reflexology

[Mac Ward]

Ironically, now that I have started squatting and deadlifting again along with cleaning up my form learned by Rip's books, I have had almost no significant back problems.

Ditto.

[Mark E. Hurling]

I looked up the TENS thing you are saying and it is the same. Except he does not use pads but fork-like equipment which he applies every time at different spots. Unlike the pads this thing hurts like hell and most of the time I have to tell him to lower the current. The guy who mentioned the placebo effect may be right. I actually feel better after each visit but it seems my crappy form resets the injury after the workouts.

It's ultimately up to you, but he sounds like a quack. You don't have to amp the current up to the point you can't stand it for it to work for one thing. I have a pretty high threshold of pain so I had mine dialed up to 7 on a scale of 8. The guy who mentioned the placebo affect may still be right though. I'll just let you navigate how far off you may be on parts of this sentence though. In the end though, form-form-form. Get it hardwired in with light weights or no weight and learn the feel of it. Once you get that ingrained, you may find your problems are behind you.

[Mark Rippetoe]

I'm not sure I understand the alleged mechanism of TENS. How exactly is it supposed to work?

[Jonathon Sullivan]

It stimulates production of endogenous opioids and, if memory serves, GABA. I think there's been some handwaving about pain-gating as well. Some people with chronic pain, including low back pain, seem to derive some benefit from it. I've known a number of surgeons who used it (on themselves--those poor fuckers all have bad backs, bad marriages and bad dispositions). A bit out of my field, but my purely subjective sense of it is that it's not being used as much as it used to be, even in pain clinics.

And by a pathologist? For knee pain? I don't know the whole story here, but something sounds hinky to me.

[Mark E. Hurling]

I'm not sure I understand the alleged mechanism of TENS. How exactly is it supposed to work?

It's the same premise as massage in essence. Especially in the form of shiatsu. You place enough stress on the muscle either manually with the thumbs (as in shiatsu), the elbows or palms (in Swedish massage), voltage (with the TENS). This causes the muscle to contract strongly enough to fatigue it past the point of the muscle's ability to stay contracted in spasm or otherwise. I've gotten training in Swedish massage at the People's Republic of Santa Monica School of massage to try to alleviate some of Dearly Beloved's fibromyalgia misery and woe. I also picked up some shiatsu along the way. Both rely on the same underlying doctrine to achieve release and the TENS folks say much the same.

[Gunnhild Bruno]

I'm not sure I understand the alleged mechanism of TENS. How exactly is it supposed to work?

It's supposed to alleviate pain by applying electrical current to the nerves. I can believe that this produces temporary relief to varying degrees for certain kinds of chronic pain, especially pain from impinged or damaged nerves. And certain kinds of pain that persists when you're not moving/working the affected area.

But when it comes to sports injuries or post-surgical rehab pain, where the problem is pain while you're working/moving an injured area, I'm skeptical. The therapist explained that it was supposed to reduce my perception of pain so that I could do the rehab exercises. It didn't in my case, but I did the rehab exercises anyway.

What I don't understand is how it could possibly change anything structurally. If someone is using it for that, that sounds like total BS to me.

Sully, what is your take on TENS?

[Jordan Feigenbaum]

TENS (as presented to us in our neuro classes during my M1 courses)- electrically stimulate a dermatome/skin area and this causes a volley of electrical activity/neurotransmitter modulation within the spinal cord between the cutaneous (pressure/pin-prick/ stretch receptor) nerves and the slow-pain (chronic pain) afferents. By stimulating the cutaneous nerves above threshold the discharge interrupts signals of afferent slow pain nerves destined to ascend in the anterolateral spinothalamic tract. The research presented to us showed TENS had limited effects because slow pain (chronic pain) is diffuse and poorly localized, similar outcomes are seen with a dorsal root rhizotomy. I thought I remember reading something about stimulating the analgesic center or median raphe nucleus magnus that helped alleviate chronic pain? God I can't believe how much neuro I've already forgotten!

[Jonathon Sullivan]

I thought I remember reading something about stimulating the analgesic center or median raphe nucleus magnus that helped alleviate chronic pain?

Yeah, this rings a bell, which is why I seem to recall that opioid receptors are involved. The other stuff you mentioned sounds like the pain-gating phenomena I mentioned. I suppose I will have to refresh my memory on this when I return to real life in the lab tomorrow.

God I can't believe how much neuro I've already forgotten!

Are you really saying you can no longer pick out the abducens nucleus or superior olive on an unlabled brainstem section?

Join the club.

[Roy]

When dealing with sciatica before I read some mention of an electrical test which is supposed to be used to help determine nerve damage. Here's a link to a blurb about it, but not sure if this is what the OP was dealing with or not.

http://www.medicinenet.com/nerve_con...st/article.htm

[Mark E. Hurling]

Now that the folks who have studied this stuff in depth have weighed in on the TENS, I'm now curious if the premise of shiatsu and massage that I put forward hold water. I have worked on people who would have congested spasmed muscle tissue ranging in size from grapes to golf balls. These would (usually) seem to go away, I figured because the knot of muscle had released per the fatigue principle. Does Western medicine explain that particular phenomenology? I'm not challenging anyone or anything here, I'd like an alternative view or explanation.