Tuesday, November 17, 2015

Old Dog, Old Tricks

What goes around comes around.

TENS, or transcutaneous electrical nerve stimulation, has been around as long as I can recall.

It fell out of favor because there wasn't any valid scientific affirmation that it was effective in reducing pain, and of course, the practice was abused, so the value of the technique was discounted both medically, and remuneratively.

The substitute, like many other conservative pain management techniques, was pills.

Of course, now we have an opioid "crisis" partly of our own making.

Now, coming full circle, we have physicians touting chiropractic as a reasonable pain management tactic, albeit within guideline specifications.

And TENS is also being promoted as another tool in the pain arsenal that can provide some relief.

Healthesystems, a workers’ compensation cost-management company, published results from an anecdotal study indicating that one in four opioid patients can get off the drugs and manage their pain using TENS.
Bowzer's back pain...

The Healthesystems article suggests that TENS is better for "active" pain as opposed to "resting" pain - i.e. the technique is more useful where pain is experienced in movement, as in doing a job.

The American College of Occupational and Environmental Medicine treatment guidelines recommend against TENS as a treatment for acute pain, but say it may be useful as an adjunct treatment for some types of chronic pain.

Similarly, the Official Disability Guidelines from Work Loss Data Institute allow a TENS trial for some types of chronic pain, such as low back pain.

“In general, there’s not a lot of evidence to support TENS,” WLDI President Phil Denniston told WorkCompCentral, acknowledging that it does work for some patients.

And Denniston said anything that can help get patients off of opioid drugs, such as TENS or yoga, is worth considering.

There you go: the more things change, the more things stay the same (and all of the other trite phrases that express similar sentiments).

In other words, what we have learned, is what we already knew: treatments that are palliative, or even just placebos, are less expensive, and less harmful, than managing the penalty of addiction to opiates.

Or, as Bowzer would counsel, you can't teach an old dog new tricks, but you can build upon the foundation.

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