Abstract
Evidence from recent animal studies indicates that the analgesic effect of low-frequency
transcutaneous electrical nerve stimulation (TENS) is reduced in opioid-tolerant animals.
The aim of the present study was to compare the analgesic effect of conventional (high
frequency) and acupuncture-like (low frequency) TENS between a group of opioid-treated
patients and a group of opioid-naive patients in order to determine if this cross-tolerance
effect is also present in humans. Twenty-three chronic pain patients (11 who took
opioids and 12 who did not) participated in the study. Participants were assigned
in a randomized crossover design to receive alternately conventional and acupuncture-like
TENS. There was a significant reduction in pain during and after conventional TENS
when compared to baseline for both the opioid and nonopioid group (P < .01). For acupuncture-like TENS however, the analgesic effect of TENS was only
observed in the nonopioid group (P < .01), with opioid-treated patients showing no change in pain scores during and
after TENS when compared to baseline (P > .09). The reduced analgesic effect of acupuncture-like TENS in opioid-treated patients
is coherent with previous animal studies and suggests that conventional TENS should
be preferred in patients taking opioids on a regular basis.
Perspective
This study shows that patients taking opioids on a regular basis are less susceptible
to benefit from acupuncture-like TENS. This phenomenon is probably attributable to
the fact that the analgesia induced by acupuncture-like TENS and opioids are mediated
by the same receptors (ie, μ opioid receptors).
Key words
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Article info
Publication history
Published online: September 27, 2010
Accepted:
June 28,
2010
Received in revised form:
June 8,
2010
Received:
January 11,
2010
Footnotes
S.M. is supported by CIHR (Canada) and FRSQ (Québec).
Identification
Copyright
© 2011 American Pain Society. Published by Elsevier Inc. All rights reserved.
