Managing and controlling pain — common mistakes

When discussing TENS, always link it explicitly to the Gate Control Theory of Pain. Explain how stimulating large nerve fibres (A-beta) can inhibit the signals from small pain fibres (A-delta and C) at the spinal 'gate'.

No, this is a common misconception. The pain is a real, physical sensation. However, the brain is not just a passive receiver of pain signals; it actively interprets them. Psychological factors like thoughts, emotions, and attention can significantly amplify or dampen our perception of pain. CBT works by helping patients manage their reaction to the real pain, reducing distress and disability, not by suggesting the pain is imaginary.

Not necessarily, especially for chronic pain. While analgesics are very effective for acute pain (e.g., after an injury or surgery), their long-term use for chronic conditions can be problematic. Non-opioids can have side effects, and opioids carry a high risk of tolerance and addiction. For chronic pain, a multimodal approach that includes physical and psychological therapies is often more effective and safer in the long run than relying solely on medication.

No, the effectiveness of TENS varies considerably between individuals and pain conditions. It often works best for neuropathic pain (pain from nerve damage) and musculoskeletal pain. However, some people find it provides little to no relief. The success of the treatment can also depend heavily on correct electrode placement, as well as the frequency and intensity settings of the device, which often require trial and error to optimise for the individual.