TENS

Question 1

how to perform

Answer 1

expose area, pin prick test, place electrodes, attach leads, set Frequency/pulse width for high/low TENS, turn up intensity to tolerance, start timer, adverse reactions, teach patient to use at home

electrode placed where nerve is most superficial, either side of painful point, so that limb can be used normally

Conventional/high tens: strong not uncomfortable, mild pins and needles
frequency - 150Hz
pulse width - 50-80us
time - 8 hours
mode - normal

Acupuncture /low: as intense as P can bear, sharp pricking sensation
1-4Hz, 200us, 30mins

modify amount of electrodes needed
skin irritation may occur after application

Question 2

contraindications / precautions

Answer 2

MSK: 1-3 months pregnant
CR:
CV: Pacemakers, HD,
N: undiagnosed pain, Epilepsy
abnormal skin sensation, epiphyseal/bone growth areas,

Question 3

rational

Answer 3

applying low frequency electrical stimulation to the skin via surface electrodes to stimulate nerve fibres for pain relief
Nerves transmit the signals received from the TENS machine quicker to the brain then the signals of pain

high frequency stimulates alpha beta sensory fibres and reduces stimulus from other sensory pathways (C fibres)
low frequency stimulates alpha delta fibres that activate opiate mechanisms and release endogenous opiate into spinal cord that reduces activation of other sensory pathways

Question 4

physiological affects

Answer 4

pain relief
endorphins - painkillers
increase blood flow, metabolic rate, healing
decrease swelling, muscle tension
increase ROM
P nerve stimulation

Question 5

structures effected

Answer 5

nerves of brachial plexus - scapular, thoracic
muscles stimulated - spinalis, upper trapz
cervical spine - electrodes placed either side of posterior neck, on upper shoulders

Question 6

principles

Answer 6

safety:
out of childs reach
not if driving/operating hazardous equipment
switch off before applying/removing electrodes

high tens: Tingling/pins and needles.
low: Sharp, pricking sensation

time: 8hrs max, severe conditions treat for 3 weeks, reduce use over time, can be 1 night only - phantom limb pain
electrode placed close to where the pain is perceived, appropriate trigger points, over spinal nerve roots, close to SP, within the same dermatome/myotome/sclerotome