TENS (transcutaneous
electrical nerve stimulation) -
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TENS or transcutaneous electrical nerve
stimulation devices deliver electrical pulses though the skin to
the cutaneous and afferent nerves to control pain. They work on the
Gate and Endorphin Theories of pain control depending on the setting
used.
What are the Pain Control Theories?
The Gate Theory of pain control is
based on the fact the non-painful stimuli that travel quickly to the
spinal cord can block the transmission of slower-moving painful
stimuli. To increase the messages along the non-painful pathway,
techniques like massage, mobilization, compression, Stretch,
vibration, counterirritants (ie. TENS) and continuous passive motion
are all valuable.
The Endorphin Theory of pain control
involves the release of chemicals within the body called endorphins,
which have many effects on the body and assist in the regulation of
body systems. One of these affects pain relief, which is accomplished
by the release of a number of endorphins, each with their own trigger
frequency and duration of pain relief.
At a low frequency, a stimulation of 1-4 pulses per second with a TENS
unit, the body releases enkephalins. The pain relief occurs after 20 –
30 minutes or stimulation and lasts for about 4 hours. An intermediate
frequency or 15 – 128 pulses per second can release dynorphin in the
spinal cord to block pain. The pain relief takes 10 – 15 minutes, but
lasts for over an hour. A frequency of 200 pulses per second releases
serotonin. This treatment has pain relief effects immediately, but
only lasts as long as the treatment is applied.
Who can benefit from TENS?
Anyone who is suffering from:
~ Myofascial trigger points
~ Muscle, tendon, tenoperiosteal
lesions (tendonitis, muscle strain) |
~ Bone, peristeal lesion (shin splints, epicondylitis,
etc.)
~ Whiplash pain or complications |
What are the contraindications of TENS?
~ On patients with cardiac
pacemaker
~
Over the Carotid Sinus
~
In an area where tissue lacks normal sensation
~
Over the eyes
~
Over an open skin infection, lesion or on either side of a suture or
cut
~
On pregnant females (certain treatments can induce abortion) |
~
If the patient does not understand modality
~
In the epileptic or patients with seizure disorders
~
If the stimulation removes protective pain
~
Over malignant tumours or cancerous cells
~
Over the anterior chest wall in the cardiac or the elderly
~
In cerebrovascular patients
~
Within 20 feet of short wave diathermy device |
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