IFC / TENS

Question 1

Types of Pain

Answer 1

• Acute and Subacute Pain (0-3 months) = ankle sprains, MCL sprains, quadriceps strain, acute tendinitis
• Chronic Pain (3+ months) = persistent LBP, broken foot with persistent pain, post surgical pain

Question 2

IFC and TENS Uses

Answer 2

• Pain reduction
• Muscle activation

Question 3

IFC Overview

Answer 3

• Alternating current modality that modulates (reduces) pain by stimulating nociceptors
• Benefits = easy set up, good effect on pain, and less risk for skin irritation
• Four e-stim pads – where signals intersect they cancel each other out leaving behind the difference called beat frequency (100H or 100pps)
• Two e-stim pads – used for smaller areas while four pads if for bigger areas

Question 4

TENS Overview

Answer 4

• Method of activating nerve fibers by delivering impulses through skin using surface electrodes in order to reduce pain
• TENS and IFC are the same but IFC treats larger areas

Question 5

Acute Pain Parameters for TENS

Answer 5

• 0-6 weeks
• High frequency/ low intensity TENS (conventional or high frequency)
• Frequency ranges between 50-110pps
• Paresthesia, post-op pain, joint pain, soft tissue pain
• Amplitude = strongest possible without motor contraction or increased pain

Question 6

Subacute Pain Parameters for TENS

Answer 6

• 6-12 weeks
• Unresponsive subacute pain (pt is not getting benefits from TENS anymore)
• Now using burst train TENS (mixture of conventional and acupuncture)
• High frequency pulses delivered at low frequency bouts
• Frequency = 100pps delivered at 1-5pps
• Paresthesia, assist with muscle contraction
• Amplitude = strongest tolerated

Question 7

Chronic Pain Parameters for TENS

Answer 7

• 3+ months
• Acupuncture like TENS
• Low frequency and high intensity
• Frequency = below 10pps, normally 1-4pps
• Aid with muscle contraction to produce extra segmental analgesia, pain relief with arthritic conditions
• Amplitude = most tolerable painful stimulus

Question 8

TENS/IFC Contraindications

Answer 8

• Pacemaker (physician approval)
• Pregnancy (cannot do abdomen, low back, or hips)
• Lack of normal sensation
• Impaired cognition
• DVT
• Malignant tumors
• Precaution – active epiphysis

Question 9

TENS Side Note

Answer 9

• If patient says they are not feeling the tingling anymore when they have TENS on then You do not actually turn it up, but You switch the setting
• If it was on brief train TENS then change it to modulated TENS, if it was on modulated TENS then change it to brief TENS