Transcutaneous Electrical Nerve Stimulation

TENS stands for Transcutaneous Electrical Nerve Stimulation. It has a pulsed rectangular waveform with frequency around 150Hz. The device has electrodes which are placed on the skin in the area where you're experiencing pain. The electrical stimulation help in blocking pain signals by stimulating the production of endorphins, which are natural pain-relieving chemicals in the body. It modulates pain through presynaptic inhibition. TENS is used in physiotherapy for pain before moving towards the initiation of exercises,

Research Based Evidence on the Application of TENS

• Application of TENS in the treatment of Central Neuropathic Pain and Peripheral Neuropathic Pain is found useful. CNP is caused due to spinal cord injury, stroke, or multiple sclerosis while PNP occurs in individuals with diabetes, cancer, or herpes zoster. Favorable outcome was reported for the application of TENS in patients with CNP, which improved the analgesic, effect as compared to PNP.
• Similarly evidence suggest that use of TENS have minimum adverse like erythema and skin irritation and  vasovagal response is seen in some individuals, which presents as nausea and dizziness.
• TENS is contraindicated in patients with epilepsy, malignancy, deep vein thrombosis, cardiac pacemaker, implantable cardioverter defibrillator, spinal cord stimulators.
• Evidence supports the use of TENS in primary dysmenorrhea patients. TENS is available in many types but most commonly used are High TENS and Low TENS. Use of High TENS is recommended in PD if patent is taking certain medication ( research specifically states opioids ) as Low TENS and opioids follow the same pathway to reduce pain. TENS can also be used as a non-pharmacological therapy to reduce pain and shorten the active labor phase.

 

Indications

• Chronic pain
• Acute pain
• Musculoskeletal pain
• Arthritis pain
• Nerve-related pain (e.g., sciatica)
• Labor pain (in some cases)
• Postoperative pain management
• Osteoarthritis

• Rheumatoid arthritis

• Low back pain
• Neck pain
• Fibromyalgia
• Muscle strains
• Tendinitis
• Bursitis
• Spondylosis

Contra-indications

• near the eyes
• impaired sensation
• near carotid sinus
• cardiac pacemakers
• over an active implantable device (such as defibrillators or deep brain stimulators)
• Pregnancy (first three months)
• individuals with epilepsy or seizures (in some cases)
• open wounds