How long should you use a TENS unit for pain relief?
· A TENS may be used to help with many types of chronic (long-term) pain, such as: Arthritis or other joint pain Back and neck pain Fibromyalgia Muscle pain Neuropathic pain When is it best to use TENS? Research has shown that TENS is most helpful for chronic pain when used for at least 30 minutes while you are active.
What is TENS (therapy)?
How Long to Use a TENS Unit. How long your sessions last will depend on how quickly you see pain relief. It takes a while for some people, while others report getting relief nearly immediately. TENS unit sessions are typically between 20 – 30 minutes long because that's how long it takes for most people to get pain relief.
What are the best TENS unit usage best practices?
· Professionals usually suggesting making a TENS therapy session last for around 30 minutes at a time. However, there’s no real danger to longer sessions as long as you give your skin a break from the electrode pads every 20 minutes or so. One of the only risks from TENS is the potential skin irritation that can come from leaving pads on in one ...
Will a TENS unit work if I have 4 patches?
comparatively short, typically lasting only for up to a few hours post treatment. Acupuncture-like TENS Acupuncture-like or Low frequency/High intensity TENS parameters include a low frequency (usually 1-4Hz), a high intensity (high enough to produce visible muscle contractions) and a long pulse duration (~200µs). Acupuncture-like TENS primarily
What is the duration of treatment for burst TENS?
Acupuncture-like TENS (AL-TENS) Low-frequency trains or bursts (2–4Hz) of high-frequency pulses (100–200pps) are often used in clinical practice.
What TENS unit settings work best?
Set the pulse rate to between 80Hz – 120Hz and a pulse width between 175uS – 200uS. For pain you have had for more than a few weeks (chronic or persistent pain) – use the 'modulation' setting to prevent your body getting used to the stimulation, which would make the unit less effective.
How long should a TENS unit treatment last?
Mostly, the pain relief will last from anywhere between 5 minutes and 24 hours. Typically, the level of pain relief will vary depending on the type of pain and the intensity of that pain.
What is conventional TENS used for?
The purpose of conventional TENS is to selectively activate large diameter non-noxious afferents (A-beta) to reduce nociceptor cell activity and sensitization at a segmental level in the central nervous system.
What are the types of TENS?
To get the most out of your electrotherapy, you should understand the different types of TENS units and what they're used for.Transcutaneous Electrical Nerve Stimulation (TENS) ... Interferential Current Electrical Stimulation (IFC) ... Neuromuscular Electrical Stimulation (NEMS) ... Russian Stimulation.
How many types of TENS are there?
There are four varying types of TENS treatments, each offering unique properties to aid in patient healing and wellness. It's up to chiropractors to understand the difference between them and their efficacy across different situations.
What is TENS plus EMS?
Transcutaneous Electrical Nerve Stimulation (TENS) machines stimulate the nerves exclusively for the purpose of relieving pain, whereas Electrical Muscle Stimulation (EMS) machines are designed to stimulate the muscles for the purposes of strengthening and rehabilitating them.
What is the full form of TENS?
Transcutaneous electrical nerve stimulation (TENS) is a method of pain relief involving the use of a mild electrical current. A TENS machine is a small, battery-operated device that has leads connected to sticky pads called electrodes. Credit: You attach the pads directly to your skin.
How does TENS work to relieve pain?
A transcutaneous electrical nerve stimulator (TENS) sends electrical pulses through the skin to start your body's own pain killers. The electrical pulses can release endorphins and other substances to stop pain signals in the brain. TENS can reduce pain.
What should be the frequency to apply TENS?
How Often Should You Use Your TENS Machine? You can safely use a TENS machine as often as you like. Usually for 30-60 minutes up to 4 times daily. TENS can provide relief for up to four hours.
How many Hz is a TENS Unit?
Conventional TENS has a high stimulation frequency (40-150 Hz) and low intensity, just above threshold, with the current set between 10-30 mA. The pulse duration is short (up to 50 microseconds). The onset of analgesia with this setup is virtually immediate.
What are the parameters of TENS?
In the study Barbara, Amy and Lisa (2012) discussed the parameters of Electrical Stimulation (TENS) that are Frequency, Ramping of stimulation frequency, Pulse width/duration, Amplitude/ intensity. ... ... Individuals can use TENS for selfmanagement according to the severity of the treatment of the painful condition.
How long does a Tens unit last?
It takes a while for some people, while others report getting relief nearly immediately. TENS unit sessions are typically between 20 – 30 minutes long because that's how long it takes for most people to get pain relief.
How to increase conductivity of Tens unit?
Make sure to clean and dry your skin before attaching the electrodes. This will increase conductivity, increase the lifespan of the TENS unit electrode pads, and decrease skin irritation.
Can you move around while receiving tens?
If you want to be able to move around while receiving the treatment, you'll definitely want to look into wireless portable TENS units. Wireless TENS units provide pain relief in the same manner as regular units, but they run on a battery.
Is it common to overuse tens?
Problems arising from overuse of TENS units aren't common, but why risk your health? It's best to follow the instructions for your particular device just to be safe.
Can tens units be used in different sessions?
The instructions that come with your TENS unit will probably say something similar, but it's possible that they recommend different session lengths. You should always read the directions for each device before using it.
Is a wireless unit good for pain?
Also, wireless units typically aren't as powerful and a regular unit. This is ok for moderate pain, but those with severe pain might find them unsatisfactory. It would be nice if everyone could use the same settings and a particular length of time worked for everyone, but that's not the case.
What is the purpose of tens?
The type of stimulation delivered by the TENS unit aims to excite (stimulate) the sensory nerves, and by so doing, activate specific natural pain relief mechanisms. For convenience, if one considers that there are two primary pain relief mechanisms which can be activated : the Pain Gate Mechanism and the Endogenous Opioid System, the variation in stimulation parameters used to activate these two systems will be briefly considered.
What is a tens in acupuncture?
Acupuncture TENS (Lo TENS, AcuTENS) Use a lower frequency stimulation (2-5Hz) with wider (longer) pulses (200-250ms). The intensity employed will usually need to be greater than with the traditional TENS - still not at the patients threshold, but quite a definite, strong sensation.
What nerves are stimulated by acupuncture?
Stimulation of appropriate nerve root (s) Stimulate the peripheral nerve (best if proximal to the pain area) Stimulate motor point (innervated by the same root level) Stimulate trigger point (s) or acupuncture point (s) Stimulate the appropriate dermatome, myotome or sclerotome.
How many bursts per second in a tens machine?
As described above, the machine is set to deliver traditional TENS, but the Burst mode is switched in, therefore interrupting the stimulation outflow at rate of 2 - 3 bursts / second. The stimulation intensity will need to be relatively high, though not as high as the brief intense TENS – more like the Lo TENS. It is proposed that the application of BURST mode TENS can effectively stimulate both the PAIN GATE and the OPIOID mechanisms simultaneously.
How to stimulate both nerves at the same time?
A third possibility is to stimulate both nerve types at the same time by employing a burst mode stimulation. In this instance, the higher frequency stimulation output (typically at about 100Hz) is interrupted (or burst) at the rate of about 2 - 3 bursts per second. When the machine is ‘on’, it will deliver pulses at the 100Hz rate, thereby activating the Aβ fibres and the pain gate mechanism, but by virtue of the rate of the burst, each burst will produce excitation in the Aδ fibres, therefore stimulating the opioid mechanisms. For some patients this is by far the most effective approach to pain relief, though as a sensation, numerous patients find it less acceptable than some other forms of TENS as there is more of a ‘grabbing’, ‘clawing’ type sensation and usually more by way of muscle twitching than with the high or low frequency modes.
How many Hz does a Tens machine have?
To be clinically effective, it is suggested that the TENS machine should cover a range from about 2 – 150 pps (or Hz).
What is tens in medical terms?
TENS is a method of electrical stimulation which primarily aims to provide a degree of symptomatic pain relief by exciting sensory nerves and thereby stimulating either the pain gate mechanism and/or the opioid system. The different methods of applying TENS relate to these different physiological mechanisms.
How long does a Tens session last?
Professionals usually suggesting making a TENS therapy session last for around 30 minutes at a time. However, there’s no real danger to longer sessions as long as you give your skin a break from the electrode pads every 20 minutes or so.
Is electrotherapy portable?
While units used to be made strictly for use in professional settings, now there are portable, home-use options. With the increasing popularity of electrotherapy comes a slew of questions about how it works. One question that we get a lot at iReliev is: How often can you use a TENS unit?
Can you become addicted to Tens?
Since TENS does not enter the body in any way, it does not have what it takes to be addictive in any way. Therefore the answer the last of the sample questions above is simple. There is no limit to how much TENS one can use before becoming addicted because there is no addiction involved with TENS.
Is Tens a prescription drug?
Every pain killer, whether over the counter or prescription, has a specific safe dosage that should not be exceeded. However, TENS is not like these drugs at all. TENS is an extremely safe and non-invasive alternative to these pain killers.
Is it safe to use tens?
When you’re using a home-use TENS device as instructed, it’s safe to use TENS as often as you need. With that answer in mind, it may be that TENS is more effective for certain patients with more frequent uses. Remember, TENS also encourages the release of endorphins with each use, which work as the body’s natural painkiller.
What is TENS protocol?
This protocol aims to provide an overview of Transcutaneous Electrical Nerve Stimulation (TENS), the choice of stimulation parameters and a guide to its application. The information on this website is primarily aimed as a guide for clinicians who want to use TENS for pain management. It should be stressed that this protocol is not designed to be exhaustive; for more detailed information on TENS, the reader is directed to a number of references at the end.
What is the intensity of a tens unit?
Intensity refers to the magnitude of current or voltage applied by the TENS unit. TENS units are typically designed with a constant current or constant voltage output. Basically this means that either the voltage or current (respectively) will vary to maintain a constant current or voltage amplitude (within limits) as the impedance (resistance) of the electrode-patient system changes. The intensity of a constant current unit is measured in milliamps and the intensity of a constant voltage unit is measured in volts.
What is a tens modulated output?
The modulated output means that there is a variation in either pulse duration, frequency or amplitude parameters in a cyclic fashion. Indeed, some units have modulation of two or all three of these parameters. If the output is set for amplitude modulation, a cyclic modulation in amplitude is produced which increases from zero to a pre-set level then back to zero again. This choice of modulated output has been included by manufacturers apparently to overcome accommodation of nerve fibres and to provide more comfort to the patient.
What is the unit of pulse duration?
The unit of pulse duration is usually given in microseconds (µs) which are units of time, hence it is more correct to use the term ‘duration’ rather than ‘width’. The pulse duration is usually defined as the duration of only the positive component of the waveform. TENS pulse durations are in the µs range (1µs = 1 x 10-6s).
What is tens in electrical?
TENS is a pulsed current, i.e. a current in which the unidirectional or bidirectional flow of current periodically ceases over time.
What is the action potential of tens?
An action potential (nerve impulse) is initiated in the underlying nerve fibres by the flow of current between two TENS electrodes. TENS is believed to relieve pain by several mechanisms which involve the stimulation of specific types of nerve fibres:
Can you wet a self adhesive electrode?
Self-adhesive electrodes can be wet with a few drops of water and then let air dry to increase their adhesiveness. It is important to follow the manufacturer’s instructions for this procedure.
Definition
- TENS is a method of electrical stimulation which primarily aims to provide a degree of symptomatic pain relief by exciting sensory nerves and thereby stimulating either the pain gate mechanism and/or the opioid system. The different methods of applying TENS relate to these different physiological mechanisms. The effectiveness of TENS varies with th...
Availability
- TENS is most commonly delivered from small, hand held, battery powered devices. They can be purchased 'over the counter' in many (but not all) countries. In some locations, they need to be 'prescribed' by a therapist, doctor or other healthcare practitioner. Most multi-modal clinic based stimulators include TENS as an option, though its use in the clinic is less well supported than its …
Uses
- It is interesting that in therapy practice, the majority of practitioners consider TENS as a treatment options in circumstances when a patient is experiencing CHRONIC pain. This is not a problem as there is a significant evidence base to support this mode of application. There is however, a significant and growing body of evidence that supports the use of TENS as a valid and effective …
Operation
- In addition, most modern machines will offer a BURST mode (D) in which the pulses will be allowed out in bursts or trains, usually at a rate of 2 - 3 bursts per second. Finally, a MODULATION mode (E) may be available which employs a method of making the pulse output less regular and therefore minimising the accommodation effects which are often encountered with this type of …
Advantages
- Most machines offer a dual channel output - i.e. two pairs of electrodes can be used simultaneously. In some circumstances this can be a distinct advantage, though it is interesting that most patients and therapists tend to use just a single channel application. Widespread and diffuse pain presentations can be usefully treated with a 4 electrode (2 channel) system, as can …
Characteristics
- The pulses delivered by TENS stimulators vary between manufacturers, but tend to be asymmetrical biphasic modified square wave pulses. The biphasic nature of the pulse means that there is usually no net DC component (often described in the manufacturers blurb as zero net DC), thus minimising any skin reactions due to the build up of electrolytes under the electrodes.
Mechanism of action
- The type of stimulation delivered by the TENS unit aims to excite (stimulate) the sensory nerves, and by so doing, activate specific natural pain relief mechanisms. For convenience, if one considers that there are two primary pain relief mechanisms which can be activated : the Pain Gate Mechanism and the Endogenous Opioid System, the variation in stimulation parameters us…
Mechanism
- A third possibility is to stimulate both nerve types at the same time by employing a burst mode stimulation. In this instance, the higher frequency stimulation output (typically at about 100Hz) is interrupted (or burst) at the rate of about 2 - 3 bursts per second. When the machine is on, it will deliver pulses at the 100Hz rate, thereby activating the Aβ fibres and the pain gate mechanism, b…
Administration
- Usually uses stimulation at a relatively high frequency (80 - 130Hz) and employ a relatively narrow (short duration) pulses though as mentioned above, there is less support for manipulation of the pulse width in the current research literature. Most patients seem to find best effect at around 200ms. The stimulation is delivered at normal intensity - definitely there but not uncomfortable. …
Performance
- This is a TENS mode that can be employed to achieve a rapid pain relief, but some patients may find the strength of the stimulation too intense and will not tolerate it for sufficient duration to make the treatment worthwhile. The pulse frequency applied is high (in the 80-130Hz band) and the pulse duration (width) is also high (200ms plus). The current is delivered at, or close to the t…
Example
- The diagram below shows stimulation (at around 100Hz) delivered in BURST mode (at 2-3Hz) such that both the A Beta (due to 100Hz) and the A delta (due to 2-3Hz) are stimulated
Variations
- In modulation mode, the machine delivers a less regular pattern of TENS stimulation in an attempt to reduce or minimise the accommodation effects of regular, patterned stimulation. Machines offer different methods of varying the stimulation pattern some vary the frequency, some vary the intensity and some vary the pulse duration, and some machines offer a choice between these m…
Treatment
- Stimulation Intensity : As identified above, it is not possible to describe treatment current strength in terms of how many microamps. The most effective intensity management appears to be related to what the patient feels during the stimulation, and this may vary from session to session. As a general guide, it appears to be effective to go for a definitely there but not painful level for t…
Management
- If the pain source is vague, diffuse or particularly extensive, one can employ both channels simultaneously. A 2 channel application can also be effective for the management of a local + a referred pain combination one channel used for each component. The low frequency (Acupuncture like) TENS can be effectively applied to the contralateral side of the body.
Contraindications
- It has been widely cited that application of the electrodes over the trunk, abdomen or pelvis during pregnancy is contraindicated BUT a recent review suggests that although not an ideal (first line) treatment option, application of TENS around the trunk during pregnancy can be safely applied, and no detrimental effects have been reported in the literature (see www.electrotherapy,org for …
Bibliography
- Robertson, V. et al (2007). Electrotherapy Explained. Elsevier. Walsh, D. (1997). TENS: Clinical Applications and Related Theory. Edinburgh, Churchill Livingstone.
Selected publications
- Ainsworth, L., et al. (2006). \"Transcutaneous electrical nerve stimulation (TENS) reduces chronic hyperalgesia induced by muscle inflammation.\" Pain 120(1-2): 182-7. Alves-Guerreiro, J., et al. (2001). \"The effect of three electrotherapeutic modalities upon peripheral nerve conduction and mechanical pain threshold.\" Clin Physiol 21(6): 704-11. Bjordal, J. M., et al. (2007). \"Short-term …