Pain Management  Anesthesiologic Approaches  Neurostimulatory Approaches  Pharmacological Approaches  Psychological/Mind-Body Therapies  Rehabilitative Approaches  Surgical Approaches Conventional Approaches Neurostimulatory Approaches Another approach to pain relief is the stimulation of nerve pathways to reduce pain and facilitation motor function. The simplest form is called counter-irritation, which is systematic rubbing of the painful part. Conventional pain therapies that enhance this effect with electrical stimulation of the nerves include transcutaneous electrical nerve stimulation (TENS), peripheral nerve stimulation (rarely performed), spinal cord stimulation (also called dorsal column stimulation), and brain stimulation. Complementary approaches include acupuncture (including electrical stimulation of acupoints) and acupressure. The latter approaches and TENS are most commonly used to treat pain; spinal cord stimulation is well accepted by pain specialists and its role in pain management is growing. Transcutaneous electrical nerve stimulation (TENS) TENS has been used successfully to help control chronic pain in various conditions, including chronic neuropathy, arthritis, postoperative pain, post-fracture recovery, low back pain, postherpetic neuralgia, myofascial pain, and advanced painful malignancies (Thorsteinsson, 1987). The device is an electrical unit that delivers different frequencies and intensities of stimulation to the skin through electrodes. To increase the chance that TENS can help, the patient is given a TENS device and then instructed to apply a variety of different types of stimulation during a trial period. Patients vary a great deal in the type of TENS that works.