Influence of burst TENS stimulation on the healing of Achilles tendon suture in man.

Published online: Dec 27 2003

Burssens P, Forsyth R, Steyaert A, Van Ovost E, Praet M, Verdonk R.

Department of Orthopaedic Surgery and Physiotherapy, Department of Pathology, University Hospital Gent, Belgium


Retrograde or antidromic stimulation of the nociceptive C fibres is known to lead to the release of sensory neuropeptides Substance P (SP) and Calcitonin Gene-Related Peptide (CGRP) by the peripheral endings of these ultra-thin nerve fibres. These neuropeptides have, among others, a vasodilatory effect, which explains why they play a role in the healing of soft tissues. Burst TENS (Transcutaneous Electric Nerve Stimulation) is known to be most effective in influencing C fibre-evoked activity. This is why burst TENS was used in a randomised study as a stimulus for the healing of the sutured Achilles tendon in 10 patients, versus 10 others who received no stimulus. There was one drop-out in each group, so that 2 x 9 patients remained available for the study. A needle biopsy, performed after six weeks, showed no significant influence of burst TENS on the histological healing stage, as compared with a rat study. However, a semi-quantitative evaluation of the number of fibroblasts showed a significant advantage for the stimulated group: p = 0.007. This means that burst TENS might influence healing of Achilles tendon sutures in man. But above all, it means that a histochemical study of the influence of burst TENS on the release of substance P and CGRP, after suture of the Achilles tendon in man, would be worthwhile.