It
is the application of low frequency pulsed rectangular current through
skin to reduce pain. A small battery machine is used to generate a
current having specific stimulatory effect.
Parameters of TENS:
Pulse shape: Rectangular
Pulsed width: Measured in microseconds and often 100 μs or 200 μs
Pulse frequency: As low as 2 Hz and as high as 600 Hz but usually fixed i.e. 150 Hz.
Pulse intensity: Vary from 0 – 60 mA.
- High TENS: High frequency and low intensity
Frequency 100 – 500 Hz
Pulse width 100 – 500 μs
Intensity 5 – 30 mA
- Low TENS: Low frequency and high intensity
Frequency 1 -5 Hz
Pulse width 100 – 250 μs
Intensity more than 30 mA
Electrode placement:
- Area of greater intensity of pain/near
- Trigger or motor point
Advantages of TENS:
- It is non – invasive, portable and non addictive.
- It is cheaper than regular analgesics.
- It has few contraindications and precautions
- It has changeable battery and electrodes.
Disadvantages of TENS:
- Number of patients fails to tolerate the electrical stimulation.
- Skin irritation may occur due to allergic reaction.
- Chemical burn is also a disadvantage of TENS.
Indications of TENS:
- Chronic pain syndrome
- Phantom limb pain
- Reflex sympathetic dystrophy
- Post operative conditions
- Obstetric pain
Contra indications:
- Continuous TENS may result some electrolytic reaction below the skin
- Pacemakers
- First three month of pregnancy
- Hemorrhagic conditions
- Open wounds
- Carotid sinus
- Over mouth
- Near eyes
Treatment method:
A patient may have a single daily treatment of 40 min duration. Portal TENS can be used continuously for 24 hrs.
Modes of TENS:
a. Conventional TENS:
It is the most commonly used mode of TENS. It can be used for both Acute and Chronic pain.
Mechanism of Action:
Stimulation of large diameter through pain gate control theory
- Frequency 100 – 150 Hz
- Intensity 12 – 30 mA
- Pulse width 50 – 80 µs
b. Acupuncture like mode:
Mechanism of Action:
The stimulation of small diameter nerve fibers to release endogenous opiods
Parameters:
- Frequency 1 -5 Hz
- Intensity above 30 mA
- Pulse duration 150 – 300 µs
c. Burst mode:
This mode has characteristics of both high and low TENS. The pain control is through both routes.
Parameters:
- Frequency 50 – 100 Hz but the frequency is delivered in packets of 1 – 4 Hz
- Pulse duration of 50 – 100 µs
- Intensity below 30 mA
d. Brief intense TENS:
It has rapid onset but for short term. Clinician used it for wound debridment, joint mobilization and contracture.
- Frequency 80 – 150 Hz
- Pulse duration 50 – 250 µs
- Intensity according to tolerance of patient
I have to say I love my TENS unit--it has truly been one of the best investments for coping with my chronic pain. I typically use my unit all day long, as this provides the best pain relief for me.
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ReplyDeleteTENS machine work by sending electronic stimulating pulses across the surface of the skin and along the nerve strands. The stimulating pulses help prevent pain signals from reaching the brain.
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