Question: What is a pain pen?
Answer 1: Numerous devices have come and gone from the market over the years, some of which replicate valid medical tools or modalities in name and not necessarily effect. One such is the widely available ‘intrasonic’ device which is nothing like Ultrasound. Intrasonic is a high frequency vibration source, whereas ultrasound is electronic circuitry which energizes a piezzo-electric crystal and delivers a known amount of power (usually in watts per sq cm – despite the cM not being a valid unit of measure), and at a known frequency, hence the dose administered to a patient can be accurately calculated. Intrasonic being a moderately well engineered device, but mechanical in its energy generation cannot be measured easily. Care must be exercised when using this unit as if it is applied to bony prominences or tendons passing over superficial bone, it can cause inflammation. Laser devices which are likely to have any therapeutic effect certainly wouldn’t be sold on the open market as they are strictly legislated owing to the gross misuse of lasers for tattoo removal. There is a device on the market which emits continuous and pulsed light source, but this is not laser. The pressure of the small tip of the applicator may well cause reduction of pain if the pressure is applied to an acupuncture point.
Answer 2: The “pain pen” apparently works on the same principles as a TENS unit, (i.e. a genuine pain-relieving device) but the question in my mind is, could something as small as a pen really have a similar effect as a TENS unit because if it could why would the “professional” units be so much bigger? Pain pens can be applied to trigger points to reduce pain. I am not sure if laser devices are commonly used by physiotherapists nor why they would or might be useful for RSI.
Answer 3: I think pen pains might work by releasing trigger points. Over the last few weeks I have been seeing a physio who has been using laser (works on trigger points and looks like a pen) and ultra sound on me. I have to say I have found the most difference in my RSI in the 4 and 1/2 years I have had RSI. It is still there of course but recently I moved and even though I struggled with pain all days, some more than others, I would have expected the flare-ups to be nearer scale 8/9 (even though on most occasions I was pacing) and instead they were maybe 6/7. Of course I was on pain-killers too. Still…Oh oh oh where’s wood? Ah! TOUCHWOOD!!!!
Answer 4: The Pain Gone pens are little TENS machines, apparently. I’m not sure if (in fact I don’t think) this would have the same effect as laser. You can ask your physio for more information about the laser treatment. Ask him/her whether there’s anything available for home use by the patient. Boots sell an ultra sound massage whatsit. Can’t recall the name of it at present. Boots say that they test all such devices for efficacy before adding them to their list.
Answer 5: The pain pen cannot be like TENS as TENS uses electrical impulses from two electrodes to stimulate the sensory nerve endings to trigger the pain gate as often spoken about many times. LASER is used by quite a number of physios. We have two units in this Clinic. Use is two-fold:
1. some physios use it at trigger points or acupuncture points to elicit pain relief.
2. it appears to stimulate an anti-inflammatory effect by releasing latent energy into active energy. Research is being carried out in a variety of centres world wide. Both of the above are potentially useful to RSI sufferers. I tend not to use either LASER or ultrasound for treating RSI as the LASERS we have rely on direct contact and this often elicits pain in already sensitive tendons. Ultrasound can be delivered using indirect coupling methods but in my almost 20 years of treating RSI I find it is too aggressive. These comments are purely personal. Other physios will probably use these modalities to beneficial effect. I think the pain pens are still available, but as mentioned previously, I have never handled one so cannot shed any light on them! – please excuse the deliberate pun.