TENS

Question 1

4 unique characteristics of pain

Answer 1

1. Spread of pain in SC
   -2-3 segments above
   -1-2 segments below
   branches of nocioceptors descend/ascend SC before being processed
2. Autonomically enhanced pain
   - potentiated in peripheral and central
   - central sensitization=chronic pain
3. Peripheral sensitization of nocioceptors
   - toxic soup released with pain; decrease threshold of nocioceptors proximally
   - nocioceptors reach threshold with weaker stimulus
4. Visceral pain
   - neural excitation with somatic WDR-> referred
   - Hormonally mediated pain; TENS inefective

Question 2

Frequency

Answer 2

pulse per second (Hz on machine)

50-120 pps
higher increases competition

Question 3

Phase Duration

Answer 3

microseconds
20-150 us

inversely related to amplitude
short pulses best

Question 4

Amplitude

Answer 4

patient controlled dependant on comfort

higher amplitude effects more gates
“strong sensory stimulation without motore contraction”

Question 5

Waveform

Answer 5

Biphasic avoids ion buildup
Symmetric gives greater sensory stimulation
Asymmetric more under negative lead

Question 6

TENS contraindications

Answer 6

pacemaker/defib
metal in region
cancer
pregnancy

precaution if sensory deficits from SCI; go above injury