Combined therapy for pain of different origin : (Study of 100 cases)

.M Aryam.m, AbdulbkiAlhayani; Bakkosh, Kh.

	Combined therapy for pain of different origin : (Study of 100 cases)
Medical Journal of Tikrit
Article 1, Volume 19, Issue 1, 2013, Pages 76-80
Authors
AbdulbkiAlhayani .M aryam.m; Kh. Bakkosh
Abstract
Objective: Management of pain by using combined therapy usually provided fair to very good relief in patients suffering from chronic pain of different origin. The main advantage of electro-acupuncture over Transcutaneous electrical nerve stimulation (TENS) is that it bypasses local skin resistance and delivers electrical stimuli at the precisely desired level in close proximity to the nerve endings located in soft tissue, muscle, periosteum or acupuncture pints. Patient andMethods: The study include one hundred (100) patients between 20 – 65 years of age with pain of different origin, patients were divided into three groups. Backache 39 patients, Pain in shoulder and knee 54 patients. and Post herpetic neuralgia 7 patients. TENS therapy was given 4 to 6 electrodes were placed on or near the most painful area or over the related acupuncture points, also acupuncture needles applied at the related local or distal acupuncture points. Frequency of stimulation was adjusted from 50 – 80 Hz. And pulse width to 0.2 m.sec. Stimulations were scheduled trice weekly for about 30 minutes period for 10 sessions. Assessment for pain relief was done after the last day of treatment using a pain rating score Results: The patient were having pain duration of 7 to 60 days duration, Assessment for pain relief was done after the last day of treatment using a pain rating score. The results were found to be better where duration of illness was within 15 -30 days. There is no significant statistical difference between the three groups according to the pain monitoring evaluation. Conclusion: The analgesic effect of TENS and electro acupuncture does not start immediately with the onset of current flow but there is a latent period, because It produces a neuromodulation. Studies show marked increases in beta endorphin and met-enkephalin with low-frequency, with demonstrated reversal of the antinociceptive effects by naloxone. These effects have been postulated to be mediated through micro-opioid receptors. Research indicates, however, that high-frequency TENS and electro-acupuncture analgesia is not reversed by naloxone, implicating a naloxone-resistant, dymorphin-binding receptor. The mechanism of the analgesia produced by TENS and Acupuncture is explained by the gate-control theory proposed by Melzack and Wall in 1965. The stimulations has also a direct inhibition of an abnormally excited nerve and as well as restoration of the afferent input. Both acupuncture analgesia and TENS are forms of this hyperstimulations and both have somewhat similar results. The advantages of this procedure are: cheap, non invasive and simple treatment are obvious. Medical complications arising from use of TENS and acupuncture are rare.
Keywords
TENS therapy; Electro; Acupuncture; Pain of different origin

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