(TENS) is a term typically referred to the use of nonpharmacologic or noninvasive kind of treatment for neutralizing superficial pains.
Researches have shown that TENs helps to control pain both over peripheral and also central mechanisms.The central mechanisms include areas of spinal cord and brainstem that are known to incorporate opioid, serotonin and muscaranic receptors which could be effectively stimulated using TENS implementation.
Across peripheral areas TENs may help induce analgesic effects on receptors such as opioid and alpha2
The process involves application of very low DC low frequency pulses through electrodes on the patients skin surface for activating the intended pain control.
The method could tried by applying different frequency ranges from as low as 10 Hz up to 50 Hz.
The circuit may be tried with on two modes the first being in the sensory intensity mode where the patient is able to feel strong effects but without motor contraction sensation, and the second is through high intensity mode in which the motor contractions are induced but without any relative pain or strong sensations.
Typically the high intensity mode is implemented through a high frequency stimulation while the motor intensity is done through a relatively lower frequency electric current.
However researches have indicated that the analgesic effects may be released through any of the above modes regardless of the frequency intensities or variations.
To be more precise, a low frequency TENs may be responsible for initiating the μ-opioid receptors in the spinal cord and brain stem, while a higher frequency TENs could be used to give rise to the activation of δ-opioid receptors around the same areas.
Further developments suggest that the application of TENs may effectively relieve pain due to the actions of serotoninergic,
noradrenergic, muscarinic, and γ-aminobutyric acid (GABA)-ergic systems
on the analgesia with the application of both low or high frequency TENs on a patients skin.