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From Acupuncture to TENS, An Innovative Path to Pain Relief

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What is Acupuncture: 


       Acupuncture, one of the most well-known treatments based in Traditional Chinese Medicine (TCM), has evolved and innovated for thousands of years. It includes a series of procedures to stimulate various acupoints on the human body for a series of diverse medical purposes. The term, “Acupuncture” most commonly refers to one acupuncture technique, which is also most often practiced and scientifically studied, which requires penetrating under the skin with thin, solid, metal needles. The purpose of the needling procedure is to stimulate the specific acupoint in order to reach the associating health improvement or positive outcome. (Traditional Chinese Medicine: In Depth)

       There are numerous acupoints located on the body. According to Schoenbart & Shefi (2014), The acupoint system has been developed based on the theory of meridians, which concluded that there are twelve regular meridians correspond to each of the six yin and six yang organs and also eight extra medians. For improvements in the health conditions of a particular organ or body part, the acupoints found along the corresponding meridian are often treated with acupuncture procedure. (Schoenbart & Shefi. 2014. Traditional Chinese Medicine Acupuncture)

How Effective Can Acupuncture Relieve Pain: 


Among the various purposes, acupuncture has been reported to deliver adequate pain relief. Pain management is often what patients are looking for with acupuncture. Throughout the years, there has been scientific progress in delineating the neurobiology of acupuncture. The most telling evidence that acupuncture is effective for pain control is its use as an analgesic for surgical procedures. The needling procedure stimulates the nerve fibers near the area in pain and block or partially block pain signal being received by the brain. “Stimulation for 30 minutes before surgery enabled a reduction of chemical anesthetic by up to 50%. A 70% rate of success for pain modulation or elimination has been reported clinically in patients with low back strain, arthritis, myofascial discomfort, migraine, and other painful disorders.” (Ulett et al. 1998. Traditional and Evidence-Based Acupuncture: History, Mechanism, and Present Status) While the effectiveness of Acupuncture to work as a cure for many pain-related diseases and disorders remains equivocal, enough cases and study results have shown that Acupuncture is a practical solution to pain management. 


From Acupuncture to TENS: 


    TENS has a reasonably short history comparing to the traditional Acupuncture invented thousands of years ago. It stands for Transcutaneous Electrical Nerve Stimulations, meaning it relieves pain by sending electrical impulses to nerve fibers. It is an alternative solution for pain management that is safe, drug-free and non-invasive. TENS is now one of the most common methods for acute and chronic pain management. Electrical stimulation of nerve fibers can stop pain signals from being transmitted to the central nervous system. Also, the contraction and relaxation of muscle caused by pulse current also release endorphins which functions as a natural analgesic. TENS shares the same featured mechanism for relieving pain by stimulating nerve fibers to block pain signals. Applying the innovative pulse current technology, TENS devices are capable of simulating the treatment of Acupuncture. Many TENS devices have the mode of Acupuncture or deep tissue massage mode. The acupuncture mode feels like being rapidly and repetitively penetrated by a thin needle when applying a TENS unit with the Acupuncture or deep tissue massage mod. No pain sensation involves in the process, but the similar heavy, achy pressure is feeling as receiving an Acupuncture treatment. TENS may not deliver precisely the same results as Acupuncture does, but since the entire process of Acupuncture process does not require applying any needles, the treatment can be conducted without restrictions of time, location, and expertise.

How Effective are TENS of Pain Relief: 


   Many studies have been conducted to examine the effectiveness of TENS on pain relief. In the discussion of Sluka & Walsh (2003) regarding the basic science and clinical efficacy of TENS, one evidence they took to support their argument is that, “TENS is a noninvasive modality that is easy to apply with relatively few contraindications and is used clinically by a variety of healthcare professionals for the reduction of pain.”In the study of Johnson & Ashton & Thompson in 1991, they examined the relationships between patient, stimulator and outcome variables in a large number of chronic pain patients utilizing TENS on a long-term basis, which potentially revealed the effectiveness and efficiency of TENS. 179 patients completed a TENS questionnaire designed to record age, sex, cause, and site of pain and TENS treatment regime. Of these 179 patients, 107 attended our research unit for assessment of the electrical characteristics of TENS during self-administered treatment. Although a remarkable lack of correlation between patient, stimulator and outcome variables was found to exist, the analysis revealed much information of importance: “47% of patients found TENS reduced their pain by more than half; TENS pain relief was rapid both in onset (less than 0.5 h in 75% patients) and in offset (less than 0.5 h in 51% patients); one-third of patients utilized TENS for over 61 h/week; pulse frequencies between 1 and 70 Hz were utilized by 75% of patients.” (Johnson & Ashton & Thompson. 1991. An in-depth study of long-term users of transcutaneous electrical nerve stimulation (TENS). Implications for clinical use of TENS) The results clearly show that TENS is effective and efficient to relieve pain. 


To Compare Acupuncture and TENS regarding Pain Relief: 


       Evidence and real-life cases have proved the effectiveness of both methods of relieving pain. While the traditional procedure of Acupuncture has a history of thousands of years, it is fair to say that TENS is a more convenient and innovative solution to pain relief since it does not require needles penetrating or a well-trained practitioner and it is portable to be applied whenever and wherever. However, beyond the fact that TENS is more convenient and less time consuming, is it necessarily more efficient on pain relief comparing to the traditional Acupuncture? It becomes a question that is worth further discussing.

     Fox & Melzack (2003) completed a study to compare the effectiveness of lower-back pain of TENS and Acupuncture. Twelve patients suffering chronic lower-back pain were treated with both Acupuncture and Transcutaneous Electrical Nerve Stimulation. The order of treatments was balanced, and changes in the intensity and quality of pain were measured with the McGill Pain Questionnaire. The results, based on the same measure of overall pain intensity, show that pain relief greater than 33% was produced in 75% of the patients by Acupuncture and in 66% by TENS. The average duration to reach pain relief was 40h after acupuncture and 23h after TENS therapy, meaning more patients found TENS brought a quicker relief to pain than Acupuncture. Although the results showed there were more patients reported pain relief after Acupuncture and TENS, statistical analyses of the data failed to reveal significant differences between the two treatments on any of the measures. Both methods, therefore, appear to be equally effective and probably have the same underlying mechanism of action. (Fox & Melzack. 2003. Transcutaneous electrical stimulation and acupuncture: Comparison of treatment for low-back pain) Thus, considering the advantages and disadvantages of both methods, it suggests that TENS is more practical for the group with pain related problems, since it, as discussed, is portable and convenient to use anywhere and anytime.  


Conclusion: 


      Acupuncture, as a widely used, Traditional Chinese Medical Philosophy based treatment that has been practiced for thousands of years, has made a tremendous contribution to pain relief and many other fields of medical applications. TENS, with modern technology, inherits the great heritage of Acupuncture and leads to an innovative path to pain relief. The advantages of portability and quick-effectiveness have made TENS more recommended for people with chronic pain, lower back pain, joint pain, arthritis, fibromyalgia and many kinds of pain in various part of the body. A growing number of people in pain are willing to choosing TENS as their efficient, drug-free and noninvasive solution to pain-related problems.

Reference: 


Traditional Chinese Medicine: In Depth. National Center for Complementary and Integrative Health. 

https://nccih.nih.gov/health/whatiscam/chinesemed.htm 


Bill Schoenbart & Ellen Shefi. (2014). Traditional Chinese Medicine Acupuncture. HowStuffWorks. 

https://health.howstuffworks.com/wellness/natural-medicine/chinese/traditional-chinese-medicine-acupuncture.htm 


Ulett et al. (1998). Traditional and Evidence-Based Acupuncture: History, Mechanism, and Present Status. SOUTHERN MEDICAL JOURNAL 


Kathleen A. Sluka & Deirdre Walsh. (2003). Transcutaneous electrical nerve stimulation: Basic science mechanisms and clinical effectiveness. The Journal of Pain 


Johnson & Ashton & Thompson. (1991). An in-depth study of long-term users of transcutaneous electrical nerve stimulation (TENS). Implications for clinical use of TENS. Pain. Volume 44, Issue 3, March 1991, Pages 221-229 


Fox & Melzack. (2003). Transcutaneous electrical stimulation and acupuncture: Comparison of treatment for low-back pain 


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