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Transcutaneous Electrical Nerve Stimulation: Treatment, Cost and Side Effects

Last Updated: Apr 20, 2024

What is the treatment ?

Transcutaneous electrical nerve stimulation (TENS) is a nonpharmacologic remedy for pain. It utilizes an electric current generated by a battery operated gadget to excite the nerves. This is also a noninvasive treatment as it does not require surgery. TENS is used to refer to all the different types of therapies that use transcutaneously applied electric currents to excite the nerves. The current not only interferes with pain signals being sent to the brain through the spinal cord and therefore helps to relieve the pain and relaxes the muscles but also leads to the production of endorphins. These are hormones produced by the body, and they act as natural painkillers. Studies show that long-term use of TENS may cause tolerance to develop due to the long-term application. None the less, trials which are ongoing are refining the criterion of stimulation in order provide the best possible relief. The strategies being employed are both pharmacologic and nonpharmacologic. The TENS devices are designed mostly for use in hospitals or any other healthcare facility, but some models are also available on the market for home or domestic use to lessen chronic and acute pain.

How is the treatment done?

The treatment is usually administered by placing electrodes on the skin typically at the site of injury. There is no specific prior preparation procedure for this treatment. The electrodes or pads ought to be placed on either side of the affected region, somewhat 2.5cm apart. None the less, they should never be put on the neck, the mouth or eyes and the chest and upper back specifically at the same time. If a person is using the TENS machine at home, there is a procedure to follow.

First and foremost, the machine should be switched off before attaching the electrodes to the skin. Once the electrodes are correctly positioned, and in the right place, the machine is turned on. After one is done using it, it should be switched off and the electrodes detached from the skin. These electrodes deliver a controlled amount of electric current with fluctuating frequencies. The frequencies may range from as low as 10 hertz to as high as 50 Hertz. The intensity may also be varied from motor to sensory intensities according the patients' needs. Trials have shown that adequate dosing, more specifically the intensity, is crucial to delivering the desired pain relief. Sensory intensities is delivered when a strong, comfortable feeling is required but without motor contraction. The high intensity, on the other hand, does induce motor contractions but it is not painful. Typically, the treatment is applied at high frequencies that is about 50 hertz with sensory intensity or low frequencies, below 10 hertz, with an intensity that induces motor contraction. Laboratory tests conducted have shown that despite the intensity applied, activation of the central mechanisms to produce analgesia is done by different frequencies. Analgesia is the lack of sensibility to pain. It, in particular, refers to absence of pain without the loss of consciousness. In specific, low-frequency application specifically stimulate μ-opioid receptors located in the brainstem. They are also found in the spinal cord. On the other hand, high-frequency TENS trigger δ-opioid receptors located in the same places as the μ-opioid receptors.

Who is eligible for the treatment?(When is the treatment done ?)

There are some health conditions that may bar a person from using transcutaneous electrical nerve stimulation. It is not always safe for everyone to use and medical advice should be sought prior if:

  1. You have any heart problem or have an artificial cardiac pacemaker or any other implanted device. Use of TENS cause interference and lead to failure of the implanted gadget. Actually, it is best avoided for anyone with a pacemaker.
  2. You have a metallic objected implanted in the body.
  3. You are expectant, or might be, especially in the early in the pregnancy.
  4. You are epileptic.

Who is not eligible for the treatment?

There are some health conditions that may bar a person from using transcutaneous electrical nerve stimulation. It is not always safe for everyone to use and medical advice should be sought prior if:

  1. You have any heart problem or have an artificial cardiac pacemaker or any other implanted device. Use of TENS cause interference and lead to failure of the implanted gadget. Actually, it is best avoided for anyone with a pacemaker.
  2. You have a metallic objected implanted in the body.
  3. You are expectant, or might be, especially in the early in the pregnancy.
  4. You are epileptic.

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Are there any Side Effects?

This is a generally safe treatment procedure for most people. However, it may bring about some side effects to a few people. In a few occasions, the electrical current may be too harsh and extreme for a patient. It may cause irritation and burns on the skin causing disfigurement. Other people with severe skin allergies may have a reaction to the pads causing their skin to be irritated. However, all hope is not lost for such individuals as special pads have been made available to them. If any of the side effects occur, it is always advisable to stop the treatment and seek medical assistance.

What are the post-treatment guidelines?

Once the transcutaneous electrical nerve stimulation treatment has been administered successfully, there are no specified post-treatment guidelines. If the results are permanent, then one there is no further need to use TENS. However, if the results of the therapy are short lived, and the pain reoccurs, one only has to use the machine gain to get relief.

How long does it take to recover?

TENS is a treatment for pain, and as such it is used as long as long the pain lasts. This may take one day or even months depending on the type of pain and the condition causing it. For instance, if it is used during child birth, it is in use until the labor process is over. If it is used to reduce pain caused by an illness such as arthritis, then the treatment is sure to be used for a long time.

What is the price of the treatment in India?

TENS is a relatively cheap means of pain management especially because all that one need is to buy the machine. Once that is accomplished, there is no other recurrent expenditure as is the case in drug medication. In India, one can purchase a TENS machine from a certified pharmacy. The cost ranges from 1000 to about 5000 rupees. However, this does not automatically mean that the more expensive machine is necessarily the better choice in comparison to the low-priced ones. One just has to do enough research to find out which machine is better and to make sure one goes not get a counterfeit product.

Are the results of the treatment permanent?

Transcutaneous electrical nerve stimulation is not actually an antidote for pain. It is usually only used to deliver short-term alleviation that is when the machine is being used. It is not yet a fully proven therapy for pain as still; most clinical trials are still on going. None the less, reports are showing that it has good results on certain individuals depending on the health status and the condition being treated. One advantage of the TENS machine is that is small and lightweight and therefore can be used almost throughout the day for as long as one desires. It can be clipped to the belt, put inside the pocket or even held in the hands. However, one should avoid its use while bathing, diving, and operating machinery. It is generally very safe and worth trying if in need, and it can also be supplemented with the other treatments.

What are the alternatives to the treatment?

One can choose other means of pain treatment if they see fit. There are pain killers a person can use or even surgery if it is a condition treatable by it. However, transcutaneous electrical nerve stimulation is always a better option as it is non-invasive. It will not require a lengthy recovery time like surgery. This benefits the patient as they can continue with their day to day activities without requiring bedrest. It also out shines painkiller medication as it does not lead to addiction when used for a long time. Another advantage is that it does not introduce chemicals into the body like drugs do. These chemicals lead to complications such as liver damage and renal failure. All in all, TENS is the better option in pain therapy.

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Written ByDr. Sidharth Verma PDCC - Pain Management,MD - Anaesthesiology,DNB Anaesthesiology,MBBSOrthopaedics
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Reviewed ByDr. Bhupindera Jaswant SinghMD - Consultant PhysicianGeneral Physician
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