- Hi, I'm Bob Schrupp, physical therapist.
- Brad Heineck, physical therapist.
- And together,
we are the most famous physical therapists,
on the internet.
- In our opinion, of course.
- Today, we're gonna talk about the T.E.N.S. unit.
- Sure. - Just very quickly,
three things that everybody should know.
One, the first thing you should know is how does it work?
T.E.N.S.? What are you talking about in a T.E.N.S. unit?
Transcutaneous Electrical Neuromuscular Stimulation.
- That is a mouthful.
- Yeah.
- Let's stick to T.E.N.S.
- Yeah. Let's stick to T.E.N.S..
It's basically a little electrical unit,
that's gonna give us some electrical impulses.
And what you do is you actually,
can you see this, Nancy?
- [Nancy] Uh huh.
- Here's the unit here.
And it's very simple to use.
You just push this on button and then,
you can see it came on. - [Nancy] Back up a little.
- Back up, Nancy says. - [Nancy] Yeah.
- Get up, back up. - [Nancy] laughing.
- And then, you actually just push which mode you want.
And then, this has got one lead hooked up to it, right now.
You just go up and then keep pushing it until
you start feeling it.
You're gonna feel a little, what tingling, right, Brad?
- Yep. Pins and needles,
a lot of people refer to it as that.
- Okay, we're coming back, we're coming back.
- Back, back.
- Okay, so these electrodes,
Brad, can I have a forearm?
- Yes, please.
- These electrodes,
just pop 'em on.
Let's say he's having forearm pain.
You would put the electrodes right over the pain, itself.
Now you can see this one's already
starting not to stick, a little bit.
- Been used. - Yeah.
Sometimes a little bit of water helps keep 'em on.
But, the electrodes do not last forever.
You're gonna need, quite often,
a new set of electrodes after a while.
So, we took this on, we push it up.
Now, what that's doing,
let's get away from that, now.
What's happening, when those electrodes,
when you have pain,
that pain,
the message of pain is sent up to the brain
via the nerves, right?
- This is a pretty basic drawing here.
- So, of course, again,
we're not gonna get into heavy neuroanatomy, here.
- Right.
- So basically what we do is,
we're gonna send little impulses,
this sends little impulses that are supposed
to try to cut off that nerve pathway.
- Sure.
- And that message is no longer getting up to the brain.
It's also theorized that it might be
creating some natural opiates in your brain.
- Yeah.
- So that's how it works.
We'll go to now,
the second phase of this.
The second thing that you should know
about the T.E.N.S. unit,
which is, who should use it.
- Right.
- Okay.
The second thing that everyone should know
about a T.E.N.S. unit is who can use it.
Who is it for?
And first off, Brad,
I'd say, as physical therapist, generally,
this is a treatment of last resort.
- Right. - You agree?
- Right.
- We've tried everything else, first.
We've tried manual therapy.
We've tried other modalities,
maybe ultrasound or something like that.
It's just not working.
It's not getting better.
It's been chronic pain.
And these are, I'd say one person who,
one sort of group of people that can use it
are people who have been using a lot of medication.
They're trying to get their medication down.
- Right.
Or they have medication that's working,
but there's side effects to their liver,
- Sure. - to their stomach.
So they cannot use a medication.
They need some alternative.
- So I would say, let's start going down the list, Brad.
- Alright.
Arthritis. - Arthritis.
Yep. So you can put on there.
You're not having surgery yet.
Fibromyalgia, good one.
They're having pain everywhere,
no way to control it.
- Low back pain.
You got chronic low back pain.
You just cannot get rid of it.
That's probably where
I've used it the most with the T.E.N.S.
- Same with me, yeah.
I've had probably 50% success with it.
Brad, you thought maybe a little less.
- Yeah.
Oftentimes it can work, but you've got the leads
and it has to, you know, the mechanics of using it,
the leads get in the way and whatnot.
- It does, the leads,
it does clip onto your belt.
So it is, where's? (laughing) - Oh, we lost it.
- Anyway, it does clip onto your belt.
- Right. - It works pretty well.
We'll find it in just a minute.
The third thing is, where we're at,
neck pain would be another one.
- Sure. - And same thing.
Chronic neck pain. - Right.
- Bursitis, cancer pain,
as long as you're not putting it right over
the area that considers to have the tumor.
But, let's say you're having pain down your arm.
- Right.
- You could use it for cancer pain.
They have used this for labor pain, at times.
This isn't something we get involved with, but-
- Right.
- I've heard in the past they've used.
A lot of neurological symptoms,
this is where I think it's great for.
I've had some stroke patients who have used this.
Who have- - Sure.
- had some of that,
kind of phantom pain.
- You hear that.
- And also, the studies have shown that this
actually works pretty well with neuropathy.
You know, the pain in your legs from-
- Diabetes. - diabetes.
- Um hmm.
- Now, if you have numbness, obviously,
you can't use it,
because what could happen is
you could actually get some burning
from the pads and not even know it.
- Sure. - You know what I mean, so-
- You turn it up too high and not know it.
- Right.
- That'll never happened on normal skin.
So you don't have to worry about electrocuting yourself,
by any means.
- Before, by the way, before we go
into who should use the T.E.N.S. unit.
The way, generally the way you're gonna do this,
is you're gonna go to get a prescription from your doctor.
And you're gonna go to your physical therapist
and they're gonna give you a unit
to take home and try.
- Right.
- So that's the best way to do it.
Now you can,
I've seen these that you can buy these online.
- Um hmm.
- But I don't think they're very strong.
And some of 'em are very deceptive.
They're actually not T.E.N.S. units.
They're EMS units, more the muscle stimulator units.
- Sure.
- And those are totally different things.
Now they may help you with a different way,
but they're not a T.E.N.S. unit.
- Right.
- Alright. Why don't we, Brad?
Why don't we talk about who's not supposed to use.
- Okay.
- Alright.
If you have a pacemaker or defibrillator.
- Mmm.
- You're definitely not gonna wanna put this over that area.
I wouldn't even use it at all.
- Right. If a patient had that,
I just don't even think about it.
- Alright, Brad, is this a hint?
- Yeah.
- Don't work it on your eyes.
- Oh, I thought you meant your glasses. (laughing)
- Over your glasses, either. - Killing me.
- If you're having a headache,
you're not supposed to put it on your temples, like this.
- Right. You bet.
- Okay.
You're not supposed to put it
on the front of your neck,
on your carotid arteries.
There's some little sensors in your carotid arteries
that could knock off everything.
- Yeah. It throws off your blood pressure, in fact.
- Don't put it through your chest.
In other words, one in the front, one in the back.
- (laughing) Yeah. - Okay.
- You know, Bob thinks it's funny,
but you know, someone might do this kind of thing.
- Brad, say ah.
- Ahh.
- Don't put it internally.
- Alright.
- By internally, we also mean,
- Rectally
- down there. - Cavities, cavities.
- Okay. Don't put it on fragile or broken skin.
- Right.
- Don't put it on infectious skin.
That's more of, the worry is that,
you could put it on here and then you could
spread it to something else.
- Sure.
- Cause the infection would be on here.
- Mm hmm.
- Do not put it over a tumor.
They have found that this actually could help a tumor grow.
- Right, yeah.
- So, what else am I missing, Brad?
I would avoid, oh, this is a standard one.
Do not put it-
can you face this way, Brad?
Do not put it directly on the spinal cord, itself.
- Right.
So right on the spine.
We put 'em right on the sides of the spine.
- Right.
- On the muscles.
That's where if you're having pain, you put it.
Do not put it,
I would not use it on a pregnant person.
- No. - I just wouldn't do it.
- That's off my lap, mine too.
- And I wouldn't do it on somebody with epilepsy, either.
- Just... - Right.
- Who knows that it might trigger.
- So, that's it Brad.
That's the three things you should know.
You should know how it works.
You should know who to use it for.
You should know who shouldn't use it.
- Right.
- Alright.
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because Bob, tell him.
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- Vibrant is the word. - I used your word say, Brad.
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