TENS

What is TENS?

Pain management can be challenging, with medication being the foremost treatment. Transcutaneous electrical nerve stimulation (TENS) is a non-invasive stimulation technique that can be used in conjunction with medication.

TENS is the application of electrical stimulation to the skin for purposes of pain control. The electrodes, or the sticky pads, are applied over the painful area to activate different underlying nerve fibers at the spinal level. This is done to prevent the sensation of pain from traveling to the central nervous system, where we perceive sensation. The general idea is that if you feel a tingling sensation, then it replaces the feeling of pain in a specific area.

How can this help with my back pain?

Often times your back hurts because something is off in the way that your spinal joints, muscles, and nerves work together to move. The exact cause varies from person to person but it's more common than you think. Let's take a look at a research study for information on how TENS helps with back pain.

A randomized control trial conducted in 2019 used a high-frequency TENS (hfTENS) device to examine the effects of hfTENS on patients suffering from chronic lower back pain. Chronic referring to pain that is persistent or long-lasting. The participants in the study were tested on their perceived level of painfulness for sensory testing. They were randomly assigned to either an hfTENS group or control group that received therapy without a hfTENS device. (Jamison et al., 2019).

The results of this study showed that hfTENS was beneficial in significantly reducing lower back pain and reducing associated pain interference. The participants that received hfTENS also reported less overall pain and less pain interference, as well as significantly lower catastrophizing pain scores. (Jamison et al., 2019). Catastrophizing pain scores were perceived levels of pain that might have been extreme and had an impact on their daily living.

How can this help with my neck pain?

A systemic review published in 2014 reviewed the effectiveness of TENS across already-existing studies. There was an array of injuries and conditions reviewed but I chose to focus on neck pain as it is a common complaint in addition to back pain. Neck pain can stem from a strain or a pinched nerve that isn't necessarily due to underlying disease.

There was one specific study conducted by the European Federation of Neurological Societies where TENS was more effective than a placebo treatment based on nine controlled trials with over 200 patients experiencing neuropathic pain, which is pain caused by damage to the nervous system. Of these trials, cervical radiculopathy or pain from a pinched nerve in the neck, was found to benefit in pain reduction. (Johnson & Bjordal, 2014).

Clinical experience suggests that TENS is useful when used with pain medication for any type of pain providing it is administered at a sufficiently strong intensity close to the site of pain. (Johnson & Bjordal, 2014). However, this varies as pain levels are different from person to person and a "strong" intensity is open to interpretation depending on the therapist administering treatment.

Even though TENS is a useful modality, it is recommended as a preliminary or add-on therapy since it is noninvasive, safe and can be self-administered.

The examples used were for lower back and neck pain but TENS can be used on other parts of the body as well. For example, it can be used on the arm, elbow, hip, knee, and foot. If you were to go to a physical therapy clinic, you might just see some patients using a TENS device too!

You can even purchase a TENS device without a prescription from pharmacy stores or over the Internet. However, TENS is not a cure-all method, it should be used in adjunction to medication. With a good balance of TENS and medication, a more normal way of living can be attained.

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