Patel Prachi, Green Maja, Tram Jennifer, Wang Eugene, Murphy Melissa, Abd-Elsayed Alaa A, Chakravarthy Krishnan
Houston Methodist Willowbrook Hospital, Neuroscience Centre, Houston, Tx, USA.
NXTSTIM INC. Department of Pain Medicine, San Diego, CA, USA.
J Pain Res. 2025 Jan 9;18:137-153. doi: 10.2147/JPR.S493162. eCollection 2025.
Transcutaneous Electrical Nerve Stimulation (TENS) and Electronic Muscle Stimulation (EMS) are non-invasive therapies widely used for pain relief and neuromuscular adaptation. However, the clinical research supporting the efficacy of TENS in chronic pain management is limited by significant methodological flaws, including small sample sizes and inconsistent reporting of stimulation parameters. TENS modulates pain perception through various techniques, targeting specific nerve fibers and pain pathways. High-frequency TENS is effective for segmental pain control, while low-frequency TENS, reliant on endogenous opioid pathways, may be less effective in opioid-tolerant patients. Additionally, TENS may influence autonomic functions, such as micro-perfusion and sympathetic tone, further broadening its therapeutic potential. EMS, on the other hand, enhances muscle strength and neuromuscular function, particularly in rehabilitation settings, by recruiting additional muscle fibers and improving neuromuscular efficiency. To address the limitations in existing clinical applications, future advancements in TENS and EMS technologies should focus on real-time optimization of stimulation parameters, consistent therapy delivery, and improved accessibility. Integrating automated and personalized adjustments can help streamline treatment, enhance patient compliance, and overcome traditional barriers to the effective implementation of these modalities. Additionally, developing systems that enable remote monitoring and customization of therapy protocols will expand the usability of TENS and EMS in diverse care settings. Future research must focus on rigorous study designs, standardized protocols, and meaningful patient-centered outcomes to fully realize the therapeutic potential of these modalities. Innovations like NXTSTIM EcoAI™ represent a significant advancement in delivering tailored, effective, and patient-friendly pain management and rehabilitation strategies.
经皮电神经刺激（TENS）和电子肌肉刺激（EMS）是非侵入性疗法，广泛用于缓解疼痛和促进神经肌肉适应。然而，支持TENS在慢性疼痛管理中疗效的临床研究受到重大方法学缺陷的限制，包括样本量小和刺激参数报告不一致。TENS通过各种技术调节疼痛感知，针对特定神经纤维和疼痛通路。高频TENS对节段性疼痛控制有效，而依赖内源性阿片类途径的低频TENS在阿片类耐受患者中可能效果较差。此外，TENS可能影响自主功能，如微灌注和交感神经张力，进一步拓宽其治疗潜力。另一方面，EMS通过募集更多肌肉纤维和提高神经肌肉效率来增强肌肉力量和神经肌肉功能，特别是在康复环境中。为了解决现有临床应用中的局限性，TENS和EMS技术的未来进展应侧重于刺激参数的实时优化、一致的治疗传递和更高的可及性。整合自动化和个性化调整有助于简化治疗、提高患者依从性并克服有效实施这些治疗方式的传统障碍。此外，开发能够远程监测和定制治疗方案的系统将扩大TENS和EMS在各种护理环境中的可用性。未来的研究必须专注于严谨的研究设计、标准化方案和有意义的以患者为中心的结果，以充分实现这些治疗方式的治疗潜力。像NXTSTIM EcoAI™这样的创新代表了在提供量身定制、有效且患者友好的疼痛管理和康复策略方面的重大进步。
