High frequency, low intensity, gate control theory mechanism
Low intensity activates large muscle (type I) and large skin (A-beta) nerves for gate effect
Segmental effects based on gate theory: large-diameter fibres inhibit pain from small fibres
High intensity of most TENS devices causes burning from skin but no Deqi from muscle
Pads are placed near the site of pain as large-diameter fibres are widely distributed
High frequency (50-200 Hz) produces best presynaptic inhibition at low intensity (for gate) but produces spasm at high intensity
Pulse trains maximise comfort of low-intensity, high-frequency stimulation
Analgesia has rapid onset and short duration, requiring continuous treatment all day long
Tolerance develops from continuous therapy
From Pomeranz & Stux (1995)
Low frequency, high intensity, Deqi mechanism High-intensity pulses produce (type III) Deqi via small muscle nerves to release endorphins Non-segmental and segmental effects: small fibres act on three sites: spine, brainstem and pituitary High intensity of some TENS devices activates small muscle (type III) nerves producing Deqi Pads placed on acupuncture points as these are over small-diameter afferent nerves (type III) in muscle Low frequency (1-4 Hz) produces no muscle spasm at high intensity and hence allows strong stimulation needed for Deqi Pulse trains cause muscle spasms at high intensity and do not permit adequate intensities for Deqi Analgesia has slow onset and long duration; needs only 30 minutes of therapy for prolonged effects No tolerance from short, 30-minute treatments
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Have You Always Been Curious About Acupuncture, But Were Never Quite Sure Where To Stick The Needles? If you associate acupuncture with needles, pain and weird alternative medicine then you are horribly misinformed about the benefits of the world's oldest form of medicinal treatment.