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How does TENS work? | The Physio Fix

TENS can help in relieving chronic back pain and reduce discomfort.

TENS stands for Transcutaneous Electrical Nerve Stimulation. A pain-relief therapy that was developed in the 1960s, has gained popularity in both clinical and home settings. TENS is a safe and very effective method for both acute and chronic pain management without any significant side effects. The therapy involves the usage of a portable device connected to electrodes that are placed on the skin near the area of pain. 

HOW TENS WORKS?

TENS works by delivering small low-voltage electrical impulses to the targeted area via. the electrodes placed on the skin to relieve pain. Now, the question " how does TENS work?" is answered via. the two main theories that explain the mechanism of action of the Transcutaneous Electrical Nerve Stimulation device. 
  • PAIN GATE THEORY: Also known as the "Gate Control Theory", proposed by Melzack and Wall in 1965. According to this theory, The electrical impulses delivered by the TENS device tend to block the pain signals from reaching the central nervous system i.e. primarily to your brain. This happens by stimulating the non-painful sensory fibers that ultimately inhibit the transmission of pain signals to the CNS. 
  • ENDORPHIN RELEASE: Endorphins are referred to as the natural painkillers of the body. Application of TENS can increase the production of endorphins which bind to the opioid receptors in the brain and spinal cord hence, reducing the perception of pain. 

PARTS OF A TENS UNIT:

A TENS unit generally comprises three main components i.e. electrodes, a portable device, and leads. 
Electrodes are sticky or self-adhesive pads that are attached to the skin near the painful area.
A portable device refers to the main unit that houses the batteries and controls, responsible for the generation of electrical impulses. 
Leads specifically refer to the wires that connect the main unit to the electrodes for the transmission of impulses. 

HOW TO USE TENS?

A TENS unit usually comes with a complete usage guide. In the packaging, you'll find a TENS device, Electrode pads, leads, batteries, an instruction manual, and maybe a carrying case too. 
  • Before using a TENS unit, you should read the instruction manual to ensure you have a clear understanding of the settings and controls that are specific to your model of TENS. 
  • Attach the electrodes to the main unit via. leads/wires.
  • Clean and dry the area of the skin where you will be placing the electrodes to ensure they adhere properly to the skin.
  • Now, attach the electrodes to the skin around the painful area or you can place them along a nerve pathway. 
  • Turn on the TENS unit by making sure that its intensity is set to the lowest before you begin the therapy. 
  • Select the appropriate mode depending on your needs. Continuous mode is often used for alleviating acute pain, Burst mode is effective for treating chronic pain by stimulating the endorphin release, and Modulation mode for long-term pain relief sessions.
  • The frequency, intensity, and pulse width settings are adjusted as recommended. You should begin with lower settings and gradually increase as per your tolerance or as needed. 
  • The treatment duration for TENS therapy typically ranges from 20 to 60 minutes, depending upon the condition and tolerance of the patient. 
  • Turn off the TENS unit before removing the electrodes from the skin. Carefully, peel them off from the skin and attach them to the plastic sheet to preserve their stickiness. 
  • It is advisable to clean the skin after the session to get rid of any residue. 
  • Examine the treatment area of the skin for any redness or irritation. 
  • Do not wet the TENS unit or electrodes. Keep away from sunlight as well.
Generally, high frequency (50-150 Hz) is used in continuous mode/conventional mode to relieve acute pain, and low frequency (1-10 Hz) to relieve chronic pain by inducing muscle twitching. 

WHEN TO USE TENS?

TENS can be used in several conditions for effectively relieving the pain. Some indications have been listed below:
  • Arthritis ( Osteoarthritis or Rheumatoid arthritis)
  • Chronic back pain
  • Fibromyalgia
  • Diabetic neuropathy
  • Post-surgery i.e. postoperative pain 
  • Dental pain 
  • Musculoskeletal injuries such as ankle sprain
  • Muscle spasms
  • Myofascial pain syndrome
  • Labor pain
  • Phantom pain after amputation of a limb or body part
  • Rehabilitation

WHAT ARE THE CONTRAINDICATIONS OF TENS?

As, TENS can be used in several conditions to relieve acute and chronic pain but, there are some contraindications i.e. when you should not use a TENS unit. These may include:
  • Over the abdomen or pelvic area during pregnancy. 
  • Cardiac pacemakers
  • Metal implants 
  • Epilepsy as it may trigger seizures. 
  • Burn wounds
  • Open cuts or unhealed skin injury
  • Any skin condition ( eg. eczema )
  • Cancer
  • Fractures
  • Recent surgery

WHAT ARE THE BENEFITS OF USING TENS?

 TENS offers several potential benefits including drug-free pain relief thus, avoiding the risk of side effects of many drug therapies. It can be used to treat a variety of pain conditions, including both acute and chronic pain, muscle spasms, strains, sprains, and postoperative pain. It is portable and convenient to use and offers no or minimal side effects. It allows the users to adjust the frequency and intensity along with the duration of treatment according to their needs and tolerance. It provides immediate pain relief that leads to improved mobility and thus, helps in improving the overall quality of life.

WHAT ARE THE LIMITATIONS OF TENS?

TENS has several limitations including, temporary pain relief as it only helps in relieving the pain arising from a certain condition but, does not help in curing that condition. Its effectiveness varies from person to person depending upon the type of pain and the condition that causes it. Prolonged usage of TENS can result in skin irritation or an allergic reaction at the attachment site of electrodes. It may not provide adequate relief if the electrodes are not placed properly or do not stick to the skin completely. 
TENS is used to manage the symptoms of a condition that typically includes, pain and does not treat the underlying cause of the pain. 

ARE TENS UNITS SAFE?

TENS units are generally considered safe and effective if used correctly. While it is beneficial to take some precautions before using it for the pain associated with a specific condition. You should consult a healthcare provider before you begin with the TENS therapy. It is advisable, not to apply TENS over broken skin, eyes, face, brain, spinal cord, or near the heart.

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