Have you heard of TENS? Transcutaneous Electrical Nerve Stimulation
is a type of electrical current that is applied to the skin to stimulate the
peripheral nerves and relieve pain. There are some types of pain that
respond really well to TENS, mostly acute pain like pain after an injury,
trauma, post-surgical and menstrual cramps. Today I’ll explain how you apply this modality
to get the most of your TENS machine. So, let’s talk about TENS today
Before I continue, let me remind you that this video is not intended to replace medical advice.
It is for educational purposes only. You should contact your
doctor for a proper diagnosis and treatment plan for you.
In case of emergency, go to the nearest emergency department or call an ambulance.
TENS is a machine that delivers low voltage electrical current that has some specific patterns
and frequencies to be able to reduce pain. We don’t know how exactly TENS works to reduce
acute pain, but there are many reports that TENS is effective to treat acute pain, mostly after an
injury to a tendon, muscle, bone or ligament. Also post-surgical pain and menstrual cramps. There
are patients who use TENS for headaches, neck pain, neuropathic pain and diabetic neuropathy.
I usually suggest them to try TENS before they buy the equipment. And if it works,
they can use the machine everyday. There are no side effects with TENS
There are some people who should not use TENS, if they have some electrical devices implanted
in their body, for example a pacemaker, a brain stimulator, a spinal cord stimulator,
and people who have epilepsy should now apply close to the neck or head.
TENS should not be applied in areas of the skin that there are
wounds or infections. The skin has to be healthy and intact.
You can purchase the TENS device in almost every pharmacy in Canada.
In other parts of the world, maybe you need to ask a physiotherapist how you can purchase one.
I’ll put some links in the description of this video below of some machines that you can purchase online.
This video is not sponsored by any maker of TENS machine.
I bought my machine maybe 10 years ago, when I was at a pain conference. I really
like it and I use it almost every time that I have an acute pain episode.
The machine is small, and it has a rechargeable battery.
I tell my patients, if you apply TENS and it relieves your pain, then you may leave that in the
skin as long as you want. So, if you can, you can carry the device in your pocket. The problem is
that your body will adapt to the current in about 30 minutes, and then the pain will return. That is
why it is important to buy a machine that you can have many options of frequencies and wave shapes.
TENS current can be of two types, high frequency,
which is around 100 Hz, or low frequency which is around 2 Hz.
High frequency TENS is known as conventional TENS. It is a pleasant current and does not
bother the person. You feel the shock and stop feeling the pain. The pain relief is
almost immediate. And as soon as you turn the machine off, the pain immediately comes back.
Conventional TENS works by competing with the painful sensnation at the spinal cord.
This is known as the gate control theory. There is only one gate to send an impulse to the brain,
if you use that gate to transmit the electricity from TENS, then, the painful sensation is blocked.
Low frequency TENS is known as acupuncture like TENS. It is a bit unpleasant you feel like needles
entering the skin. This type of electrical current activates areas of the brain that are similar to
the areas activated by acupuncture. These areas in the brain will produce endorphins and therefore,
the effects of this TENS will last for hours or many days after the machine is turned off.
Here is the TENS machine.
so you see this is the tens machine that I have. It's small like a cell phone. When I turn on,
you see that it has all these different types of options here. This one here is to select which
type of mode. It changed to acupuncture-like mode. And number three. Each one of those is a
different type of current, some of them are high frequency, some are low frequency. And then what
we have here are the two channels. So, it is asking for the channel. First, the channel A.
So, what I'm going to do, this is channel A here. So connect this channel A here.
So it's linked to these pads here, so then what I do is I just connect to one pad and the other one,
so then I can connect the second channel here, would be
here channel B and then I can put other pads around the body.
so here another pair, so this is pair B and this is pair A, right? And so each one of those pairs,
we will attach to different parts of the body, so the current will go from this to
this, the one that I will adjust the intensity here, on the, So channel A is blinking now,
so it's controlling these two pads here, this channel, and then if I change here, A or B,
now it's blinking B, so this means that the i'm controlling now the intensity of the this channel,
or this two pads. So the way it works is, I attach the pads to a body part that I'm going to treat.
So let's say that I have pain here. let's say that it's a tendinitis here. so I attach the pads here.
In here right? let's say that I want to treat this area of pain,
and I'm using these ones are attached to channel B, so what happens you see, channel B is blinking,
so now I am going to increase the intensity and here is increasing, and now I'm feeling,
I'm feeling now, the I'm feeling this like a needle coming through my skin,
here, but it's not uncomfortable, it's not pain, it's just an electrical shock,
and I can increase the intensity. If I keep increasing the intensity, here you see? so this
channel B is increasing and the higher I go the more I feel, so this would be enough, oh
there is some muscle contractions here, so when you see some muscle contraction,
like you are seeing here, this is not TENS, this is electrical muscle stimulation, so I need to
choose a different type of mode, here, so I choose this in the M, the mode, so now, it goes to four,
and you see when you change to a different mode of electrical stimulation it automatically the
intensity goes to zero, and you have to start increasing the intensity all over again. So
now I’m feeling a different type of current. This one you see? There is no muscle contraction. I'm
not moving the muscles and what I'm feeling here is exactly like this, it's like a ball rolling,
like a roll going from here to here. So it's just going like a roll, and it's pleasant, it's nice,
and I can increase the intensity, oh this is a little too much, yeah, this is high already,
and i'm feeling like a ball here, rolling here, but again, it's not painful, and you see there's
no muscle contraction with this number four, and then I can go to let's say number five,
the drawing there looks like a there is a needle, so let me see. so I start increasing
the intensity, it's not like a needle, it's more like a acupuncture, when the acupuncture needle is
doing stimulation, like this, that's how this one feels like, and then you can play around,
so what I do is I play around, I put in the area of pain that I'm feeling pain, and then I try a
couple of them, and I see which one abolishes the pain, which one is best for my pain,
so if you remember well the high frequency will eliminate the pain right away,
the low frequency you will still have some pain but the low frequency TENS it's going to release
those endorphins, dinorphines, and enkephalins, and they will accumulate in the brain, and help
the pain relief, to last days and sometimes up to seven days, so that's why I like TENS because
you can mix different currents, yeah and you can apply like I could apply the other pads in
a different part of the body, and at the same time have current here, and current in another part,
let's say that I would if I wanted to apply a pad here and here to treat elbow pain, I could
do that, it's you have you adjust the intensity of channel A and B, but the current is the same
whether whatever it's the type of the mode of current, that is applying here is the same here,
and when you change, it changes both at the same time. so you see, it's not difficult, it's
pleasant like here, i'm feeling the electrical shock, going from one to the other, one i'm using
like mode six, let's say if i change to mode seven, and then increase the intensity, here
yeah, i'm feeling, it's a different type of current, and again if you see muscle contraction
then it's not TENS, it's electrical muscle stimulation but TENS does not move the muscles,
so this one is TENS and it's okay, it's pleasant, and you can apply and use it.
So, when you buy your machine you may also check if it comes with different pads, for example, this
is one really nice, because these two pads can be attached to the low back area, the lower back
for low back pain, so it comes with this strap, and so then you can close here, so then you can
wrap it around your lower back, and what you do is so you put your channel one and you just
attach here, and here, so then these two pads will be delivering this, is good for low back pain,
but also from for menstrual cramps, you put this on the back , and then alleviates
menstrual cramps. the other type of pads that came with this machine that i bought,
is for the feet, so here we have so you can attach the pads here and here,
here the electrodes you attach here, so then when once you regulate the current, here you're
going to notice current that delivers from this three parts here, so you put your feet here,
and then you will feel electrical shocks on the bottom of your feet. so this is good for plantar
fasciitis, for foot pain, pain arthritis, so when you buy a machine ,you may take a
look to see if they come with different pads and different ways of attaching to your body.
These are the sites for applications of the electrodes. so this one here.
is if the person has shoulder pain and pain in the back of the shoulder, and upper back.
They can apply these pads from one channel on the top of the shoulder
and the pads of the second channel in the around the shoulder blade on the same side.
Now this one is if the person has pain on both shoulders, and it's more on the
upper back and trapezius area, so they can apply one channel on the right side,
and one channel on this on the left side. And this one is for pain in the front
of the shoulder. so the person can apply one channel, the two pads around the deltoid area,
and the other one in the pectoralis area, in front of the shoulder.
The next one here is for pain the elbow and pain in the wrist, so they can apply the pads above
and below the elbow, and the other channel all the pads go above and below the wrist.
This here is for pain in the upper back and lower back. so for this one, the person may
if the person has pain on one side of the back, for example, the left side, and
so they can apply one channel in the upper back, and the other one in the lower back.
And this one, is if the person has pain in the mid-thoracic area, and on both like
around the both of their shoulder blades, so they can apply one channel on the left side,
and one channel on the right side. And here's the reverse, if they have pain more in
the middle of the back, the upper back area, this is more like a pain the rhomboids muscle, so they
can cross the channels, here you see the green means the first channel, so one pad is on the
left side upper area and the second green one is on the right side in the lower area,
and the other channel is reversed so the current is concentrated in the mid point.
This one here is for pain the low back pain area. so one channel is on the left
side the other one is on the right side, and they apply above and below the pain area.
This one is if the pain is right in the middle of the lower back. so they can cross one channel,
crossing right and left, and the other channel crossing left and right.
So here is for elbow pain. so this is for lateral epicondylitis, so they can
put one pad above the elbow and the other one below the elbow.
This one is for menstrual cramps. for menstrual cramps the person can put the pads on the back,
the lower back, but they can also put in the front, so they can put a one right and left. the
first channel the green one they put one pad on the right side, and one on the left side, and the
other channel they put below the inguinal area. And for this one is pain in the hips, so
right and left hip, this could be helpful for bursitis, and trochanteric bursitis,
so they put one channel on the right, on the right, and the other channel on the left.
This is for neck pain, more like a cervical pain, and sternocleidomastoid areas, scalenes muscles,
so they can put one pad right below the ear, and the other one close to the collarbone.
Here is for knee pain, so here they can put the pads above and below the knee, they can cross
the pads, for example, the right and left, you can cross
this one, is also for knee pain so they can put the pads more on the lateral side of the knee,
instead of putting on the front of the knee. This is for Aachilles tendinitis which is a type
of heel pain, and they can put a one pad above and the other one below the achilles tendon.
So here is for foot pain, and they can, this is if a person has a strain or a sprain of the ankle,
for example they can put the pads above and below the tendon, ligaments of the ankle.
And also if they have pain of the foot itself, the metatarsal area, this is good if they have
an inflammation, like a tendonitis, or a sprain of the foot, they can put below and above.
And last one, this is for foot pain, more localizing like the plantar fasciitis,
and they can put the pads on the bottom of the foot and apply the current,
so they put one channel on the left foot and the other channel on the right foot.
So here's a summary if you want you can download this handout. there is a link
in the description of this video below, and you can download this handout, with all these
pictures, so you can print and use with your TENS machine.
So that's all that i had about tens today if you're interested in purchasing a machine
as i said there are some links in the video description below and talk to your doctor about
this. if this is indicated for you also ask a physiotherapist. If you have your physiotherapist
ask them to try a TENS machine before you buy your own, so you can see if it works for you or not.
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