TENS

Question 1

What is TENS?

Answer 1

Electrical stimulation
Low frequency currents applied to skin via lead wires and surface electrodes
Simulate sensory nerves
Asymmetrical
Biphasic - alter positive and negative electrodes
TENS works in 2HZ- 250 HZ per sec

Question 2

When would you use TENS?

Answer 2

Acute pain: joint pain, low back pain

Neurogenic pain: post operative, obstetric

During labour

Chronic pain: arthritis, RA

Question 3

What are the advantages of TENS?

Answer 3

Noninvasive
Few side effects
Patient controlled
Portable 
Battery operative

Question 4

What are the disadvantages of TENS?

Answer 4

Allergic skin reactions to:

Gel, electrode material, tape

Question 5

What should you always do before giving to your patient?

Answer 5

Test TENS on yourself

Question 6

What can you alter on the TENS machines? What are the different parameters?

Answer 6

Pulse width - duration of impulses
Frequency - rate
Intensity - strength

Question 7

What are the three pulse widths?

Answer 7

Conventional - HiTENS - me and Rosie
Burst lowTENS- rate of 2-3 bursts per second - Ryan
Modulation- less regular, changes bursts - George

Question 8

What are the physiological effects of TENS?

Answer 8

Pain gate- in HiTENS - 80-130hz

Stimulate sensory nerve endings
Mechanoreceptors simulated and A beta Fibres stimulated
Prevent c fibres
Close pain gate

Endogenous opioids-

Release opiates
Stimulate a delta fibres
Endorphins released
Inhibit c fibres
Low TENS 2-5 hz

Question 9

What are the different clinical treatment parameters

Answer 9

Conventional is most comfortable to start 
Acupuncture, 
Burst
Modulated
Brief intense tens

Question 10

Explain conventional TENS

Answer 10

High frequency 
80-130hz
Normal intensity
Not uncomfortable 
30 mins minimum and as long as needed 
Limited carry over effect 
Good for acute pain

Question 10

Explain acupuncture tens

Answer 10

2-5hz
Longer pulse
Strong sensation
Within tolerance
30 mins minimum 
Given intervals throughout day
Increased carry over due to encephalon release
Used for chronic pain

Question 11

Explain burst tens

Answer 11

90-130
High intensity
Series of pulses 
Stimulate pain gate AND opioid 
2-3 burst per second

Question 12

Explain modulated tens

Answer 12

Like burst but modulated control meaning stimulation pattern is varied
Delivers irregular burst of stimulation

Question 13

Explain brief intense TENS

Answer 13

Repaid pain relief
High frequency
High pulse width
Intensity close to tolerance 
15-30 Min only

Question 14

Where do you place the electrodes?

Answer 14

Dermatomes
Myotomes
Motor points
On Nerve root
Trigger points

Question 15

What are the contraindications of tens?

Answer 15

No specific for tens

Question 16

What are the contraindications for electrode modalities?

Answer 16

Must be able to cooperate 
Not first 12 weeks of pregnancy 
Not over uterus 
 Not with tumour or suspected malignancy 
Over eyes
Epiphyte all plates on children 
Over pacemakers 
Skin allergies 
Eczema 
Abnormal skin sensation
Bleeding
Compromised circulation 
Anterior aspect of neck
Active TB
Epilepsy

Question 17

What are the precautions of tens?

Answer 17

Abnormal skin sensation
Epilepsy
Abnormal electrodes

Question 18

What are the hazards of tens?

Answer 18

Drop in blood pressure
Skin irritation
Skin burns
Electric shock

Question 19

What is mandatory of tens treatment?

Answer 19

Explanation as to what you're doing
Consent
Tests - SHARP AND BLUNT TEST
questions
Earnings