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Pathways Medical Center Richmond, VA 23235
As a pain specialist who has used acupuncture for 15 yr, I was happy to read about the use of this technique in a prestigious journal (1). Based on my reading of this article, a similar article by the same group published earlier (2), and a television news flash about the earlier article, I can not see a difference between electroacupuncture and percutaneous electrical nerve stimulation. I see no difference between acupuncture needles and "acupuncture-like needle probes." I believe that the brand of needles specified in the second article are sold as acupuncture needles. I wish that we were not afraid of the word acupuncture or electroacupuncture. I see no advantage in using the term percutaneous electrical nerve stimulation.
References
Department of Anesthesiology & Pain Management University of Texas Southwestern Medical Center at Dallas Dallas, TX 75325-9068
Forest Park Institute for Pain Management Ft. Worth, TX 76102
In suggesting that classical acupuncture and percutaneous electrical nerve stimulation (PENS) are the same because both techniques involve insertion of similar appearing needles, Dr. Pinsker has failed to understand the two fundamentally important differences between these two nonpharmacologic analgesic techniques.
Although we have no objection to the use of the term acupuncture (or electroacupuncture), it would be inaccurate to describe PENS therapy by either of these terms (1–5). We would encourage pain specialists like Dr. Pinsker to compare PENS to classical Chinese acupuncture. In a study involving transcutaneous electrical nerve stimulation, we found that dermatomal stimulation was as effective as acupoint stimulation in producing an analgesic-sparing effect (6). It is possible that simultaneous percutaneous electrical stimulation at both acupoints and dermatomes would produce an even more profound and longer-lasting analgesic effect in patients with acute and chronic pain syndromes. Finally, we would encourage our colleagues in pain management to consider the use of these complementary pain-relieving therapies as adjuvants to conventional pharmacologic and nonpharmacologic modalities rather than as alternatives.
In describing a "new" type of pain therapy, it is important to use precise terminology in defining the treatment. Insertion of the thin "needles" per se is not the critically important feature of either acupuncture or PENS. We would hope that the use of more precise terminology will minimize confusion regarding these nonpharmacologic therapeutic modalities in the future.
References
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