Transcutaneous electrical nerve stimulation (TENS) is a non-invasive therapy that uses electrical impulses to stimulate the nerves in order to reduce pain. It is commonly used to relieve chronic pain, as well as acute pain related to conditions such as arthritis, low back pain, and neuropathic pain. TENS works by stimulating the nerves with a low-voltage electrical current, which can help to reduce the perception of pain and improve muscle function. In this article, we will discuss the various aspects of TENS therapy, including its mechanism of action, applications, benefits, and limitations, as well as its importance in pain management.
Mechanism of Action
TENS therapy works by stimulating the nerves with a low-voltage electrical current, which can help to reduce the perception of pain. The electrical impulses are delivered through electrodes placed on the skin, which are connected to a TENS device. The device generates the electrical impulses, which are delivered to the nerves through the electrodes. The intensity, frequency, and duration of the impulses can be adjusted to suit the individual’s needs and condition.
TENS therapy is thought to work by several mechanisms. One theory is that it works by stimulating the production of natural pain-relieving chemicals called endorphins, which are released by the body in response to pain. Another theory is that it works by blocking the transmission of pain signals to the brain, which can help to reduce the perception of pain.
Applications
Chronic Pain
TENS is commonly used to relieve chronic pain, which is pain that lasts for more than three months. It can be used to relieve pain related to conditions such as arthritis, low back pain, and neuropathic pain. TENS therapy has been found to be effective in reducing chronic pain, and it is considered to be a safe and non-invasive alternative to pain medication.
Acute Pain
TENS is also used to relieve acute pain, which is pain that lasts for less than three months. It can be used to relieve pain related to conditions such as injury, surgery, or trauma. TENS therapy can be used to reduce the pain associated with acute injuries, as well as the pain associated with post-surgical recovery.
Benefits
TENS therapy has many benefits, including reducing pain, improving muscle function, and promoting healing. It is considered to be a safe and non-invasive alternative to pain medication, and it has been found to be effective in reducing chronic pain and acute pain. TENS therapy is also portable and easy to use, making it a convenient option for individuals who need to manage their pain on the go.
Limitations
TENS therapy has a few limitations, including skin irritation and muscle cramping. These side effects are usually mild and temporary, and can be minimized by properly positioning the electrodes and adjusting the intensity of the impulses. TENS therapy is not recommended for individuals with certain medical conditions, such as heart conditions, or for individuals who are pregnant or have a pacemaker.
Importance
TENS therapy is an important tool in the management of pain, particularly chronic pain. It can be used as an alternative to pain medication, which can have unwanted side effects, as well as addiction and dependence. TENS therapy
Musculoskeletal Pain.
One of the most common applications of TENS therapy is in the management of musculoskeletal pain. This includes conditions such as arthritis, low back pain, and neuropathic pain. TENS therapy has been found to be effective in reducing pain, improving mobility, and promoting healing in individuals with these conditions. A systematic review of randomized controlled trials found that TENS therapy was more effective than placebo in reducing pain in individuals with chronic musculoskeletal pain, and that it was as effective as other non-pharmacological treatments, such as physiotherapy.
Postoperative Pain
TENS therapy is also used to manage postoperative pain, which is pain that occurs after surgery. It has been found to be effective in reducing pain, improving mobility, and promoting healing in individuals who have undergone surgery. A systematic review of randomized controlled trials found that TENS therapy was effective in reducing postoperative pain, and that it was as effective as other non-pharmacological treatments, such as physiotherapy.
Transcutaneous electrical nerve stimulation is a technique in which mild electric currents are applied to areas of the skin by a small power pack connected to two electrodes. It is also known as TENS and sometimes denoted as TNS. A passive, non-invasive, non-addictive modality with few side effects, TENS works to improve mobility, decrease pain perception and may be used to control acute and chronic pain.
The method involves passage of a low-voltage electric current to electrodes pasted on the skin. The current may be delivered intermittently. The mild electric current generates heat that serves to relieve stiffness, improve mobility and relieve pain. The treatment stimulates the body’s production of endorphins or natural painkillers. Transcutaneous electrical nerve stimulation can be of three types namely Conventional TENS, acupuncture-like TENS and auricular TENS.
Frequency, intensity and site of application depend on the specific condition and treatment goals. TENS can be used to treat a number of disorders like acute and chronic pain associated with cancer, joint disorders, Alzheimer’s disease, heart disease, autoimmune disorders, back pain, dysmenorrhea, nerve disorders, labor pain, nausea, diabetic peripheral neuropathy, postoperative recovery, gastroparesis, cognitive impairment and much more.
Transcutaneous electrical nerve stimulation is used in a variety of different clinical settings and has become popular with both patients and health professionals. It may be prescribed in combination with other treatments, primarily to provide relief from acute forms of nerve pain. TENS should not be used in people with implanted medical devices such as cardiac defibrillators, pacemakers, intravenous infusion pumps or hepatic artery infusion pumps. Portable TENS equipments are available for use which can be worn around the waist.
TENS, might in some cases, have side effects such as skin irritation and redness, hives, welts, allergic skin reactions, and burns. A number of isolated side effects such as nausea, muscle ache, headache, increased hair growth, dizziness, and loss of sensation have also been reported. So this technique should be used only under the strict supervision of an experienced licensed healthcare practitioner.
Transcutaneous Electrical Nerve Stimulation For Pain Relief
Transcutaneous Electrical Nerve Stimulation, or TENS, is used for such pain conditions as post-surgical, visceral, neurological, sympathetically mediated, arthritic, myofacial and low back. It is also used to treat bladder incontinence. It is one of the most commonly used types of electro analgesia. Neuromodulation is produced by restoration of afferent input, direct inhibition of abnormally excited nerves, endogenous pain control and presynaptic inhibition in the dorsal horn of the spinal cord.
The unit includes one or more electrical signal generators, electrodes and a battery. It is programmable and small and can deliver stimuli with changeable current, pulse widths and pulse rates. Biphasic is the favorite waveform. Patients are advised to experiment with intensities and frequencies to find the best setting to provide pain control. Electrodes are placed over the area of pain and other points such as acupuncture sites, trigger points and cutaneous nerves.
There are three standard setting options used that include conventional, acupuncture-like and pulsed. With the conventional setting it uses a high frequency and low setting of intensity. The duration of the pulse is short. Pain relief is effective while the device is on but pain returns when it is off. Patients will leave the electrodes on all day and turn them on in 30 minute intervals. In some patients the effects can last beyond the stimulus intervals. The acupuncture-like setting delivers a low frequency high intensity stimulus. It can be uncomfortable and some patients cannot tolerate it, it is used when the conventional method does not work. Pulsed uses low intensity firing in high frequency bursts.
The comfort of the patient is very important in determining the efficacy of the treatment. The higher pulse widths are more painful and the higher intensity impulse is as well. Electroconductive gel is applied on skin under the electrodes to minimize any blockage of the current. Complications are rare but sometimes people will have skin irritation. The tape used on the electrodes can cause irritation. People with pacemakers can have problems as well.
Initial relief of pain is experienced in 70 to 80 percent of patients but it decreases after a few months to around 20 to 30 percent. Many patients use the device on a daily basis. Pulse frequencies and patterns are adjusted consistently. The range of outcomes fluctuates a great deal, most are favorable.
After surgery TENS is very effective in treating mild to moderate pain but is not effective in treating severe pain.
There have been beneficial results in using it for myofacial and lower back pain. It has been helpful in treating diabetic neuropathy, urge incontinence and angina pecoria. For regaining motor function in stroke patients and to help with nausea in patients in chemotherapy it has been successful.
TENS should not be used on patients who have pacemakers. It may cause premature labor in pregnant women. It should not be applied over the carotid sinuses or the anterior neck. Electrodes should not be placed over areas that have been burned. TENS should be used carefully with patients that have an intrathecal pump or a spinal cord stimulator.
Transcutaneous Electrical Nerve Stimulation may help to relieve some types of pain. It is good for short-term relief as it is not as effective on chronic pain. It stimulates the production of endorphins.