TENS

Question 1

what does TENS stand for?

Answer 1

transcutaneous electrical nerve stimulation

Question 2

what is TENS?

Answer 2

-pulsed current
-low freq current

Question 3

what is interferential therapy?

Answer 3

-alternating current - uses 2 medium freq currents to create a low freq current
-less commonly used now

Question 4

what physiological effect does nerve stimulation of a motor nerve at 10-50 hz have?

Answer 4

a muscle contraction

Question 5

what effect does stimulating sensory nerve (non-pain) fibres at a freq of 90-130 Hz have?

Answer 5

-sensory stimulation

Question 6

what is the pain gate theory?

Answer 6

when a non noxious stimuli is applied - it can inhibit the transmission of pain from a delta and C fibres

Question 7

what is descending pain inhibition?

Answer 7

-use of lower freq stimulates a delta and c fibres
-stimulation of a delta and C fibres activates the opioid mechanisms
-this leads to descending inhibition of pain

Question 8

what are examples of TENS parameters?

Answer 8

-pulse or frequency
-amplitude
-pulse duration
-burst mode
-modulation

Question 9

what is amplitude influenced by?

Answer 9

-size of electrode
-placement of electrode
-patients tolerance
-area

Question 10

why is cyclical variation good?

Answer 10

as it is believed to help prevent adaption of the nerves to the current

Question 11

what are examples of different types of tens?

Answer 11

-conventional TENS
-acupuncture like TENS
-intense TENS
-burst TENS

Question 12

what is the aim of conventional TENS?

Answer 12

to selectively activate the large diameter sensory fibres without activating the pain fibres or motor fibres
-rapid onset but short acting pain relief

Question 13

what is the aim of acupuncture like TENS?

Answer 13

-selectively activate the small diameter alpha delta and c fibres

Question 14

what is brief intense TENS?

Answer 14

-to produce rapid pain relief by activating the alpha delta fibres at an intensity that is just tolerable to the patient

Question 15

what is burst TENS?

Answer 15

a conventional TENS, interrupted by bursts of 2-5 bursts / second
-higher than conventional

Question 16

which tens should you use?

Answer 16

-conventional is commonly tried first
-acupuncture like is used frequently for chronic pain (for descending pain inhibition)
-brief intense and burst tens used less frequently

Question 17

what are contraindications to using TENS?

Answer 17

-undiagnosed pain
-lack of normal sensation
-pacemakers / cardiac arrythmias
-malignant tumours
-over the carotid sinuses
-pregnancy
-epilepsy
-people who have an allergic reaction to electrodes

Question 18

what are pre-cautions for use of TENS?

Answer 18

-cardiac disease
-impaired sensation
-impaired cognition
-skin irritation
-open wounds / fragile skin

Question 19

what are adverse effects of TENS?

Answer 19

-headache
-electrical burn
-hypotension if electrodes are placed over cervical spine

Question 20

what important test must be done before TENS treatment?

Answer 20

-sharp blunt test
-w/ pts eyes closed
-if pt cannot tell difference between sharp and blunt, then sensation is impaired and TENS is not appropriate

Question 21

what are indications for TENS?

Answer 21

-acute pain eg post injury, post op
-chronic pain eg OA, RA]
-labour pain

Question 22

what 4 factors is TENS effectiveness is affected by?

Answer 22

-type of application
-site of application
-treatment duration of TENS
-optimal freq and intensities

Question 23

when is TENS used in labour?

Answer 23

-used in 1st and 2nd stage of labour
-specifically designed obstetric TENS has a boost control for contractions