![]() ![]() However, manufacturers of TENS units universally warn individuals with pacemakers, epilepsy, or are pregnant that these conditions are contraindications to use as they can lead to potential complications. Overall, for the vast majority of people, TENS is believed to be safe and well-tolerated with little to no side effects. ![]() The goal is to stimulate selectively large diameter, low threshold non-noxious afferent (A-beta). This approach enjoys use in the treatment of dermatomal pain distributions. AL-TENS aims to stimulate small diameter, high threshold peripheral afferent (A-delta).Ĭonventional TENS utilizes high-frequency, low-intensity, small pulse width. Titration is to low-frequency, higher intensity, longer pulse width. Intense TENS is used primarily as a "counter-irritant." Aiming to target small diameter, high threshold cutaneous afferent (A-delta), this type of TENS specifically seeks to block transmission of nociceptive information in nerves while stimulating other analgesic mechanisms. Both high frequencies and intensities are used for short periods of time.Īcupuncture-like TENS (AL-TENS) is an approach at hyperstimulation and often used in patients that do not respond to conventional TENS. While a significant body of work exists which suggests that TENS is effective for neuropathic, nociceptive, and musculoskeletal pain, a notable portion of these studies were noted for methodological concerns.Ī look at the three types of TENS is outlined below along with their conceptual indications. There is an overall divide across scientific literature regarding the efficacy of TENS application for particular types of pain or pain conditions. The fundamental indication for TENS is seeking to manage pain, both acute and chronic. His early work was an effort to arrive at an impactful therapy for several types of pain including migraines, back pain, and gout.Īs the study of transcutaneous electrical nerve stimulation advanced, there came new techniques inherent to the modality, such as intense TENS, acupuncture TENS, and conventional TENS. He spent several years subsequently researching spinal cord stimulators and transcutaneous electrical nerve stimulation, developing what developed into today's TENS units. After completing medical school at Duke University in North Carolina, he had additional training out of Barnes-Jewish Hospital and Massachusetts General Hospital. The TENS units and functionality as we think of it today are credited to American neurosurgeon Dr. However, it had several constraints including large size and limited adjustments. The 19th century started with one particular machine, the "Electreat," leading the way in clinical therapeutic usage of electricity in managing patient disease. By the 18th century, there were numerous devices developed to deliver electrostatic exposures with the belief of treating a wide array of conditions, from headaches to cancer, with even Benjamin Franklin being an eventual supporter. ![]() ![]() There are also ancient records of the use of electric eels for their pain management benefits - the use of electricity in managing human ailments propagated over time. The Roman physician Scribonius Largus proposed symptomatic relief to patients by having the patient be exposed and in contact with an "electric fish" from the ocean. TENS, in its earliest conceptual form, is believed to date back to approximately 60 A.D. However, while this modality of pain management has proven itself in clinical investigations, there remains to this day disagreement over which pain syndromes and conditions TENS is appropriate. Overall, the concept of TENS throughout history has been the topic of vigorous debate within scientific circles in regards to efficacy. TENS units are often highly adjustable, allowing the user to control pulse width, intensity, and frequency. Low frequency of 50 Hz are used with low intensity to produce paresthesia without muscle contractions. Compared to many medications, the device is free from the risk of overdose. It utilizes electrodes placed on the skin and which connect to the unit via wires to address a targeted therapeutic goal. The units are said to be titratable, permitting for a high degree of user tolerance with few side effects. The TENS unit is a small device, often battery-operated, which can sometimes even fit into a pocket. Transcutaneous electrical nerve stimulation, known by its acronym TENS, is a modality that uses electric current to activate nerves for therapeutic reasons. ![]()
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