Conflicting reports have appeared in the literature concerning the effects of transcutaneous electrical nerve stimulation on skin temperature. This report studied 33 patients with chronic pain involving one extremity (13 upper, 20 lower) to determine whether changes in sympathetic tone, as reflected in skin temperature, occurred in response to electrical stimulation of painful areas. Stimulation was carried out for 20 to 45 minutes. Skin temperatures were measured from the thumbs or great toes of stimulated and contralateral extremities before and during stimulation. Skin temperature rose 2.5 +/- 0.7 (mean +/- SEM) in both the ipsilateral and contralateral extremity in patients who experienced relief of pain during stimulation. There was no significant change in skin temperature in patients who experienced no relief.