TENS

In this post I’ll be discussing Transcutaneous Electrical Nerve Stimulation (TENS), which is a therapy that falls under the heading of “other modalities”. I really like offering TENS as a treatment option because it is non-invasive, and not a medication or procedure. I’m going to explain in further detail what TENS is and how it is used, and discuss some conditions that it can be useful for.

A TENS machine is a small, typically battery powered device, that has 2-4 cables with electrodes attached. The electrodes get applied in pairs directly over the painful area, and then the patient can adjust the level of intensity of the electrical stimulation. The device can be clipped to a belt. What it feels like depends partially on the type of electrical signal used, but normally it feels like a tingling or vibrating sensation. I typically counsel people that they can use it for 15-45 min at a time, several times a day as needed.

There are different theories as to why TENS is useful, but the one that I typically talk to patients about is the idea of a gate theory. Essentially, there is only so much information that a pain signal can process at one time. If another signal is added, like tingling from a TENS machine, it can overpower or drown out the pain. Think of when you cut your finger and then instinctively shake your hand. Now you’re thinking of the shaking right? It’s the same idea. This principle is thought to be at play in spinal cord stimulation, which I’ll discuss in another series of posts. It is also possible that using TENS may prompt the body to increase production of endorphins, which are naturally occurring molecules that help to relieve pain.

I don’t offer TENS therapy to patients with pacemakers or other implantable electronic devices, patients who are pregnant, and patients who have seizures. Otherwise, TENS is very safe with minimal side effects, mainly the risk of getting a rash or allergic reaction to the adhesive pads.

What conditions TENS is best for is a little controversial. Some evidence supports its use in back pain, and musculoskeletal pain, but other studies found it is not effective in back pain. I anecdotally, in my own practice, have found it’s most often successful in patients with a lot of myofascial pain/tightness. Livia is a new device being marketed for menstrual pain that is a TENS device.

If you’re wondering if you would be a candidate for a TENS device, the best thing to do is see a pain management doctor in person! And subscribe to my blog here so you never miss a post.