Transcutaneous Electrical Stimulation: Use and Misuse

Wolf, Steven L.; Rao, Vaddadi R.

doi:10.1007/978-94-011-6311-8_17

Cited by 3 publications

(3 citation statements)

References 18 publications

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“…If no beneficial effect is noted within 30 minutes following its application, adjustments may need to be made in the placement of the electrodes or the settings of the controls. 12 Proper instruction and guidance, both initially and throughout the use of the device, is essential to its success. Instruction and units available for rental can often be obtained through a physical therapy department.…”

Section: Gate Control Theorymentioning

confidence: 99%

Breaking the Cycle of Pain In Diabetic Peripheral Neuropathy

Lee

1985

Diabetes Educ

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An attitude of helplessness pervades both patients and health professionals when dealing with the problems of diabetic peripheral neuropathy. Those afflicted are often overwhelmed by the pain and find themselves unable to fulfill the daily requirements of their diabetes regimen. The inconsistencies in amounts and timing of meals, levels of activity, and scheduling of insulin injections can result in hyperglycemia, a state that has been found to correlate strongly with the occurrence of nerve damage. Thus the pain perpetrates itself. For the health professional, having to confront this devastating pain without objective factors to assess and few scientific treatment measures to offer contributes to a sense of inadequacy and ignorance. It is frequently assumed that "nothing can be done." In reality, health professionals do have something to offer the person suffering from this condition. First, they can provide information about the relationship between control and complications, and explain the need for the patient to change those behaviors that may be perpetuating the pain. Second, and most importantly, health professionals can convey support and confidence, without which many patients will be unable to make the changes in their behavior necessary to resolve their pain.Normalizing blood glucose is the goal of therapy in diabetes. Although still controversial, much of the current research supports a relationship between poor metabolic control and diabetic complications. 1,2 In the case of peripheral neuropathy, the complication itself may interfere with optimal blood glucose regulation. Severe pain, compounded by its ensuing sleepless nights and depression, makes adherence to a consistent daily pattern of meals, injections, activity, and monitoring virtually impossible. Without a consistent regimen, blood glucose control is unlikely. In order to minimize the risk and the damage caused by complications, it is essential that interventions by health professionals result in enabling patients to maintain their diabetes regimen and thus optimal blood glucose control. Clinical ManifestationsThe debilitating effects of the condition can be extreme to the point of causing feelings of profound hopelessness. A vigorous and positive approach by the health professional is necessary to counteract these feelings and to motivate patients to begin managing their diabetes more aggressive-ly. Patients describe their pain as a constant, sharp, electrical tingling or burning sensation, usually in the feet and legs, and often in the hands. Sometimes putting on clothes is a torture because the person may suffer from hypersensitivity to touch. Physical activity is severely limited due to the pain in the lower extremities. With continued disuse the muscles may atrophy, and in some cases the complications are similar to those seen with chronic bedrest: loss of muscle strength and tissue, skin breakdown, and constipation. The pain becomes more severe at night making sleep difficult, if not impossible. The resultant fatigue further depletes ...

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Section: Gate Control Theorymentioning

confidence: 99%

Breaking the Cycle of Pain In Diabetic Peripheral Neuropathy

Lee

1985

Diabetes Educ

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“…For information about these treatments, the reader is referred to Wurm (1985), Friedberg (1985), Yeh, Gonyea, Lemke, and Volpe (1985), and Wolf and Rao (1983).…”

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confidence: 99%

“…Other biological treatments, such as nerve blocks, sympathectomies, chymopapain injections, and transcutaneous electrical nerve stimulation, will also be excluded. For information about these treatments, the reader is referred to Wurm (1985), Friedberg (1985), Yeh, Gonyea, Lemke, and Volpe (1985), and Wolf and Rao (1983) .…”

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confidence: 99%

Chemical interventions for pain.

Aronoff¹,

Wagner²,

Spangler³

1986

Journal of Consulting and Clinical Psychology

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Chemical interventions are among the most popular treatments for pain. This article reviews properties and pharmacological effects of medications for pain, including peripherally acting analgesics, centrally acting narcotics, and adjuvant analgesics including antidepressants. The role of the endogenous opioid system in pain and depression is briefly discussed. Clinical management issues in both inpatient and outpatient settings are explored, with emphasis on the need to address the psychosocial context in which medications are prescribed.Chemical interventions for pain are often considered the treatment of first choice by both lay people and health care practitioners. Popular culture and the media emphasize chemical pain management with promises of "fast relief through "the pain killer more doctors recommend." The availability and variety of medications often lead people to believe that chemical intervention is the preferred method for relieving pain of all types. In addition, media reports of recent research on endorphins and other endogenous "pain killing" substances highlight the importance of chemicals for the treatment of pain.Although there is little argument that medications are effective for many pain syndromes, for other cases one must be aware of the problems created by such a unidimensional focus. Often both practitioners and patients attempt to generalize from the acute to the chronic pain situation without appreciation of the differences.Chemical interventions, which are often prescribed with great authority and which offer the lure of popularity, mystery, and hopefulness, should be seen as a double-edged sword. Medications can cause iatrogenic complications, and sufficient consideration should be given to the side effects of medication, potential addiction, and problematic interaction with other medications. Unidimensional focus on chemical intervention may prevent patients from seeking other therapies or may lead them to neglect other factors that may be influencing their pain. This article examines pain interventions through medications, including analgesics, sedatives and hypnotics, and antidepressants. With a topic as broad as this, some limitations are necessary. First, discussion of chronic pain will be limited to nonneoplastic pain. For a review of chemical interventions for acute and cancer pain patients, see Foley (1985) and Inturrisi and Foley (1984). Other biological treatments, such as nerve We gratefully acknowledge the assistance of Amy Kelly, Robin Epstein, and Murdock MacKenzie in preparing this manuscript and two anonymous reviewers for their helpful comments on a draft of this article.

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