Are you interested in learning more about using a TENS unit for controlling pain?
If the answer is, “yes”, then you’ve come to the right place!
In this video, I’ll provide an overview of TENS and how it works to reduce pain.
But I’ll also tell you how to know when it may not be a safe option for you.
And finally, as someone that has trained hundreds of physical and occupational therapists on TENS,
I’ll provide you with easy to understand examples of how you should expect TENS to feel for you.
And because there is so much information on how to use a TENS unit with different conditions,
I’ll also share with you my plans for making a series of upcoming videos on this topic.
My name is Kevin and I want to thank you for checking out this video. So let’s talk about
TENS units today. While they are sold over the counter and are generally safe to use,
they could cause injury if not used properly. As a doctor of occupational therapy,
I’ve treated countless patients and trained many therapists on how to safely use them.
I will share with you valuable information to help you to better understand TENS units
and how they work, but without knowing your unique situation, this information should not
be seen as a replacement for consulting with your doctor or therapist. However,
as the basis of any good healthcare visit, this information can help you start a good discussion
with your provider based on your situation and hopefully result in a more productive visit.
So what is TENS? Well, TENS stands for transcutaneous electrical nerve stimulation and
as the name tells us, it is a form of electrical stimulation, also commonly called estim,
that is used for pain. TENS can be delivered in the more powerful, complex units you may have seen
in a therapy clinic or in the battery-operated portable devices that can be used at home.
For today’s discussion, we will be talking about the portable units that are used at home.
TENS works by delivering low voltage electrical current to the tissue where the pain is
through electrodes that are placed on the skin. If done correctly, it feels very comfortable—no
shock therapy going on here! So why would anyone want to use TENS instead of
proven medications for pain? Well there a lot of reasons—primarily that medications, prescription
or over the counter, can cause unwanted side effects starting with more mild issues such
as upset stomach to more dangerous issues such as increased bleeding and dependence. And in today’s
world where opioid addiction and the overdose deaths that result from it are at crisis levels,
Congress has passed bills looking to maximize non-pharmalogical approaches for pain relief.
Estim or TENS would be an example of such an approach; this type of treatment has been around
for many years, has been supported in random clinical trials, and has been approved by the FDA.
So it’s now time to ask, how does TENS actually work to reduce common types of pain?
Today, we’ll focus on how TENS acts to reduce general peripheral neurological pain or what
some people call ‘nerve pain’; to keep is simple, this will cover a general perception
of pain that is not caused by active swelling or inflammation—that type of pain is treated
differently with estim, so we’ll cover that condition separately in an upcoming video.
But as far as answering the question of how TENS can reduce general pain, well,
research has identified 2 different mechanisms on how it works…and those mechanisms can be leveraged
on a portable TENS unit based on the settings that are selected. The first mechanism is referred to
as Gate Control. Without getting too deep into the physiological details as to how it works,
what the estim is basically doing is providing a new sensation to overwhelm the pain sensation.
So think about a time when you accidentally hit your thumb with a hammer…or stubbed your toe
hard when you didn’t have shoes on—what is the first thing you do? Besides for screaming out
something that isn’t suitable for this channel !—if you’re like most people,
the first thing you do is to grab and squeeze the thumb you just hammered or squeeze the toe you
just stubbed…and the reason you automatically do that is because you subconsciously are providing a
sensation to overwhelm the pain. While a squeezing sensation doesn’t normally feel great, it feels a
whole lot better than the thumping of the pain caused by hitting that hammer on your thumb.
TENS, using a gate-control setting, seeks to do the same thing—which is to overwhelm the
pain using a new sensation. With TENS, this feels more like a tingling sensation—again,
while it doesn’t necessarily feel fantastic, it’s a lot better than feeling the pain you have.
In my experience, there a few people that absolutely don’t like that sensation it provides,
although I find if I tweak the settings they can usually tolerate it. However, I find most people
really like the sensation because it masks the pain and with the right setting can almost feel
like a massage. And even if it doesn’t completely mask the pain, it still should take the edge off.
The Gate control setting is good for acute or new injuries and provides immediate pain relief.
However, once the TENS is removed, the pain relief effect goes away pretty quickly.
The other major way estim can be set up to control general pain is through an opiate-mediated
mechanism. Again, without getting too deep into the physiological details as to how it works,
what the estim is doing is basically promoting the body to release endorphins.
You probably have heard of endorphins, most likely in relation to exercise,
and may know them as the body’s natural pain killers. Sometimes you’ll hear someone say how
they just started exercising a couple of weeks ago and say how much better they feel. The truth
is that, in two weeks, they’re not already in great shape, but the exercise has facilitated
the release of endorphins and that’s why they are feeling better. TENS attempts to mimic exercise,
when maybe you’re in too much pain to actually exercise, by setting up the estim to provide
a muscle twitch. How I would describe it would be as a tapping sensation—it doesn’t hurt, but
over time it can feel a bit noxious—think about a little kid hitting you in the arm over and over,
it doesn’t hurt, but it can get irritating. If I have someone that doesn’t like the sensation,
I can generally tweak the settings so that it doesn’t bother them or at least bother them so
much. The Opiate-mediated mechanism is really good for chronic pain; think of conditions
such as arthritis or neuropathies, where by releasing endorphins you can start to feel better
and then can become more active which will then release more endorphins without the use of TENS.
This mechanism will not provide immediate relief, but its effects are longer lasting
than using the Gate Control mechanism, lasting up to 6 to even 8 hours after the TENS is removed.
TENS can be safely used for most people but you want to make sure it is safe for you.
Again, this video is not to replace any advice your doctor or therapist can give you based on
your specific medical history. Having said that, one thing I would always advise on is
looking at the TENS unit’s owner manual and refer to the contraindications section which
tell you conditions where you should absolutely not use the device. You also should review the
warnings and precautions which will tell you if you should consider not using the TENS unit or if
you could use it, but by using extra caution for the particular device you have—this is important
for safety and liability purposes. While this is not an exclusive list, what I can tell you
is that common contraindications for TENS units are to not use it on someone with an implanted
electrical device such as a cardiac pacemaker, not to use directly over sites of active cancer,
not to use over the front of the neck and also to not to have the current go through the
head…after all, this is not electro-convulsive or shock therapy that we’re doing here!
Hopefully that gives you a better understanding of how TENS works. In the next video in this series,
I will share with you tips on what to look for in buying a good, low-priced TENS unit if you are
looking to buy one out of pocket; there are a lot of options, but I want to make sure that you get
one that is easy to use, but also has a good bit of functionality without spending a ton of money.
After that, we will cover how to set-up a TENS treatment safely then discuss how your TENS unit
can be used for different conditions with each condition having its own video. So definitely
subscribe to the channel and hit that notification bell so you don’t miss any of these upcoming
videos. And if there is a specific condition you would like to learn how TENS might help,
please add that in the comments sections. I hope you have found this information helpful,
and if you did, once again, please subscribe to the channel.
As always, I hope that we can all learn from each other on how to take little, easy steps in making
big improvements in our lives. Thank you again for watching and until next time, have a great day!