What Is Tens And Will It Help Me With My Arthritis Pain?

TENS stands for transcutaneous electrical nerve stimulation. It
describes the delivery of electrical current to peripheral
nerves (nerves located in the skin) using electrodes that are
applied to the skin. TENS can be used either in an office
setting or self-administered by the patient.

A TENS unit consists of a central power source which is shaped
like a small box that looks like a beeper. The box contains
controls that modulate the intensity, frequency, and waveform of
the current. Connected to the central power source are lead
wires. Attached to the lead wires at the other end are
electrodes that are self-adhesive and applied directly to the
skin. The electrodes are designed to conduct the current from
the central power source to the skin.

To use the TENS, the lead wires are connected to the central
power. Electrodes are then attached to the lead wires at the
other end and then applied to the affected area of the body.
Once the TENS is set up, the TENS unit is turned on. The patient
will sense the current which is increased to the point where it
is felt to be comfortable. The patient should leave the TENS at
that setting. During the day, the body accommodates to the
electrical stimulus and the patient may be tempted to increase
the current intensity. That should not be done because,
prolonged intense electrical stimulus can lead to muscle fatigue
and rebound pain!

TENS current can be adjusted for waveform, current level, and
frequency. The medical person, either a physician or physical
therapist, should instruct the patient as to the best setting
for their individual case. TENS frequencies below 10 Hz are
termed low frequency. Frequencies higher than 50Hz are called
conventional or high frequency TENS.

The ability to change frequencies, duration of therapy,
waveforms, and intensity makes TENS a versatile tool in pain
management.

TENS is used to ameliorate pain related to a number of
conditions seen in a rheumatology office. These include: chronic
low back pain, osteoarthritis, chronic neck pain, and
fibromyalgia. TENS is covered by most insurances including
Medicare.

Studies regarding the effectiveness of TENS for different
conditions have been, in the past, flawed by poor study design.
However, in recent years, the ability to adequately blind the
patient and the examiner have yielded some excellent studies
showing the effectiveness of TENS in both relieving pain as well
as in reducing the amount of pain medication a patient may
require.

This latter benefit is particularly important when it is
realized that TENS is an extremely safe treatment modality with
virtually no side effects.

How does TENS work? There are a few theories that explain the
effectiveness of TENS. The first is the gate theory. This is the
oldest explanation. According to this theory, application of
electrical stimulus to peripheral nerves sends signals to the
spinal cord and these signals block the transmission of pain
signals by the spinal cord. In essence, this theory is similar
to that offered as an explanation for the effectiveness of
acupuncture. Indeed, the low frequency form of TENS has been
used as a type of "electrical acupuncture."

Studies of high frequency TENS has demonstrated that levels of
glutamate and aspartate (chemicals that may induce pain) are
reduced in the spinal cord. Low frequency TENS increases
serotonin and endorphin levels within the central nervous system
thereby reducing pain.

The effectiveness of TENS has been demonstrated in at least two
trials demonstrating equivalency of TENS against non-steroidal
anti-inflammatory drugs in osteoarthritis of the knee.

TENS can be used as a single therapeutic modality or in
combination with other treatments including medicines.

The demonstration of effectiveness compared with
anti-inflammatory medicines as well as its possible ability to
decrease the amount of analgesics and narcotics a patient may
require is an obvious benefit. Because of these many advantages,
TENS is an attractive treatment modality for use in the
rheumatology office.

About The Author: Nathan Wei, MD FACP FACR is a rheumatologist
and Director of the Arthritis and Osteoporosis Center of
Maryland. He is a Clinical Assistant Professor of Medicine at
the University of Maryland School of Medicine. For more info:
http://www.arthritis-treatment-and-relief.com/arthritis-treatment.html