The Editorial Executive Committee welcomes letters, which should be less than 250 words. Before a decision to publish is made, letters which refer to a published article may be sent to the author for a response. Any letter may be sent to an expert for comment. When letters are published, they are usually accompanied in the same issue by their responses or comments. The Committee screens out discourteous, inaccurate or libellous statements. The letters are sub-edited before publication. Authors are required to declare any conflicts of interest. The Committee's decision on publication is final.
Letter to the editor
In the relief of pain, including back pain, transcutaneous electrical nerve stimulation (TENS) has a place, provided certain criteria are met. If correctly applied, a central effect does occur (with elevation of the pain threshold), thereby reducing pain and agitation, and minimising any associated narcotic withdrawal effects. The works of Professor J.S. Han have proven that TENS, if applied to certain specific points, e.g. the first interosseus motor point of the thumb, produces a rise in endorphins in both the spinal cord and brain with an elevation of cortisone levels in the blood stream.1 The work of Professor G. Ulett has proven that the effect is not caused by suggestion alone.2
This response is determined not only by the correct placement of the conducting pads, but also by the frequency of the stimulation. Stimulation at two cycles per second (2 Hertz) releases the beta endorphins, 15 Hertz releases the metenkephalins and 100 Hertz releases the dynorphins.
The use of these devices also has the advantage of economy and ease of use, even to the point of supervised self use.
James J. Nichols
- Han JS, Sun LS. Differential release of enkephalin and dynorphin by low and high frequency acupuncture in the central nervous system. Acupuncture the Scientific International Journal 1990;1:19-27.
- Ulett GA. Beyond yin and yang; how acupuncture really works. St Louis, Missouri: Warren H. Green, 1992.
- Long DM. Fifteen years of transcutaneous electrical stimulation for pain control. Stereotact Funct Neurosurg 1991;56:2-19.
- Sotosky JR, Lindsay SM. Use of TENS in arthritis management. Bull Rheum Dis 1991;40(5):3-5.
- Langley GB, Sheppeard H. Transcutaneous electrical nerve stimulation (TENS) and its relationship to placebo therapy: a review. NZ Med J 1987;100:215-7.
- Langley GB, Sheppeard H, Johnson M, Wigley RD. The analgesic effects of transcutaneous electrical nerve stimulation and placebo in chronic pain patients. A double blind non crossover comparison. Rheumatol Int 1984;4:119-23.
- Shapiro AK. A contribution to a history of the placebo effect. Behav Sci 1960;5:109-35.