Transcutaneous electrical nerve stimulation (TENS)?

Transcutaneous Electrical Nerve Stimulation (TENS) has been widely used for the treatment of pain in general, including chronic pain. Inexpensive units can be purchased for under $25 at drugstores or online. They are generally intended to be placed on or near the painful part of the body.

Recently a very advanced TENS unit, Quell, was approved by the FDA for chronic pain for both daytime and sleep ( The comments on Amazon suggest that this unit has been very helpful for many people, even for neuropathy and lower back pain. The manufacturer says that the mechanism is the stimulation of production of endorphins, the body’s natural opioids. Thus, though it is worn on the leg, it works even for pain that is not in the leg since it uses the general opioid gates in the lower brain rather than the specific gates along the spine.

The question mark in the heading of this section is because TENS has not generally been used for retraining the brain, but for temporary pain relief. Perhaps the benefit of TENS could be enhanced with the idea that you are choosing to use TENS, or any other temporary relief method, as a way of retraining your brain that it is not important to pay attention to the chronic pain. You find out that you do just fine, probably better, without the “benefit” of the pain so why choose to pay attention to the pain and thus strengthen it?

Acupuncture, hypnosis and psychoactive drugs

Acupuncture, hypnosis and some psychoactive drugs such as amitriptyline and Lyrica can help with the brain problem of chronic pain.  The focus of this document is, however, is on therapies you can do yourself.  I made an exception and did include Cognitive Behavioural Therapy because it is so effective and because, like all the other treatments presented here, it is something you do, not something done to you.  You heal yourself with the help of a therapist.

This is in agreement with one of the conclusions from the National Pain Strategy: “Self-management programs can improve quality of life and is an important component of acute and chronic pain prevention and management.”