TENS - Dennis McMasters, OT

Transcutaneous Electrical Nerve Stimulation (TENS) is the application of electrical stimulation for pain control, that applies low-voltage electrical impulses to the nervous system using surface electrodes. TENS is used as a component of pain management that provides the therapist with a technology to provide an analgesic (absence of pain) effect that facilitates greater independence with activities of daily living for patients. The four types of stimulation commonly used are: Subsensory(microcurrent) which is applied for pain, depression, anxiety; Sensory(conventional) applied for chronic pain during occupational tasks; Motor level, applied for longer lasting pain relief and joint mobilization;  Noxious, applied for wound debridement, painful procedures, passive stretch and used when other forms listed above have been in-effective. Interferential Electrical Stimulation (IFS) is another type of current than can penetrate deeper skin and tissue. IFS uses two medium frequency currents which are passed through the tissue simulataneously so that their waves cross and intersect causing them to interfere with each other. The four primary applications for IFS are: pain relief, muscle stimulation, increase blood flow and edema control. Electrode placement for the use of TENS & IFS usually use motor points, trigger points and acupuncture points. The most common adverse reactions to the use of TENS & IFS with patients is skin irritation. Patients who have sensitivity to adhesive electrodes are the most susceptible. Electrodes can be placed unilateral, bilateral or contralateral to the painful site. Some of the main contraindications to the use/application of TENS or IFS are: pacemakers, not on abdomen or trunk of pregnant women, over the eye, individuals with epilepsy, malignancies, decreased sensation, over the carotid sinus or transcerebrally. TENS & IFS can be a safe and effective adjunct or alternative to pain medication or surgical interventions to modulate pain so the patients can increase or continue their independence with activities of daily living. Please consult the following resources are a more indepth discussion for the use of TENS & IFS: “Physical Agent Modalities “ by Dr. Alfred G. Bracciano and “Physical Agents in Rehabilitation” by Dr. Michelle H. Cameron.