General • An Approach to painConcepts: control – Trancutaneous – Trancutaneous Electrical Nerve Stimulation: – Any – Any stimulation in which a current is applied across the skin to stimulate nerves – 1965 Gate Control Theory created a great – 1965 popularity of TENS – TENS – TENS has 50-80% efficacy rate – TENS – TENS stimulates afferent sensory fibers to elicit production of neurohumneral substances such as endorphins, enkephalins and serotonin (i.e. gate theory)
TENS • Indications – Control Chronic Pain – Management postsurgical pain – Reduction of posttraumatic & acute pain
• Precautions – Can mask underlying pain – Burns or skin irritation – prolonged – prolonged use may result in muscle spasm/soreness – caffeine intake may reduce effectiveness – Narcotics – Narcotics decrease effectiveness
TENS may be: • high voltage • interferential • acuscope • low voltage AC stimulator • classical portable TENS unit
Biophysical Effects • Primary use is to control pain through Gate Control Theory • May produce muscle contractions • Various methods – High TENS (Activate A-delta fibers) – High – Low – Low TENS (release of of -endorphins -endorphins from pituitary) – Brief-Intense – Brief-Intense TENS (noxious stimulation to active C fibers)
Techniques of TENS application: • Conventional or High Frequency • Acupuncture or Low Frequency • Brief Intense • Burst Mode • Modulated
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