The multifunctional cause of non-musculoskeletal chronic pain such as fibromyalgia can lead to difficulty not only in diagnosis, but also management and prognosis.This has resulted in a plethora of treatments being discussed and proposed, many evidence based and some not! The sometimes murky world of e-stim modalities has punctured this space with varying success, the most positive of which revolve around acute pain symptoms and shorter term pain abatement.
If you suffer from the symptoms of chronic pain of a non-musculoskeletal nature then e-stim in the form of TENS or Inferential therapy might be a treatment option for you. We hope by reading this blog you can now appreciate the mechanisms involved in e-stim in order to mitigate chronic pain, through primarily the gate theory and the opiate mediated theory. We hope we have outlined the positive results of current research indicating the effectiveness of e-stim with pain relief, albeit only temporary in nature and as such e-stim should only constitute one modality in a varied management plan.
We hope that if you engage in e-stim in a self-administered fashion the contraindications and precautions outlined are adhered to, especially those directly related to your condition (e.g. Fibromyalgia - care taken due to altered sensations). For specific precautions to your own non-musculoskeletal condition please consult your Doctor.
In our opinion e-stim does indeed have a place in a varied overall pain management plan for patients with chronic pain that is the result of a non-musculoskeletal condition. However treatments that aimm at targeting the whole body effects (larger surface areas) of chronic pain may be more important to gain more long-term pain relief. Other modalities that can be used alongside e-stim treatments include;
- low impact exercise (especially aquatic exercise)
- heat therapy
- massage
- stretching
- professionally diagnosed and monitored drug therapy
Individualisation of management plans for patients with non-musculoskeletal chronic conditions is paramount. Success of any management plan is contingent with individual preference and a variety of modalities that provide the most beneficial results in the short and long term.
E-Stim is indeed a conversation you should have with your therapist or Doctor if it is not part of your overall management of chronic pain caused by non-musculoskeletal factors.
References
Chaitow L. Fibromyalgia and Muscle Pain. Thorsons Pub; 1995:1-205.
Clauw DJ. Fibromyalgia: more than just a musculoskeletal disease. Am Fam Physician. Sep 1 1995;52(3):843-51, 853-4. [Medline].
Merskey H. Classification of chronic pain: Description of chronic pain syndromes and definitions of pain terms. Pain. 1986;Suppl 3:S217.
Wolfe F, Smythe HA, Yunus MB, et al. The American College of Rheumatology 1990 Criteria for the Classification of Fibromyalgia. Report of the Multicenter Criteria Committee. Arthritis Rheum. Feb 1990;33(2):160-72
