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occipital nerve stimulator/TENS frequency
« on: Jul 27th, 2005, 6:05pm »
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Does anyone know what frequency/Hz (electrical impulse or cycles per second) is used in the Occipital Nerve Stimulation? I've used Transcutaneous Electrical Nerve Stimulation with some success in reducing pain during cluster cycles. The TENS device uses pads stuck to the skin, and its effects range from a pulsing massage feeling to an intense pinching sensation at higher frequencies. I've put the pads accross the back of my neck and also from jaw to temple on effected side. Both areas seem to reduce pain, or at least distract me from the pain significantly. Also my eyelid twitches.  Shocked  The same nerve paths that cause pain during an attack are lit up, but in a pain interupting way. Like oxygen, I can't see using it at work regularly. I used it at home morning and evening this last round. These things cost around a hundred dollars for a decent set up. No - I'm not selling them! There are many brands. Likely most available commercially are similar to what a chiropracter or orthodontist uses for neck, back, and jaw problems. I'd be very interested in frequency being used for the ONS that has been tried with some success. I couldn't find this information in searching the board posts. Sorry so lengthy! Rich
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Re: occipital nerve stimulator/TENS frequency
« Reply #1 on: Jul 28th, 2005, 7:03pm »
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I had an ONS trial implant in March of 04'. I can't tell you what frequency it was. I can tell you it was adjustable from no electric to 'shockyourheadoff' electirc. A TENS unit wouldn't compare IMO.
 
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Re: occipital nerve stimulator/TENS frequency
« Reply #2 on: Jul 28th, 2005, 9:26pm »
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Sorry - I used a TENS unit for about 6 months following a knee injury that was hard to heal.  I have a feeling that the frequency and intensity I used for pain relief can't be compared to what you'd set for a CHA.  Actually, I never thought about using it for my cluster attacks.  I still have the unit.  If you find an answer, please PM me with any success you might have.
 
PF Wishes,
 
Kris
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Re: occipital nerve stimulator/TENS frequency
« Reply #3 on: Jul 29th, 2005, 12:34pm »
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Unsolved - was the ONS very helpful? I think I read some posts a few weeks back on that. Seemed like you had trouble keeping things attached? Thanks for the info.
 
Kris - I haven't found any additional info on TENS specific to cluster headache. But a web search shows it to be used often for back pain and other chronic pain conditions with quite a bit of success. Seems to vary by individual, which we see with most CH treatments as well.
 
 I would try your TENS with pads close together on the back of your neck at or just into the hair line. I started out at low level/just perceptable to get a feel for it. Then turned it up to fairly strong/just bearable intensity. I varied the pulse rate from slow to intensly fast every couple of minutes over a 15 to 20 minute period, and it seemed to help abort attacks and to change pain intensity to shadows when not able to use the TENS. I may have been near end of cycle too (I hope so!). Also it was interesting to try directly over temple to jaw area. Don't place it across or near your heart or front of neck though!
 
Disclaimer: I'm not a doctor or salesman! Be careful with electrical currents applied to your body. Read directions and check with your doctor to ensure your safety. Best of luck, Rich
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Re: occipital nerve stimulator/TENS frequency
« Reply #4 on: Jul 29th, 2005, 2:28pm »
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No, the ONS didn't help me at all. It was very uncomfortable and generally a pain in the ass. The wires got blood on them the first night and the left side quit working but It was fixed first thing the next morning. All it did was shock me ... it didn't stop or reduce the pain of a cluster attack. I kept it for 7 days and then it was removed.
 
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Re: occipital nerve stimulator/TENS frequency
« Reply #5 on: Jul 29th, 2005, 5:30pm »
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I don't know if this is the same as the ONSI op but I would like to suggest you ask on the OUCH UK support board where a couple of people have had the ONSI op done and will be able to advise you best.
 
http://www.clusterheadaches.org.uk/cgi-bin/yabb/YaBB.pl?board=001
 
On the subject of TENS, I have a TENS machine I use for my bone disease so... in my "infinite" wisdom I thought I'd give it a go for CH one day.. I damn near broke it ripping it off. It did not help, it aggravated the living hell out of me and stressed me beyond belief. I would not recommend it based on my personal experiences but then that really isn't what it was designed for either!
 
I hope this is of help to you. Let the guys here know how you get on too okay?
Regards
Helen
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Re: occipital nerve stimulator/TENS frequency
« Reply #6 on: Jul 29th, 2005, 8:47pm »
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Yes, LeLimey ... I had the ONSI done by MHNI. It's the same thing. I had my head shaved and the wires placed (surgically) and the whole process was a pain in the ass. The electrical current didn't penatrate deep enough to affect my clusters. It was a very weird experience to say the least.
 
Unsolved
 
PS. Those that were around in March 04' knew about it because I was posting about it. I even posted a lousy pic of the wires sticking out of my head (it looked nasty)  Wink
« Last Edit: Jul 29th, 2005, 8:49pm by unsolved1 » IP Logged
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Re: occipital nerve stimulator/TENS frequency
« Reply #7 on: Jul 29th, 2005, 8:56pm »
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As posted before Unsolved, none of the UK sufferers who have had the ONSI got relief straight away. The units had to be modulated and remodulated over a period of weeks to get relief, and the whole thing appears to work better after scar tissue has formed around the wires to hold them firmly.
 
Sadly we will never know if your ONSI would have helped if left for longer than a week and if it had been adjusted but I think it is important that people reading this realise that time and adjustments to the stimulation seem to be important factors in the ONSI's success.
 
Wendy
 
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« Reply #8 on: Jul 29th, 2005, 8:59pm »
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I'm one of the ones who went for a consult to have one tried as well.  However, the neurosurgeon felt that it wouldn't help me due to several factors.  I've made a long post about it probably back earlier this year after I had the consultation appointment, but I'm too tired to go searching for it now!
 
I can't even handle the muscle stim machines used for PT.  I've had to use it after a few injuries while in PT.  Fortunately, they haven't suggested it for my AVN.  While most people like the muscle stim, there is a small handful who find it to be incredibly painful as it tenses the muscle beyond belief, instead of relaxing it.
 
The last time it was used for me, I was in PT for tendonitis in my right arm.  I needed it to heal ASAP because I was a piano major - so I was trying to keep up with the PT as best I could.  However, even on a low setting, first my hand would be drawn upward back towards my wrist in a very bad jerking movement.  Sometimes my whole hand contracted and jerked downwards towards the inside of my forearm.  On the whole, that muscle stim really caused my muscles to spaz out and tense up far more than they already were!
 
So yeah...I've always been too afraid to even entertain the idea of trying TENS.
 
Best of luck!
Carrie Smiley
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Re: occipital nerve stimulator/TENS frequency
« Reply #9 on: Jul 29th, 2005, 9:01pm »
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Wendy,
 
Even at Jefferson, they will only do the trial first.  I told them about Mike's story and how it took about 6 months or so before it truly helped.
 
However, they said the protocol here was to do the trial stim first, and if that worked, then they would implant the permanent device.
 
I was so hoping that I could try it and that it would finally be the thing to help me, but the neurosurgeon was very up front and honest with me in his analysis of the entire thing.  I did appreciate that!
 
I'm so glad that there are people getting relief from it in the UK!  I know of a few in the US who've gotten relief from it, but it's migraine they are using it for - not CH.
 
Hugz,
Carrie Smiley
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Re: occipital nerve stimulator/TENS frequency
« Reply #10 on: Jul 29th, 2005, 9:10pm »
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Am I being stupid here Carrie or is it a total waste of time and money, as well as risk and pain to patient to do the "trial" if the best evidence suggests it doesn't work that well straight away? Why bother at all?
 
Mike got some relief from his second ONSI pretty much straight away, he didn't have to wait 6 months, but his Ch only became really dramatically improved after the unit had been adjusted quite a few times.
 
W
« Last Edit: Jul 29th, 2005, 9:11pm by pubgirl » IP Logged
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Re: occipital nerve stimulator/TENS frequency
« Reply #11 on: Jul 29th, 2005, 9:24pm »
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I dunno Wendy.....I honestly don't know any of the data on how succesful this 'test run' has been overall.  I didn't qualify for the study on ONSI for chronic daily headache, so I went for my own consult.
 
I guess we'll have to wait and see what some of the studies regarding the trial implant say!  I'm sure I was given an answer as to why they do the trial, but I forget right now.
 
My pain level is killing a handful of brain cells every minute. LOL
 
Hugz,
Carrie
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Re: occipital nerve stimulator/TENS frequency
« Reply #12 on: Jul 29th, 2005, 10:32pm »
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You're right ... they won't 'implant' a stimulator unless the 'trial' is a success (in the US anyways)
 
It's hard to explain the feeling of one. The electricity was on top of my head and not in my head. I don't think it would've helped me no matter how much they adjusted it
 
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Re: occipital nerve stimulator/TENS frequency
« Reply #13 on: Aug 3rd, 2005, 9:30pm »
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Hello--I'm new here, so I hope no one minds if I jump in this discussion.  However, I am a physical therapist who has been fighting this pain for 18 years, and I've tried a lot of things in that amount of time.
 
I've never tried "trans-cranial" TENS, because it is not a recommended thing to do.  I wouldn't want to chance having an electrical current of any kind going through my brain.  Fortunately, you can place the electrodes at other points on your body.  Placing electrodes along accupuncture meridians which pass through your pain zones can be effective, but you need to know which ones are "best."  Also, there are some points you do not want to stimulate (there is one point which can induce early labor in pregnant women).
 
If you are skeptical about oriental medicine, consider this:  the skin impedence (resistance to electrical current) is significantly lower over accupuncture points.  There is an electrical modality which is kind of on the periphery (because it is quite uncomfortable) called electro-accupuncture, or "neuro probe."  This delivers a current through a very small point (size of the tip of a ball-point pen).  It hurts, but it's better than a hit.  Isn't everything?  Anyway, with it you can find the exact accupuncture point to stimulate.  I've used this in the past (belonged to a Canadian who I worked with for a while) on points at the base of my skull and the "hoku," or main body point on the back of my thumb web space, and for a while it would abort the headache.  Then it seemed to exacerbate them, like someone flipped the "turbo" switch on my pain.  Shortly after, the owner of the unit went back to Canada and took it with her.
 
Regarding the frequency of a TENS, it depends on what you want it to do.  A high freqency will mask some of the pain immediately, but only while the TENS is on.  Unfortunately, your nervous system accomodates to the current and it becomes less effective.  Some TENS units have a setting which keeps the current changing to avoid this.
 
If you set the TENS at a low frequency, you will trigger endorphine release from the brain, which will give a longer-lasting pain relief up to several hours.  Some TENS units will have a setting which combines the two frequencies (called "Burst mode" ), giving you the best of both worlds.
 
There are so many different makes and models out there (everyone makes a better unit), each with a different "language," that it is very difficult to tell you what setting would be best.  I usually have to read the manual if it's a new brand to me, and figure out the best setting for my patient.
 
Man, I'm really sorry this was so long.  I just wanted to share some of my experience.  Bottom line--placement of the electrodes across the cranium is dangerous, you should keep the pos. and neg. electrodes at least one electrode width apart for best results, and you should really see a PT who can show you how to set it up properly, and who can warn you of any contrainications (ie pacemaker).  If you don't have ins., tell the PT that and they will try to work something out, maybe only see you one or two sessions.  
 
Good Luck, and wishing you lots of PFDAN's.
 
--Scott
« Last Edit: Aug 3rd, 2005, 9:34pm by Salvelinus » IP Logged

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Re: occipital nerve stimulator/TENS frequency
« Reply #14 on: Aug 4th, 2005, 9:52am »
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Quote:
Placing electrodes along accupuncture meridians which pass through your pain zones can be effective, but you need to know which ones are "best."

Until now I thought the 'meridians' carried Chi, the 'energy of live'. Now it turns out this 'energy of live' is nothing more than an electric current from some simple electronic gadget. - There's nothing like a day when you learn something new!
 
Oh yeah, and try one point after the other until the cluster attack ends, then shout Eureka, I found the best point.  
 
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Re: occipital nerve stimulator/TENS frequency
« Reply #15 on: Aug 18th, 2005, 7:46pm »
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Actually, I don't think anyone really knows what they are.  To me, the fact that you can find points with an electric current is proof that they exist.  How they were found thousands of years before electricity was discovered is beyond me.  I just think it's really cool.  Smiley
 
You could probably very easily find books on accupuncture which show the meridians and main points.  Like I said, the neuroprobe was effective to abort quite a few clusters.  It didn't always work, but isn't that the story on all the treatments so far?
 
BTW, I've never been able to abort a CH with TENS.  At the most, it would probably be a nice distraction, and might help with the shadows afterward.
 
Namaste,  
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