Transcutaneous Electrical Nerve Stimulator

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"TENS" redirects here. For other uses, see TENS (disambiguation).
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A Transcutaneous Electrical Nerve Stimulator, more commonly referred to as a "TENS unit" and pronounced /ˈtɛnz/ tens, is an electronic device that produces electrical currents used to stimulate nerves through unbroken skin. The name was coined by Dr. Charles Burton.[1] The unit is usually connected to the skin using two or more electrodes. A typical battery-operated TENS unit consists of a pulse generator, frequency and intensity controls, and a number of electrodes.

Contents

Uses

TENS is considered a method in the treatment of pain [2], and has a wide following; still others maintain that it is ineffective. A 2007 meta-analysis of studies going back many years indicates that TENS is an effective treatment for chronic musculoskeletal pain[3].

In palliative care and pain medicine, TENS units are used in an attempt to alleviate neuropathic pain [4] (pain due to nerve damage). Some patients benefit from this approach, while others may not, depending on individual differences [5] , and pain threshold [6]. Further use is documented in the attached references: in obstetric care, particularly in labour [7]; knee pain[8] [9] [10]; lithotripsy or bladder-stone removal [11]; limb pain [12].

Most people use pre-gelled self-adhering electrodes (single patient use) to transmit the electrical signal through the skin, while most clinicians use carbon-impregnated silicone rubber electrodes with a water based conductive gel so that the pads may be cleaned between applications on different patients.

TENS units are also used by the BDSM community for erotic play involving electrical stimulation. See also Erotic electrostimulation.

History

Electrical stimulation for pain control was used in ancient Greece, 63 A.D. It was reported by Scribonius Largus that pain was relieved by standing on an electrical fish at the seashore.citation needed In the 16th through the 18th century various electrostatic devices were used for headache and other pains. Benjamin Franklin was a proponent of this method for pain relief. In the 1900s a device called the electreat, along with numerous other devices were used for pain control and cancer cures. Only the electreat survived into the twentieth century, but was not portable, and had limited control of the stimulus.

The first modern, patient-wearable TENS was patented in the U.S.A. on June 18, 1974 (U.S. Patent 3,817,254 ). It was initially used for testing the tolerance of chronic pain patients to electrical stimulation before implantation of electrodes in the spinal cord dorsal column.[13] The electrodes were attached to an implanted receiver, which received its power from an antenna worn on the surface of the skin. Although intended only for testing tolerance to electrical stimulation, many of the patients got so much relief from the TENS itself that they never returned for the implant.

A number of companies manufacturing TENS appeared after the commercial success of the Medtronic device became known. The neurological division of Medtronic, founded by Don Maurer, Ed Schuck and Dr. Charles Ray, developed a number of applications for implanted electrical stimulation devices for treatment of epilepsy, Parkinson's disease, and other disorders of the nervous system. Maurer founded Empi, Inc. in 1977, and in the late 1980s purchased the TENS product line from Medtronic. Today many people confuse Tens with Ems. Ems and Tens devices look similar and both use long electric lead wires and electrodes. Tens is for blocking pain, where Ems is for stimulating the muscle.

Safety

TENS Electrodes should never be placed:

Do not turn TENS up too high as this can cause over-stimulation which may make pain worse. There should be no muscle contraction.

TENS should also be used with caution in people with epilepsy or pregnant women (do not use over area of the uterus as the effects of electrical stimulation over the developing fetus are not known). TENS should not be used by people with an artificial cardiac pacemaker due to risk of interference and failure of their implanted device. Possible failure of these warnings can result in a cardiac arrhythmia.

In the situation where low frequency (or acupuncture-like) TENS is being used, it is necessary to increase the intensity of the stimulation to the point where a demonstrable muscle twitch is evident. This 2-6Hz (pulses per second) output increases the systemic release of endorphins which in turn cause pain relief.

See also

References

  1. ^ Burton, C., & Maurer, D.D. (1974). Pain suppression by transcutaneous electrical nerve stimulation. IEEE Transactions on Biomedical Engineering, 21, 81–88.
  2. ^ D. N. Rushton, Electrical stimulation in the treatment of pain. Disabil. Rehabil. 24:407–515 (2002).
  3. ^ http://www.painjournalonline.com/article/S0304-3959(07)00073-5/abstract
  4. ^ T. Forst, M. Nguyen, S. Forst, B. Disselhoff, T. Pohlmann, and A. Pfutzner, Impact of low frequency transcutaneous electrical nerve stimulation on symptomatic diabetic neuropathy using the new Salutaris device. Diabetes Nutr. Metab. 17:163–168 (2004).
  5. ^ L. S. Chesterton, P. Barlas, N. E. Foster, G. D. Baxter, and C. C. Wright, Gender differences in pressure pain threshold in healthy humans. Pain 101:259–266 (2003).
  6. ^ L. S. Chesterton, N. E. Foster, C. C. Wright, G. D. Baxter, and P. Barlas, Effects of TENS frequency, intensity and stimulation site parameter manipulation on pressure pain thresholds in healthy human subjects. Pain 106:73–80 (2003).
  7. ^ J. T. van der Spank, D. C. Cambier, H. M. De Paepe, L. A. Danneels, E. E. Witvrouw, and L. Beerens, Pain relief in labour by transcutaneous electrical nerve stimulation (TENS). Arch. Gynecol. Obstet. 264:131–136 (2000).
  8. ^ M. M. Ng, M. C. Leung, and D. M. Poon, The effects of electro-acupuncture and transcutaneous electrical nerve stimulation on patients with painful osteoarthritic knees: a randomized controlled trial with follow-up evaluation. J. Alternat. Complement. Med. 9:641–649 (2003).
  9. ^ G. L. Cheing, A. Y. Tsui, S. K. Lo, and C. W. Hui-Chan, Optimal stimulation duration of tens in the management of osteoarthritic knee pain. J. Rehabil. Med. 35:62–68 (2003).
  10. ^ M. Osiri, V. Welch, L. Brosseau, B. Shea, J. McGowan, P. Tugwell, and G. Wells, Transcutaneous electrical nerve stimulation for knee osteoarthritis. Cochrane Database Systematic Reviews 4:CD002823 (2000).
  11. ^ A. Kararmaz, S. Kaya, H. Karaman, and S. Turhanoglu, Effect of the frequency of transcutaneous electrical nerve stimulation on analgesia during extracorporeal shock wave lithotripsy. Urol. Res. 32:411–415 (2004).
  12. ^ W. P. Cooney, Electrical stimulation and the treatment of complex regional pain syndromes of the upper extremity. Hand Clin. 13:519–526 (1997).
  13. ^ Burton C. Instrumentation for dorsal column stimulator implantation. Surg Neurol. 1974 Jan;2(1):39-40.

G. Vrbová, O. Hudlicka, K. Schaefer Centofanti; l Application of Muscle/Nerve Stimulation in Health and Disease;Springer 2008.

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  • This page was last modified on 18 July 2008, at 13:20.

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