Pain relief without drugs is the goal of research underway at the Universityof Ulster, Jordanstown. Dick Ahlstrom reports
A clinical trial is underway in the North to see whether tiny electrical signals can be used to block the pain associated with multiple sclerosis. Success could mean a safe way to control pain without the use of drugs.
The trial got underway in April and results should be available in early 2003, according to Dr Andrea Lowe-Strong, who is leading the research. She is a senior research fellow in the School of Rehabilitation Sciences at the University of Ulster, Jordanstown.
"Multiple sclerosis is a neurological disease that affects the nervous system," explains Lowe-Strong. "It hits people in the prime of their life, between 20 and 40. They don't know how it comes about."
While the cause isn't known, the disease's impact on nerve fibres is clear. A substance called myelin coats and protects the fibres, acting like the plastic cover on electrical wires. "The myelin cover of nerves begins to break down and the nerve transmission becomes disrupted" with multiple sclerosis, says Lowe-Strong.
It is a common disease, affecting 3,000 - about one in 500 people - in the North, she says. It can lead to muscle weakness in any part of the body, affecting speech, movement or eye control and common symptoms include incontinence and severe, difficult to control pain.
The majority of patients cite pain as the worst symptom and the one most desirable to control, she says. Her research group became involved in the research trial "basically because the people who are working on this project were involved in rehabilitation research and pain relief", she says. "We had looked at this type of electrical stimulation before and decided to apply it to MS pain."
She received funding for the trial from the MS Society as part of a stg£350,000 research programme with the university. All the money was collected as charitable donations from the people of Northern Ireland, she adds.
The technique is known as TENS, transcutaneous electrical nerve stimulation. The trial is now up and running and involves 90 patients, she says. It follows some earlier pilot studies to validate the approach. "No one has looked at the potential of TENS devices for pain relief for people with MS."
All patients are being treated in their own homes, so the technique remains free of a clinical surrounding. Other advantages are it is non-invasive, involves no drugs and does not cause side-effects. It is safe enough for women in labour, who use similar devices to control pain.
The idea is that electrical impulses are used to scramble the impulses carried via the nerves. "It is basically electrical stimulation. What it is doing is stopping electrical signals from getting to the brain. What this device does is give them control over their pain."
The team put together a device that has electrodes mounted in a belt that can easily be slipped around the waist. "This is useful as a lot of MS patients have reduced dexterity," she says. They can position the electrodes to deliver pain relief to the lower back, "but these units could be used in any pain area".
Similar devices are already used in sports and pregnancy, but this is the first time they have been studied in relation to MS, she says. The research project involves optimising the signal to optimise the result for the patient.
It is battery-driven so voltages are very low, but the frequency of electrical stimulation and not voltage is the key issue, she explains. Each trial group is being tested at different impulse frequencies, with the emphasis on low- and high-frequency ranges, she says. She can not give details of voltages or frequencies while the trail was in progress.
"We are trying to find ways of enabling people with MS to have more control over their lives, and control over pain is a vital part of that," she says. "These techniques may help improve the quality of their lives and provide them with alternatives to pharmacological methods."
People who would like to be part of the research project can contact Dr Lowe-Strong at the University of Ulster. The contact number is 0044 28 9036 8052.