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Transcutaneous electric nerve stimulation (TENS) units can be helpful in dealing with localized pain, and are widely used both in health care provider's offices and physiotherapy clinics. TENS therapy can also be performed at home.
With this technique, electrodes are placed on the skin and joined to the TENS unit with wires. Electric signals are then sent to the nerve endings, blocking pain signals before they reach the brain. It is believed that this signals may also stimulate the production of endorphins, the body's natural pain killers. TENS therapy is not considered painful, although some people report feelings of mild discomfort.
Pain relief from TENS therapy can be long-or-short-term in nature. Because the treatments are safe and have no known side effects, they can be repeated as necessary.
Electro-Medical Therapy History
The application of electro-medical therapy is not a new concept. Its therapeutic value was recognized long before William Gilbert defined electricity in 1600. Both Aristotle and Plato refer to the Black Torpedo (electric ray fish) prescribed in 46 A.D. by the physician Scribonius Largus for the relief of a variety of medical conditions from headaches to gout. In the 1800's dentists reported excellent results using crude electrical devices for pain control. By the turn of this century, electrical devices were in widespread use to manage pain and "cure" everything from cancer to impotency.
In 1965 Drs. Ronald Melzack of Canada and Patrick Wall of the U.K. published a paper explaining a new comprehensive theory, known as the Gate Control Theory, of how pain is processed by our nervous systems. This theory also explained how electrical stimulation can influence the physiology of pain. By 1967 electrical devices were surgically implanted to control severe low back pain. Shortly thereafter, surface electrical units were used to test the person's response as a means of screening suitable surgical candidates. It was soon discovered that these surface electrical stimulators were also effective and they could be used for the relief of pain without the surgery. Since then, these devices, known as Transcutaneous electrical nerve stimulators (TENS), have become widely accepted by health care providers to control most forms of pain.
Frequently Asked Questions about TENS
What is TENS?
TENS or Transcutaneous Electrical Nerve Stimulation, is a small "beeper size" device that clips on a belt. It operates on a volt battery and is used as a method of pain relief and rehabilitation enhancement. TENS has been approved by the FDA. It is prescribed by health care providers and is reimbursed by most insurance companies.
What kinds of pain respond to TENS?
Pain that warns us of external danger and internal illness serves a useful purpose. But the chronic and acute pain associated with long-term illness, surgical incisions, and unknown diagnoses do not provide insight into illness, and therefore should be relieved. TENS is an excellent, non-drug alternative for chronic pain such as lower-back ache and arthritis. It is also useful in relieving acute pain associated with surgery, traumatic injury, and other conditions.
How can TENS relieve pain?
TENS can relieve pain by blocking the pain message sent by the body's nervous system. This is accomplished by placing electrodes over the painful area and administering a low-volt electrical current. The current overrides the nervous system's message of pain, thereby blocking it.
Does TENS treatment have any risks or side effects?
Unlike surgery or prescription drugs, TENS is virtually risk free from injury, side-effects or addiction. The low-volt electrical current delivered by the electrodes only penetrates the skin to the level of the nerve fibers, usually only one to two inches. This poses no danger to most individuals. However,health care providers or midwives before using TENS. Also, neck and head pain that requires locating electrodes on these areas of the body should be conducted only with the consent of a health care provider. Use caution when you drive or operate heavy machinery. Most importantly, always use TENS according to your health care provider's directions.
What is the most effective way to use TENS?
To achieve the best results of TENS therapy, it is important to remember that TENS merely activates the body's own pain-fighting mechanism. Placing electrodes directly over or around the painful area delivers pain-blocking current to the nerves leading to that area. Some healthcare professionals have found that placing the electrodes along acupuncture points is also effective. Also, it is good to vary the placement of the electrodes each treatment to avoid skin irritation.
How long does it take for TENS treatment to produce results?
In most cases, studies show that it takes roughly 30 minutes for TENS treatment to begin to relieve pain. However, for conventional, high-frequency TENS treatment, there is no set treatment limit. Some patients find hours of pain relief from short 30-to-60 minute sessions. Others use their TENS units for several hours a day or all day, depending on the pain generated by daily activities. Always use your TENS unit according to your health care provider's directions.
When can TENS treatment be administered?
TENS can be administered any time of day or night. It is recommended that TENS not be used while sleeping. This is simply because movement during sleep may cause electrodes to come off or be pressed into the flesh, causing skin irritation. However, always use your TENS unit according to your health care provider's directions.
Indications for use of TENS
SYSTEMIC PAIN
Bursitis
Cancer
Causalgia
Multiple Sclerosis
Neuralgia
OsteoarthritisPhantom Limb Syndrome
Raynaud's Syndrome
Rheumatoid Arthritis
Synovitis
Diabetic Peripheral Neuropathy
HEAD & NECK PAIN
Cluster Headaches
Dental Disorders
Migraine Headaches
Spondylosis
Sprains/StrainsSuboccipital Headaches
TMJ Syndrome
Torticollis
Trigeminal Neuralgia
Whiplash
ABDOMINAL PAIN
Diverticulosis
Dysmenorrhea
LABOR & POSTOPERATIVE PAIN
TENS USE DURING LABOR
Transcutaneous Electrical Nerve Stimulation (TENS) provides yet another form of counter-stimulation and has been used for several years in the management of postoperative and cancer pain. It has been postulated that TENS helps to relieve pain by stimulating the release of endorphins. The TENS equipment consists of a small, battery driven pulse generator, connected to one or two pairs of electrodes which are attached to the skin with adhesive tape. When it is turned on, the TENS machine causes a tingling sensation underneath the electrodes - the strength of which can be adjusted at the generator controls
TENS is most useful during labor in helping to relieve pain. Consequently, the electrodes are usually placed on each side of the lower spine. A back-ground stimulation is set and the hand control unit is used to increase the intensity of the current during a contraction. In order to be of benefit, it is necessary to turn the control to a setting which is 'almost painful'. The most effective time to begin using TENS is early in labor before the pain becomes too intense.
TENS is non-invasive and simple to use. It does not have any side effects (apart from irritating the skin) and is controlled by the mother herself. TENS is also portable and does not interfere with the mother's ability to move around. If the TENS unit is used in a hospital or clinical setting, sometimes, TENS can interfere with the signal from an electronic fetal monitor. In this event, TENS may have to be abandoned. However, for a homebirth or a non-invasive birth center, this would not be a problem since they would not be using an electronic fetal monitor.
Women differ considerably in their opinions about the effectiveness of TENS in labor. It should still be combined with relaxation and visualization techniques used in a non-medicated, drug-free birth. In clinical or hospital practice, additional analgesia may be given to the laboring mother - although it is possible that drug dose requirements may be less with the aid of TENS. Not everyone finds TENS effective and some dislike the tingling sensation.
If you are interested in using TENS you should first check with your health care provider or midwife whether it will be available for you or if you should invest in purchasing a unit of your own for a homebirth. It is preferable to try using TENS before purchasing your own unit and before going into labor so at you can find out just what it feels like.
BACK PAIN
Facet Syndrome
Intercoastal Neuralgia
IVD Syndrome
Lumbago
Lumbosacral PainRadiculitis
Sprains/Strains
Thoracodynia
Whole Back Pain
LOWER EXTREMITY PAIN
Ankle Pain
Foot Pain
Fractures
Ischialgia
Knee PainPassive Stretch Pain
Sciatica
Sprains/Strains
Tendonitis
Thrombophlebitis
UPPER EXTREMITY PAIN
Epicondylitis
Frozen Shoulder
Hand Pain
Peripheral Nerve InjurySprains/Strains
Subdeltoid Bursitis
Wrist Pain
TENS PRODUCTS & SUPPLIES
TENS INFORMATION LINKS
ProMed Products: TENS Units
MOONDRAGON'S PAIN CONTROL LINKS
MoonDragon's Health Therapy: Pain Control
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