Effects of Transcutaneous Electrical Nerve Stimulation on Chemotherapy-induced Peripheral Neuropathy Symptoms

Chemotherapy Induced Peripheral Neuropathy (CIPN) is a common and serious side effect of chemotherapy treatment that causes autonomic neurons, sensory, or motor nerve damage or dysfunction. CIPN develop in some patients gradually over months to years, while in others may develop rapidly and continue to get worse during or immediately after infusion.

It was found that CIPN can also affected by race and gender. African American women exhibited two to three times higher risk for developing CIPN relative to White Women Further, non-Chinese Asians had a higher risk of developing neuropathy than Chinese or Caucasians in One study (n=255) investigated patients receiving platinum- and taxane based chemotherapy for a variety of solid tumors in Hong Kong, Singapore.

Thus, CIPN need to be managed and solved to prevent CIPN before it occurs and to alleviate symptoms after CIPN has developed. In terms of prophylaxis, American Society of Clinical Oncology (ASCO) practice recommendations state that there is no proven way to prevent, mitigate, or manage CIPN occurrence. Despite trials indicating modest effectiveness, many practitioners explore the use of neuropathic pain medications such as gabapentin, pregabalin, tricyclic antidepressants, and others for symptomatic relief. Nevertheless, only venlafaxine and duloxetine have been shown to be effective in alleviation paresthesia. Duloxetine (orally) is currently the only FDA-approved medication for the treatment of established CIPN and is an ASCO recommended therapy for patients.

Alternative and complementary medicine methods to treat CIPN have also been studied. Firstly, acupuncture is one such technique that is becoming more popular as an effective supplement to other treatments for CIPN. Secondly, Neuromodulation involves electrical stimulation of peripheral nerves (e.g., transcutaneous electrical nerve stimulators, Scrambler therapy) or modulation of the central processing of painful afferent impulses via real-time feedback using electroencephalography to "retrain" the brain to perceive neuropathic pain as a nonpainful stimulus (e.g. neurofeedback). Thirdly, scrambler treatment for CIPN has mainly favorable results, although heterogeneity and small sample sizes restrict it. Fourthly, exercise and cannabinoids are two treatments for CIPN that have a growing body of clinical and preclinical data to back them up.

Transcutaneous Electrical Nerve Stimulation (TENS) has considered as an alternative treatment to conventional pharmacotherapy for cancer patients having CIPN. TENS machine is a non-invasive, inexpensive therapy, operated by a battery. It activates peripheral nerves by delivering low-voltage electrical impulses to control any type of pain (localized, acute or chronic) through 2 -4 sticky electrodes connect via wires placed on the surface of skin, which could blocks or changes the perception of pain.