Physical Therapy Modalities And Durable Medical Equipment: Transcutaneous Electrical Nerve Stimulation (Tens)

iStock-537527362Perhaps you have been receiving physical therapy treatment and have heard your therapist use the word “TENS” while working with you or have been given a TENS unit for home use. Or maybe you have seen the Icy Hot commercials advertising their new Smart Relief Tens. TENS stands for “Transcutaneous Electrical Nerve Stimulation” and is quite simply another modality in the tool box of your physical that they can use to help provide you with additional pain relief. So without further ado, let’s take a closer look at how TENS works.

HOW DOES TENS WORK?
Explaining how TENS works can be quite a confusing process. There are two major pain relief mechanisms that can be activated by using TENS: the “Pain Gate Mechanism” and “Endogenous Opioid System”. To keep it simple and as easy as possible, we will only look at the “Pain Gate Mechanism” and break it down into simpler terms that everyone can understand.
In your body, you have different nerve fibers that are sensitive to different sensations. For example, you have nerves that are sensitive to touch/feeling and also nerves that are sensitive to pain. When the electrodes from the TENS unit are placed on your skin and the current is turned up, the nerves that are susceptible to light touch become “excited” and start sending signals to your brain letting it know you’re experiencing this sensation. By stimulating an abundance of these sensation nerve signals, this will help reduce the transmission of the pain nerve signals being sent to your brain, reducing your pain levels! Additionally, the nerves designed to experience sensation such as light touch travel much faster to the brain than do the pain nerve signals thus “gating out” the pain nerve signals and reducing your pain levels. This is the same principle as to when you hit your elbow on a table and start to rub it and you notice a decrease in pain!

CONTRAINDICATIONS/PRECAUTIONS TO TENS USE
***Disclaimer*** These are just some of the common contraindications and precautions. For further questions, please ask your physical therapy before application!
• Electrodes applied over the trunk, abdomen or pelvis during pregnancy
• Use of TENS for an individual with a pacemaker
• Electrodes applied over the anterior aspect of the neck or carotid sinus
• In areas of abnormal skin sensation
• Electrodes applied over the eyes or mouth
• Electrode application over areas of dermatitis, eczema, or open wounds
To sum things up, TENS is another adjunct that you can use during your treatment to help relieve your pain and possibly have a faster recovery time! I’ve personally had patients wear units while exercising to be able to tolerate an increase in exercise program to help return to the maximum functional capacity a lot faster. Portable TENS are being more common nowadays and are easily available for consumers. However, these units are often confusing and often do not properly instruct you on using your machine the right way. Feel free to ask any of your Physical Therapists or Physical Therapists Assistants here at Advanced PMR if you have any questions regarding TENS or would like to have it added as part of your plan of care if you aren’t currently!

Also, be sure to be on the lookout for the next installment in this series coming out in a few weeks regarding the use of Ultrasound!

Posted in: Physical Therapy

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