Question: I saw an old basketball player put something on his back on television, and he claims that it cured his back pain. What is it? Does it work?
There seems to be a new trend in advertising when it comes to healthcare. New drugs are approved by the FDA and then find themselves in commercials directly marketed to you, bypassing the traditional route that includes a prescribing physician. For example, how many times a day do you hear a commercial about a purple pill, or an ad about a pill to make you stop smoking, or that nauseating geriatric musical group that plays in the background while you hear about erectile dysfunction?
A recent addition to the commercial bombardment features the aging athlete (a basketball player, I think, but I just don't keep up with sports that use round balls) with an instrument he claims will cure your back pain. He places it on his supposedly aching back and says it is as good as what you will get in your doctor's office. What exactly is he peddling?
Apparently, the use of electrotherapy for pain control extends to about 63 A.D., when Scribonius Largus, the personal physician of Roman Emperor Claudius, stepped on some sort of electric fish while wading along the ocean shore. Some attempts to create electrotherapy were made in the 18th and 19th centuries. Electrotherapy was used for pain control from the earliest days of chiropractic history dating back to the 1920s as that profession developed various forms of physiotherapy that are used today. In the development of electrotherapy units for home use, there were some probably unimportant intermediate steps until the first practical transcutaneous electrical nerve stimulation (TENS) unit was patented in the United States in 1974.
With the advent of microelectronics, the TENS unit became smaller, portable, and battery-operated. Some are the size of a postage stamp, but most are about the size of a small cell phone. Most have two channels with two electrodes each. They can be programmed to change frequency and the strength of the pulsation applied through the skin to maximize pain control.
Our aging athlete on the television screen is promoting a very small TENS unit that has a large electrode to distribute the electric charge over a generous area of the back. They sell online for just under $40. How effective are they?
There are studies that show that TENS units can help with pain control. There are other studies that do not support this assertion. I am reminded of Wilson's law, which states that for every PhD, there is an equal and opposite PhD. In such situations of conflicting research, I fall back on my own observations.
I first saw the use of TENS units in my critical care nursing days. In postoperative surgical cases, particularly those that involve abdominal incisions that can be quite painful, long electrodes were placed on each side of the incision. What we observed was that patients who were fitted with these electrotherapy units in the recovery room needed significantly fewer narcotics after surgery for pain control, so their outcomes were better because there were fewer complications. Patients with less pain would get out of bed and move faster than those who hurt. The use of these devices fell out of favor for some reason, possibly under pressure from the hospital pharmacy. Of course, they played havoc with the EKG monitoring in the ICU because they created electrical interference.
In my own practice, I use a number of different types of electrotherapy devices. Changing an electrical waveform will change the physiological effect, so we now use a variety of different waveforms for everything from pain control to breaking muscle spasms to muscular reeducation. Some electric stimulators are placed surgically inside the body for pain that cannot be controlled any other way.
If a chronic pain sufferer responds well to electrotherapy, I will sometimes prescribe a TENS unit of some description for home care. There are other types of electrotherapy available for home use as well, such as interferential therapy or galvanic stimulators. They are easy to use, inexpensive, and effective for some people.
To me, the ideal drug is one that does only what it is supposed to do; it has no side effects; it is inexpensive and easily obtained; it is effective and safe; and, it is controlled by the patient who uses it. Obviously, no drug actually fits this description. For pain control, however, electrotherapy for home use comes as close as possible to this definition.
You may want to try what our basketball player is using, but talk to your doctor about it because there may be a form of electrotherapy that is better or more effective for you. There is a wide range of alternatives.