Effects of transcutaneous electrical nerve stimulation to the same dermatome of the limb contralateral to the assumed pain site

TAKAHIRO OKUDA, HIDEAKI TAKEBAYASHI, AKIRA MIBU, MORIHIRO TSUJISHITA, HIROBUMI KAWAMURA, TAKAO OKABE, HIROSHI KONDO
Purpose:

The purpose of this study was to identify the effects of TENS to the same dermatome contralateral to the assumed pain site based on TPT and ANS changes, and to elucidate whether the contralateral dermatome can be used as an alternate site of choice for analgesic treatment.

Methods:

Twenty-four participants (mean age 20.8±1.6 years) underwent TENS to the contralateral right dorsal wrist joint at the same dermatome level as the site of assumed pain in the left dorsal wrist joint (dermatomes C6-8, Th1). TENS using an electrostimulator (biphasic square wave and continuous wave; frequency 20 Hz; wavelength 200 μs) was performed for 15 minutes, with the intensity inducing MP at the pain threshold for the contralateral right dorsal wrist joint based on DNIC. The TPT of the left dorsal wrist joint was measured using a pain meter and recorded 2 minutes before TENS started (control), 5, 10, and 15 minutes after TENS started, and 5 and 10 minutes after TENS ended. ANS changes were evaluated by analyzing heart rate variability on electrocardiography (ECG), examining high-frequency (HF) and low-frequency (LF) components and LF/HF. The data were averaged for 1 minute just before TENS started (control), for 1 minute each from 5, 10, and 15 minutes after TENS started, and for 1 minute each 5 and 10 minutes after TENS ended. The TPT and the HF, LF, and LF/HF values were examined by repeated measures analysis of variance for comparisons by time and Dunnett’s post hoc test for multiple comparisons, with significance at p0.05.

Results:

The mean TENS intensity based on DNIC was 22.0 ± 4.7 mA. The MP level measured by the Visual Analogue Scale was 69.2±12.4. The TPT increased significantly 10 minutes after TENS started and 5 and 10 minutes after TENS ended compared with control, with no change 5 minutes after TENS started and an increasing trend 15 minutes after TENS started. LF was significantly increased 5 minutes after TENS ended compared with control, with no other significant differences in HF, LF, and LF/HF.

Conclusion(s):

TENS to the same dermatome of the limb contralateral to the assumed pain site increased TPT and tended to increase sympathetic nervous function, suggesting its effectiveness and potential use.

Implications:

This study contributes to developing TENS techniques by providing effective stimulation sets for TENS stimulus intensity and contralateral stimulation sites.

Funding acknowledgements:
This research did not receive any external funding.
Keywords:
transcutaneous electrical nerve stimulation (TENS)
contralateral limb
dermatome
Primary topic:
Pain and pain management
Second topic:
Musculoskeletal
Did this work require ethics approval?:
Yes
Name the institution and ethics committee that approved your work:
The Research Ethics Committee of University of Kochi Health Sciences
Provide the ethics approval number:
KHS102401
Has any of this material been/due to be published or presented at another national or international conference prior to the World Physiotherapy Congress 2025?:
No

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