Pain Gating for Joint Pain Relief

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We all suffer from pain at different points in our lives. Finding a therapy that works, such as TENS, can make a big difference in how we feel. Pain is a universal human experience and we all feel pain slightly differently. It is actually your built-in alarm that tells you when something is wrong. But chronic or persistent pain, such as from arthritis, can keep you from doing the things you love. Medications can help, but they can also have side-effects and make you dependent on them. Read on to find out about TENS therapy, which uses transcutaneous electrical nerve stimulation therapy to control arthritis pain without drugs or side effects.

Pain Gating for Joint Pain Relief

  [caption id="attachment_392" align="alignright" width="300"]Pain sensations travel along your spinal cord and nerve pathways as electrical signals to and from your brain. Pain sensations travel along your spinal cord and nerve pathways as electrical signals to and from your brain.[/caption] What is pain? Pain is your body's way of sending a warning signal to your brain. Pain sensations travel along your spinal cord and nerve pathways as electrical signals to and from your brain. In “Pain: Hope Through Research”, Stephanie Clipper, Senior Public Affairs Specialist with the National Institute of Neurological Disorders and Stroke (NINDS) explains it this way: We may experience pain as a prick, tingle, sting, burn, or ache. Receptors on the skin trigger a series of events, beginning with an electrical impulse that travels from the skin to the spinal cord. The spinal cord acts as a sort of relay center where the pain signal can be blocked, enhanced, or otherwise modified before it is relayed to the brain. Pain receptors and gates When you bump your knee, a pain message travels to your brain. Without thinking,  you rub your knee vigorously. By doing this, you instinctively outwit your brain. This is because your brain can only interpret a limited amount of information at a time. The faster and harder you rub your bumped knee, the better it feels. This is called “pain gating”. The Pain Gate Control Theory was developed from the research of Ronald Melzack, Canadian emeritus professor of psychology, and Patrick David Wall, a British neuroscientist who is described as “the world's leading expert on pain.” Here is an overview of how pain gating works: “Pain impulses travel into the spinal cord, carried along small fibers. These small nerves talk to other nerves which in turn travel up the spinal cord carrying the impulses. This communication can be reduced (shutting the Gate) by other larger nerves. This works by the release of chemicals including the body's own morphine-like chemicals, enkephalins. This explains how “rubbing it better” can help, and is also the mechanism behind some of the effects of acupuncture and the use of TENS machines.” How does the TENS system work? [caption id="attachment_393" align="alignright" width="300"]TENS machines are used all over the world to reduce pain and muscle spasms. TENS machines are used all over the world to reduce pain and muscle spasms.[/caption] TENS is an abbreviation of Transcutaneous Electrical Nerve Stimulation. “Transcutaneous” means across the skin. In simple terms, a TENS machine stimulates your nerves through your skin by using an electrical current, which feels like a mild tingling or buzzing sensation on your skin. Your brain is bombarded by millions of these electrical impulses, and since it can only deal with a specific amount of information at a time, the pleasant TENS impulses outnumber your pain signals. This helps to block or suppress pain messages to your brain. TENS also helps your body produce endorphins, which are hormones that block pain naturally. How do you use the TENs Machine? TENS machines are small, lightweight, battery operated devices that fit into the palm of your hand. They have rubber electrodes that attach to your skin, with leads connected to the machine. The electrodes are either self-adhesive or attach to your skin using water-based gel and adhesive tape. You position two or more small electrodes on your skin near the location of your most intense joint pain, and use a dial or knob to control the current. As the low voltage current is passed through the electrodes, you feel a buzzing or tingling sensation. You can increase the strength until it is slightly painful, and then turn the current down until it is comfortable. Many digital TENS machines are now available, and some have helpful pre-sets. Some machines also have larger controls that make it easier to use if your hand movements are limited. How effective are TENS machines for arthritis pain? TENS machines are used all over the world to reduce pain and muscle spasms. Although studies suggest that it can be effective for rheumatoid arthritis and osteoarthritis pain, the evidence suggests that it is probably more effective for treating acute, or short-term, pain rather than chronic pain. Some people find TENS machines to be very helpful, while others don’t. If you are interested in a TENS machine, see if you can try one out at your physiotherapist’s clinic first to see if it helps. Some people have short-term relief, and others find the effects last for longer. You should always use TENS treatment as part of an overall strategy for dealing with your pain. Diet, exercise, medication, relaxation techniques, and other devises such as moist heat therapy mitts and booties all play a role in managing pain. Safety tips for using a TENS machine 1. Check with your healthcare provider to make sure a TENS machine is safe for you. 2. Do not use a TENS machine if you have a pacemaker or other implanted electrical device, or if you are pregnant. 3. Do not place the electrodes anywhere on your neck, close to your eyes, in your mouth, or on areas of irritated or damaged skin. 4. If your skin is irritated when you remove the electrodes, change the position the next time you use TENS. If soreness or irritation continues, or if you develop a skin reaction to a particular adhesive tape, ask your healthcare provider for different options. 5. Do not use TENS when driving, using machinery, sleeping, or in the bath or shower. You can get more safety tips here: http://www.patient.co.uk/health/tens-machines 

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