Abstract
“Mixed pain” is a term recently introduced to define the overlapping of nociceptive, neuropathic and nociplastic pain. To date, it has been reported that pharmacological treatments might have a modest effectiveness on patients affected by mixed chronic pain, with detrimental consequences in terms of disability, physical function and health-related quality of life. In this scenario, Percutaneous Electrical Nerve Stimulation (PENS), a mini-invasive neuromodulation technique, has been recently suggested as a promising approach for the complex management of mixed pain in musculoskeletal disorders. Albeit PENS showed to be effective in reducing unspecified pain in several chronic pain conditions, there is still a lack of evidence in the literature about its role in the management of neuropathic or mixed pain not responsive to pharmacological treatments. Therefore, by the present scoping review, we portray the potential effects of PENS in the multidisciplinary and multidimensional management of mixed chronic pain in patients with musculoskeletal disorders.
Highlights
Pain is “an unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage” [1]
Their findings showed a significant decrease in Visual Analogue Scale (VAS) pain score in patients treated with Percutaneous Electrical Nerve Stimulation (PENS) compared to those treated with TENS and physical exercise, suggesting that
Technique among clinicians, we might assume that this treatment strategy could rapidly spread in the medical field as an effective and safe treatment acting on pain reduction. This comprehensive review described the state of the- art about potential applications of PENS in chronic mixed and refractory pain, suggesting its potential indication in the multimodal rehabilitative management of chronic musculoskeletal disorders
Summary
Pain is “an unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage” [1]. Mixed pain in these chronic pathological conditions contributes to increased disability and impairment in terms of both physical function and health-related quality of life (HRQoL) [3] In this context, the Percutaneous Electrical Nerve Stimulation (PENS) is a miniinvasive neuromodulation technique that has been recently suggested as a promising therapeutic intervention for the management of mixed and refractory pain in different clinical conditions [4]. The Percutaneous Electrical Nerve Stimulation (PENS) is a miniinvasive neuromodulation technique that has been recently suggested as a promising therapeutic intervention for the management of mixed and refractory pain in different clinical conditions [4] This novel technique might be used to reduce both pain perception in several musculoskeletal diseases of Physical Medicine and Rehabilitation (PRM) interest, including LBP [5], total knee arthroplasty [6], chronic pain after amputation [7], opioid-resistant cancer pain [8] and overactive bladder in children [9]. This scoping review aimed at summarizing the current literature focusing on the mechanisms of action, clinical indications, safety and effectiveness of PENS treatment in patients affected by mixed chronic pain conditions in the rehabilitation field
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