spinal opioid receptors. The aim of the present investigation was to examine whether repeated application of TENS produces analgesic tolerance in humans. One hundred healthy subjects were randomly assigned to 1 of 4 groups: control, placebo, low-frequency (4 Hz) or high-frequency (100 Hz) TENS. TENS was applied daily for 5 days to the nondominant upper limb; pressure-pain threshold (PPT) measurements were recorded before and after TENS. Temporal summation to mechanical stimulation was recorded on days 1 and 5, before and after TENS. Diffuse noxious inhibitory control (DNIC) was tested on day 5 using the cold pressor test and PPT measurements. There was an initial increase in PPTs in both low- and high-frequency TENS groups when compared with placebo or control groups. However, by day 5this TENS-induced increase in PPT did not occur, and there was no difference between active TENS and placebo or control groups. High-frequency TENS decreased temporal summation on day 1 when compared with day 5. DNIC increased the PPT similarly in all groups. These data suggest that repeated daily application of TENS results in a decrease in its hypoalgesic effect by the fifth day and that the tolerance like effect to repeated TENS results from tolerance at centrally located opioid receptors. The lack of change in DNIC response suggests that TENS and DNIC utilize separate pathways to produce analgesia.

Item Type:Journal article
Faculties and Schools:Faculty of Life and Health Sciences
Faculty of Life and Health Sciences > School of Health Sciences
Research Institutes and Groups:Institute of Nursing and Health Research > Centre for Health and Rehabilitation Technologies
ID Code:17172
Deposited By: Professor Deirdre Walsh
Deposited On:21 Feb 2011 15:46
Last Modified:28 Feb 2012 11:47

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