TENS is an established method of treating chronic musculoskeletal pain. Usually administered daily over an extended period, its use requires strict adherence and clear instructions from users.
TENS is most effective when applied to areas of skin that aren’t irritated, and should be turned on prior to beginning any activity – and left on until you finish performing said activity.
What is TENS?
TENS is an electrical current delivered to your child via electrode patches connected to a small battery-operated unit and causes an electric current which causes a tingling sensation on their body, producing no muscle contractions or discomfort. You can adjust its strength so it feels comfortable without causing muscle contractions or hurting muscles; you can use TENS for treating labor pains, joint pains, neck or back pains, diabetic neuropathy as well as chronic conditions such as fibromyalgia.
TENS is generally safe when placed correctly, although sensitive skin or allergies to adhesives on pads could potentially make TENS irritating for some children. If this is the case with your child, removal of pads is sometimes helpful as is using gentle skin prep products like Arnica to prepare their skin in advance of using TENS.
TENS can cause irritation and swelling in the area where the pads are attached, due to pad material, conductive gel used, or tape. Furthermore, intensity level may also play a part in this phenomenon – in such instances healthcare providers may recommend changing electrode sets or decreasing intensity level to address these side effects.
TENS works by blocking or interrupting the flow of pain signals to the brain by stimulating tactile sensitivity fibers near painful regions, thus overwhelming them and closing their path to the brain.
TENS is an effective solution for anyone who wishes to avoid taking pharmaceutical drugs, has medical conditions that cannot be treated with medication alone, or who wants an alternative form of pain management. While effective, TENS cannot cure underlying pain conditions nor relieve all types of discomfort simultaneously.
TENS Intensity
TENS stands for transcutaneous electric nerve stimulation and is used to alleviate pain by stimulating nerves that send signals directly to the brain. TENS therapy can be safely used at home and for most patients; however, if you take any prescription medicines or have implanted devices it is essential that you understand any risks or contraindications of TENS therapy before proceeding with any use.
Clinically, TENS is often employed to manage musculoskeletal pain. TENS has been proven effective at reducing pain intensity across both acute and chronic pain conditions in studies conducted across both groups. Furthermore, it can reduce opioid usage post-surgery as it lowers post-operative opioid requirements while simultaneously decreasing negative opioid side effects; additionally it may improve mobility by relieving muscle spasms while helping manage postoperative opioid side effects and also be used to treat chronic pain associated with conditions like fibromyalgia or other inflammatory conditions.
TENS is designed to be customizable according to individual patient needs; thus enabling patients to control the pulse amplitude, frequency and width/duration of current. These settings play an integral role in controlling what type and intensity of stimuli reach the nervous system; furthermore, placement of electrodes on skin has an effect on its effectiveness.
Research has demonstrated that TENS increases sensitivity of the a1-adrenergic receptors found on vascular smooth muscle cells to a1-adrenergic receptors due to activation of sympathetic postganglion efferent fibers, leading to vasomotricity as well as systemic arterial blood pressure adjustments via venoconstriction (26).
TENS at low frequencies (10 Hz) has been found to increase receptor sensitivity, while high-frequency TENS has the opposite effects. Furthermore, endothelial cells in vascular walls may modulate this response through physical or chemical stimuli that activate endothelium cells that cover them, producing regulatory substances like acetylcholine, vasodilatory agents, or sodium nitroprusside (27) (Fig. 3).
TENS can sometimes produce a painful sensation; however, this is usually caused by the materials used for its pads or their placement onto your skin – changing these elements or using less conductive gel/tape will often help ease this discomfort. Furthermore, certain people may have an allergic type reaction to TENS pads and hydrocortisone cream may be beneficial in providing relief.
TENS Frequency
TENS is an electrical stimulation used to treat chronic pain and muscle spasms, including chronic joint and muscle spasms. TENS involves placing electrodes at and around acupoints (sites of pressure accumulation that cause discomfort in the body) while an electrical stimulator emits pulsed energy that activates nerve endings and increases blood flow to these sites, which in turn provides localized analgesia for patients while improving joint movement, healing, and speeding recovery timeframe. TENS may be applied on any part of the body or combined with other treatments to speed recovery timeframe.
Traditional TENS machines utilize frequencies between 80-150 Hz with short pulses for a “strong yet comfortable” sensation, while Acupuncture TENS utilizes lower frequencies (1-5 Hz with longer pulses) that is much less uncomfortable compared to its counterpart. When combined, these two techniques enhance analgesia and may prove particularly helpful in relieving muscle pain in hips, back, neck shoulders or spine areas.
Endothelial cells lining blood vessel walls have an antagonistic relationship to sympathetic nervous system efferents for controlling vascular tone (1,2). Their cells also possess incredible responsiveness to physical or chemical stimuli by synthesizing and releasing substances with vasorelaxant properties – this substance works to regulate blood vessel tone as well as interact with other parts of the cardiovascular system (2,3).
TENS can alter autonomic nervous system responses to catecholamines (4,6), altering vascular reactivity (2-5), heart rate (3-8), and systemic arterial blood pressure (9). Studies have documented these changes; low and high frequency TENS modification of a1-adrenergic receptor sensitivity within the venous plexus is shown by higher frequency stimulation increasing or decreasing it respectively – low frequency increases while high frequency decreases it.
These studies aimed to determine the sensitivity of a1-adrenergics via a dose-response experiment, using low frequency TENS treatment as a dose reduction mechanism. The required amount of phenylephrine required to achieve 70% venoconstriction percentage equal to 70% (ED70) was comparable before and after TENS application; endothelium dependent responses such as acetylcholine or sodium nitroprusside responses also did not differ substantially, although treatment caused a 53% reduction in required phenylephrine dose in order to achieve 70% (ED70).
TENS Pads
TENS therapy utilizes electrode pads placed over an area that is hurtful to send an electrical current that blocks pain signals from reaching the brain, providing soothing relief while potentially decreasing medication needs for some children or young people. Pulses produced during TENS therapy also stimulate the body’s natural production of painkillers (endorphins) that help alleviate discomfort.
TENS units are lightweight and portable devices designed to alleviate pain. While initial discomfort may occur due to buzzing or tapping sensations on the skin, you can adjust intensity as necessary until it feels more comfortable for you. After some use it may even appear less intense as your body gets used to experiencing it all over again.
As part of using your TENS unit properly, it is crucial that you follow its instructions precisely. In particular, avoid touching or rubbing against electrode pads while the machine is running as this could result in burns on your skin. Furthermore, sensitive areas of your body such as open wounds, pacemakers or intravenous lines should never come in contact with the TENS device.
Electrode pads can become quite sticky when exposed to moisture. Should this occur, remove and swab with alcohol prior to reusing them.
If you need guidance in placing the pads, consult your pain control nurse specialist for guidance. TENS pads should be placed around areas that cause discomfort or over areas in which pain signals enter your spinal cord; your pain control nurse specialist should mark these sites on body diagrams on the back page.
Change the rate and mode of your TENS unit if it becomes uncomfortable, or if you prefer different sensations. Any time you change settings on your own, remember to switch back to those set by your nurse in clinic afterwards.
