TENS Flashcards
What is the rationale behind using this treatment (Pain/increase ROM/strengthen)?
pain relief
What are the physiological effects of the treatment?
TENS causes the release of inhibitory neurotransmitters which reduce activity in second order nociceptive transmission cells. The reduction in nociceptive input to the brain results in pain relief.
What structures are affected by the technique?
muscles-motor nerve fibres
blood vessels-causes vasodilation
pain processing pathways within the CNS
peripheral nerves-targets sensory nerves that transmits pain signals to the CNS
What principles are used in carrying out the technique?
first trial of TENS should be for less than 30 mins
with acupuncture like TENS the patient should not use it for more than 1 hour as it may lead to muscle fatigue
cant set the intensity beforehand
Precautions and contraindications?
pacemakers, heart disease, undiagnosed pain, epilepsy, first 3 months of pregnancy
do not use on mouth, broken skin, eyes, carotid sinus, anaesthetic skin
What is TENS?
application of electrical stimulation to the skin via surface electrodes to stimulate nerve fibres
When would you use dual channel application?
when the pain is widespread
e.g. back and leg pain
What is the relation between width and amplitude?
short pulse widths require high amplitudes to produce an adequate stimulus
wider pulse widths require lower amplitudes to produce an adequate stimulus
What are the two types of TENS and what are each used for?
high TENS- beta afferent nerve fibres can be recruited by impulses of low intensity. High frequency (150 Hz) and shorted duration (50-80 micro secs).
low TENS- delta and C nociceptive fibres can be recruited by impulses of higher intensity, lower frequencies (1-4 Hz) and longer pulse widths (200 microsecs). (Analgesia (pain relief) takes longer to occur but lasts longer).
What should the pt feel at different pulse frequency?
5-10 Hz is a slow ticking sensation
150 Hz is a continuous buzzing sensation
What are the 7 places electrodes may be placed over?
the nerve where it is most superficial and proximal to the pain
the painful dermatome or adjacent dermatome
the nerve trunk
above or below or either side of the painful area
over trigger points/acupuncture points
never places on anaesthetic area
placed so that normal use of the limb is permitted
what should the treatment time be for TENS?
max of 8 hours continuous stimulation per day
in severe conditions, continuous stimulation should be applied for 3 weeks
if the TENS gets reduced to 3 hours per day and the pain returns, increase stimulation to 4 hours a day for 1 week
Treatment time reduced slowly until no further required
can be used for phantom limb
What are basic safety principles?
switch appliance of before removing the electrodes
after each application, irritation or allergic rash may occur
application and electrodes are washed after each use
What are the 3 different modes for TENS?
burst
normal
modulation
What are the settings for conventional (High) TENS?
frequency (pulse rate(gap between)) 150 Hz
pulse width: 50-80 micro secs
tingling/ pins and needles
low intensity
up to 8 hours
