EFFECT OF TRANSCUTANEOUS ELECTRICAL NERVE STIMULATION IN PAIN REDUCTION AND VENOUS BLOOD FLOW AUGMENTATION IN VARICOSE VEIN PATIENTS
Background: Patients with varicose veins experience pain in affected leg which is due to venous blood stasis in the lower limb therefore it is essential to determine the severity of pain along with venous blood flow in the affected area. For this purpose the study was conducted to observe the effect of Transcutaneous Electrical Nerve Stimulation for pain reduction and venous blood flow augmentation. Methods: In this study, 80 subjects were included which were divided into Group A (Healthy controls) n=40 and Group B (Varicose vein patients) n=40 which was further subdivided into Group 1 (Varicose vein controls) and Group 2 (Transcutaneous Electrical Nerve Stimulation application). Numeric Rating Scale was used to measure pain score and Duplex Ultrasound was done to measure popliteal vein peak flow velocity (Cm/Sec) and blood flow (mL/min) in both Group A, Group 1 and Group 2 (before and after experiment). Results: The Mean±SD of Numeric Rating Scale (NRS) in Group 2 (5.56±0.651) was statistically significantly reduced (p=0.004) as compared to Mean±SD in Group 1 (7.36±0.757). Similarly the Mean±SD of popliteal vein peak flow velocity (15.20±1.42) and popliteal vein blood flow (93.08±5.049) was statistically significantly raised (p=0.001) as compared to mean±SD of popliteal vein peak flow velocity (10.06±1.31) and popliteal vein blood flow (71.04±2.894) in Group 1. Conclusion: TENS can be used as an effective adjunctive treatment modality in patients suffering from varicose veins.
Pak J Physiol 2021;17(2):31–4
Youn YJ, Lee J. Chronic venous insufficiency and varicose veins of the lower extremities. Korean J Intern Med 2019;34(2):269–83.
Carpentier PH, Maricq HR, Biro C, Ponçot-Makinen CO, Franco A. Prevalence, risk factors, and clinical patterns of chronic venous disorders of lower limbs: a population-based study in France. J Vasc Surg 2004;40(4):650–9.
Al Shammeri O, Al Hamdan N, Al-Hothaly B, Midhet F, Hussain M, Al-Mohaimeed A. Chronic Venous Insufficiency: prevalence and effect of compression stockings. Int J Health Sci (Qassim) 2014;8(3):231–6.
Nådland IH, Walløe L, Toska K. Effect of the leg muscle pump on the rise in muscle perfusion during muscle work in humans. Eur J Appl Physiol 2009;105(6):829–41.
Lattimer CR, Franceschi C, Kalodiki E. Optimizing calf muscle pump function. Phlebology 2018;33(5):353–60.
Naoum JJ, Hunter GC, Woodside KJ, Chen C. Current advances in the pathogenesis of varicose veins. J Surg Res 2007;141(2):311–6.
van Uden CJ, van der Vleuten CJ, Kooloos JG, Haenen JH, Wollersheim H. Gait and calf muscle endurance in patients with chronic venous insufficiency. Clin Rehabil 2005;19(3):339–44.
Campbell B. Varicose veins and their management. BMJ 2006;333(7562):287–92.
Burnand KG, Wadoodi A. The physiology and hemodynamics of chronic venous insufficiency of the lower limb. In: Galviczki P, (Ed). Handbook of venous disorders: Guidelines of the American Venous Forum. USA: CRC Press; 2019.p. 47–55.
Spinedi L, Broz P, Engelberger RP, Staub D, Uthoff H. Clinical and duplex ultrasound evaluation of lower extremities varicose veins-a practical guideline. Vasa 2017;46(5):325–36.
Hawker GA, Mian S, Kendzerska T, French M. Measures of adult pain: Visual Analog Scale for Pain (VAS Pain), Numeric Rating Scale for Pain (NRS Pain), McGill Pain Questionnaire (MPQ), Short-Form McGill Pain Questionnaire (SF-MPQ), Chronic Pain Grade Scale (CPGS), Short Form-36 Bodily Pain Scale (SF-36 BPS), and Measure of Intermittent and Constant Osteoarthritis Pain (ICOAP). Arthritis Care Res (Hoboken) 2011;63 (Suppl 11):S240–52.
Haruta N. Recent Progress of Varicose Vein Treatment Especially about Endovascular Heat Ablation, SEPS and Foam Sclerotherapy. Ann Vasc Dis 2018;11(1):66–71.
Johnson MI, Jones G. Transcutaneous electrical nerve stimulation: current status of evidence. Pain Manag 2017;7(1):1–4.
Mokhtari T, Ren Q, Li N, Wang F, Bi Y, Hu L. Transcutaneous Electrical Nerve Stimulation in Relieving Neuropathic Pain: Basic Mechanisms and Clinical Applications. Curr Pain Headache Rep 2020;24(4):14.
Sharififar S, Shuster JJ, Bishop MD. Adding electrical stimulation during standard rehabilitation after stroke to improve motor function. A systematic review and meta-analysis. Ann Phys Rehabil Med 2018;61(5):339–44.
Izumi M, Ikeuchi M, Mitani T, Taniguchi S, Tani T. Prevention of venous stasis in the lower limb by transcutaneous electrical nerve stimulation. Eur J Vasc Endovasc Surg 2010;39(5):642–5.
Martínez-Rodríguez A, Senin-Camargo F, Raposo-Vidal I, Chouza-Insua M, Rodríguez-Romero B, Jácome MA. Effects of transcutaneous electrical nerve stimulation via peroneal nerve or soleus muscle on venous flow: A randomized cross-over study in healthy subjects. Medicine (Baltimore) 2018;97(36):e12084.
Shimoura K, Iijima H, Suzuki Y, Aoyama T. Immediate Effects of Transcutaneous Electrical Nerve Stimulation on Pain and Physical Performance in Individuals With Preradiographic Knee Osteoarthritis: A Randomized Controlled Trial. Arch Phys Med Rehabil 2019;100:300–6.
Santana LS, Gallo RB, Ferreira CH, Duarte G, Quintana SM, Marcolin AC. Transcutaneous electrical nerve stimulation (TENS) reduces pain and postpones the need for pharmacological analgesia during labour: a randomised trial. J Physiother 2016;62(1):29–34.
Choi YD, Lee JH. Edema and pain reduction using transcutaneous electrical nerve stimulation treatment. J Phys Ther Sci 2016;28(11):3084–7.
Broderick BJ, O’Briain DE, Breen PP, Kearns SR, Olaighin G. A hemodynamic study of popliteal vein blood flow: the effect of bed rest and electrically elicited calf muscle contractions. Annu Int Conf IEEE Eng Med Biol Soc 2009;2009:2149–52.
Copyright (c) 2021 Pakistan Journal of Physiology
This work is licensed under a Creative Commons Attribution-NoDerivatives 4.0 International License.
Pakistan Journal of Physiology, Pak J Physiol, PJP is FREE for research and academic purposes. It can be freely downloaded and stored, printed, presented, cited and quoted with full reference of, and acknowledgement to the PJP.