[Electricity in pain management]

AVAILABLE TECHNIQUES: For more than thirty years there has been a revival of electrotherapy in the treatment of pain. Analgesia by electrical current is now based on transcutaneous or percutaneous nerve stimulation, deep stimulation, posterior spinal cords stimulation, and transcutaneous cranial stimulation.

It is now scientifically proven that electrostimulation of certain peripheral fibers and of different structures of the central nervous system plays an undeniable role in filtration and control of painful messages. However, precise indications are a prerequisite. Transcutaneous electrical nerve stimulation is only effective if it acts on neurogenic pain, only if the nerve pathways to be stimulated are superficial, and only if the conduction pathways between the area of stimulation and the superior centers are intact. Neurosurgical electrostimulation techniques should only be proposed after failure of simple therapies.

For acute pain, electrostimulation of certain intracerebral structures and transcutaneous cranial electrostimulation may be indicated. Clinicians have a multitude of electrostimulators at their disposal but generally, the parameters recommended for their use have no serious scientific basis. The selected electrical neurostimulator must provide effective nerve stimulation without causing lesions. Electrostimulation could be considered as an adjunct to medicinal treatment for pain relief.