♪ Bob and Brad ♪
♪ The two most famous ♪
♪ Physical therapists ♪
♪ On the Internet ♪
(clapping)
- Hi folks, I'm Bob Schrupp, physical therapist.
- Brad Heineck, physical therapist.
- You don't have your sign, do ya,
okay, that we are the most famous physical therapists
on the Internet. - In our
opinion, of course, Bob.
- Today Brad, we're gonna talk about,
is TENS safe to use for pain?
And Brad and I have quite a bit of experience with this.
We've been using TENSs units for 30 years.
So, at least I have been.
- Right, right.
- So I think we're well qualified to talk about it.
- You bet.
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- Great for reducing stress in your life.
- Right.
And, you know, there's people out there
who are very familiar with it.
If they are, they know exactly what we're talking about.
This is a nice, quality blanket.
- Yeah, this is a good quality blanket.
You gotta really check it out, so.
All right, so transcutaneous electrical neuro muscular
or nerve stimulation. - Sure.
- That's what TENS stands for.
How does it work?
So there's two general theories on how TENS works.
And Brad is showing one right here.
- Right. - One of the TENS units.
- This one's already hooked up on my forearm.
- Yeah, I don't know if you can see a little
pulsating going there on or not.
- Yeah, but I'll just turn it up a little bit.
- [Bob] Yeah, then you can make it go.
So he's providing electrical stimulation to his arm.
- Whoa!
- And generally how it works is the electrical pulses
prevent pain signals from reaching the brain.
So if Brad were to hurt his thumb right now,
the idea behind the stimulation is to stop
that pain sensation from reaching his brain,
that big brain of his.
So, the other-- - Wow, why Bob?
- Why? - The other thing
it does, the pulses help stimulate the body
to release natural endorphins.
- Sure.
- So that feel good substances that are gonna
make ya-- - Right.
- Feel good about things.
- It's like after you do a really aggressive workout,
and you're done, and you just feel so good.
This does the same thing, but more in a localized area,
although, it's not the same, but it's--
- Right, right.
No, it's supposed to stimulate overall body wise,
so. - Right.
But it's still not quite the same.
'Cause you're not fatigued. - It's still not
the same as running.
Right. - But you still get that,
that-- - You've been goin' off
on a tangent here. - Yeah, I know.
- Okay, so, what are the reasons, you know,
the answer is, is it safe.
The short answer is yes.
It's definitely safer than a lot of medications
especially opioids that people have
been on. - Sure, right.
- So, but there are precautions
and there's contraindications.
By contraindications, when there's a contraindication,
I would not do it at all.
- Right.
- If it's a precaution, you wanna take pause
and maybe think it through and see if that,
maybe you do wanna try it, but,.
- Sure. - So I'm gonna
list some of the contraindications.
You definitely, we've known this one for years,
no use if you have a pacemaker.
You know, they have the cardioverter defibrillators now.
- Right.
Any other device that is on you--
- Yeah, basically any device-- - that's powered--
- in your powered body. - by electricity.
You know, this could throw it off and have your--
- Bone growth stimulator, in dwelling blood
pressure monitor, neuro-stimulator.
- Right. - All those things, so.
- You're not gonna put the pads on where there's
an open wound.
Gotta have healthy skin where--
- Are you jumpin' ahead on me here?
- I'm sorry, Bob, I just wanted to say that.
- All right, next one.
Don't put it over the carotid sinuses.
That's right here. - Sure.
- That can knock things off as far as your--
- Cardiac, yeah. - Cardiac rhythm,
yeah, so, that's right here,
right where your carotid artery should be felt.
As Brad had said, damaged skin.
Number four, any reproductive organs,
you don't wanna put it over there.
- Sure, so-- - I know you wanted to, Brad.
- If you're pregnant,
or, you know, for pregnant women.
I jumped-- - That's one of 'em,
too, yeah. - I'm sorry, I did it again.
- Boy, you just can't keep yourself under control,
can ya. - I got 'em memorized, Bob.
- All right, transcranial.
This is an interesting, Brad, 'cause I remember when
they first came out with this.
So they don't want you putting it on for headaches.
- Sure.
- Anywhere on the brain there.
When they first came out, and I remember,
one of the scientists came down to Mayo Clinic
where I was working at the time.
- Sure.
- And he was working on that, trying it across
the brain. - Oh, right.
- So, they apparently-- - Were you a volunteer?
- I was not. - Oh.
- They did not do it to me, so.
- I figured something had to happen.
- You won't put it on your eyes.
I think it's obvious, but who knows what
people think? - Right.
- Don't put it on your eyes,
don't put it on any oral cavities.
- Right.
- Don't wanna put it on your tongue or anything.
If you have cancer, you definitely don't wanna do it
right over the cancer area.
- Right.
Yeah I, if there's something like that,
you need to get, contact a professional.
- Right. - Make sure.
- Did you say pregnancy, wasn't that one of
that you said? - Yes, I did Bob.
- Okay, especially on the torso.
- Yeah.
- You know, - Right, right.
- Whether or not you can do it on the extremities,
that's a little of our questionable.
- Yeah.
- Epilepsy.
They've found out that, yeah, you don't wanna put it
on the head, shoulder, or neck region
if you have epilepsy.
- It may trigger-- - Yeah, apparently.
Apparently, yes.
If you have a blood clot.
- Sure. - And, which a lot
of people get blood clots in their calves.
- Right, right.
- And it's painful.
So I could see someone saying,
"Well, I wanna put a TENS unit on there."
But you don't wanna do that.
You don't wanna loosen up the blood clot,
send it up to the lung, and-- - Right, cause a real--
- Yeah. - More of a problem
they already have, yeah.
- If you're bleeding, if you've had recently
radiated tissue, so let's say undergoing cancer treatment,
- Sure.
- And that tissue is a little thin, maybe--
- Compromised.
You don't wanna put a stimulation unit over.
- Yeah.
- And if you have any infections, osteomyelitis,
tuberculosis, anything like that, you wouldn't wanna
do it either. - Right, sure.
- So-- - I got a really
good example of, you know, something that you may
be concerned about if you got a TEN,
can you zoom in on that?
I've got the intensity cranked up enough
where my muscles are, I've got it in the place
where my muscle's contracting,
and it's oscillating like this.
And I'm not doing it at all.
And I'm not concerned.
I mean, it feels kinda good, actually.
I like TENS unit on myself, like, you know,
a lot of people do.
But that's fine.
- By the way, if you're interested in a TENS unit,
the one we really like is iReliev.
We'll have a link down below.
If you go to, it has a landing page for us, even.
- Sure. - And they got
great discounts on that. - Right, yeah.
- For each one, they take off quite a generous amount.
So, it's a, you know, relatively inexpensive device
on some of the lower end ones.
- Right.
- And it's pretty easy to use,
and you can hide it in your pocket.
Again, definitely better than any opioids.
So-- - Oh right, yep, yep.
- All right, I'm just gonna go over some of
the precautions real quick here, Brad.
So again, these are ones that you wanna
take caution on.
I wouldn't say it's absolutely no, but, cancer,
if you're gonna use it on a distal site.
So let's say the cancer is here,
but you wanna use it on your ankle.
- Sure.
- Just be precautious.
- Yep.
- Pregnancy the same thing.
If you're gonna do it over the knees,
hand, or ankle, there are some acupuncture points
that they said can actually increase
uterine contractions. - Whoa.
- So, and that was a moderate amount of evidence
that found that out
to be true, so. - Okay, sure.
- I didn't know that, did you know that?
- No, I did not, Bob.
- If you have cognitive impairment,
you may wanna be,
(chuckling)
Did you see me do that?
- Yeah.
I, they saw, Bob.
Why, Bob, why?
Let's carry one-- - I mean, obviously--
- with the program. - 'cause the person
might not understand what's going on
and they-- - Oh right, yeah.
You really do, yeah.
- Cardiovascular disease, don't apply it to the chest.
You can use at sites other than the chest wall,
but not the chest wall, obviously.
- Sure.
- Some impairments that might make it difficult to do,
if you have extreme edema, swelling,
if you have extreme adipose, which,
if you're really heavy it may not work as well.
- Right.
- If you've had adverse experience to TENS before,
like, it freaks you out, I probably wouldn't
try it again, would you?
- Yeah, I've had a couple, well, three patients,
I just turn it up a little bit, and they just,
I think it's a psychological thing.
They just-- - Yeah, there's some people--
- They feel that - that don't like
electrical stimulation. - Right.
And then there's some people that,
like I just think it feels good, it just,
as long as you don't go really high with it,
obviously. - I had a girl
in my class, I probably shouldn't even tell this story,
but she was, like, wacky about it,
like, she loved it. - Oh.
- Like, really loved it.
Like-- - Say no more.
- Say no more. - Just carry on, Bob.
Why? - All right.
And I want to again point across the chest.
And if you have impaired sensation from scar tissue,
I'd be careful there too, 'cause it just--
- Right. - probably won't,
you won't get good feedback,
and you won't know if you're doing it too high
or whatever, so. - Right, that,
at that point, you're gonna have to depend
on the muscle contraction for feedback.
- So, with those precautions and contraindications,
again, generally a very good unit to use
for pain control.
It's not gonna cure your pain.
- Right. - But sometimes
it helps you get through those times when you're
dealing with pain that just doesn't go away.
- Right. - You know,
so, intractable pain. - Again, avoiding the
medications. - Right, so.
All right, remember, Brad and I can fix
just about anything.
- Except for--
- A broken heart.
- There you go.
I don't know if this is gonna help that.
- You can't put it on the heart.
- Right, okay, well-- - So you can't.
- We're gonna have to toss that idea.
- All right, thanks.
- Another chapter.