TENS

Question 1

TENS defintion

Answer 1

use of electrical current for pain relief/modulated

activates

Question 2

Which parameter affects rate of firing?

Answer 2

frequency

Question 3

Which parameter affects depth of penetration

Answer 3

amplitude/intensity

Question 4

Tens& Pain

Answer 4

Tens does not change pain

TENS changes perception of pain vis stimulation of specific nerve fibers using electrical current

Question 5

Sensory Level Fibers

Answer 5

Sensation: pins and needles or tapping

A beta fibers in superficial dermis

Question 6

Motor Level Fibers

Answer 6

Sensation: fasiculations, twitches, contractions

Alpha motor neurons

Question 7

Noxious Level Fibers

Answer 7

Sensation: pain

A delta and C fibers

Question 8

Gate System

Answer 8

gate closes by preferential depolarization of A beta fibers- sensation of pain blocked via high rate TENS
80- 130 Hz

Question 9

Opiate System

Answer 9

gate opens by preferential depolarization of a delta and C fibers, activates the opiate system, causing the body to release endorphins
Low rate TENS
2-10 pps

Question 10

Analgesic Mechanism of Low Frequency

Answer 10

less than 10 Hz

CNS- activates opiod receptors in RVM and spinal cord descending pathway

Spinal Cord- activates serotonin and muscarinic receptors cause inc in serotonin

Peripheral NS- opiod receptors involved activates alpha adrenergic receptors

Question 11

Analgesic Mechanism of High Frequency TENS

Answer 11

increase concentrations of beta endorphins in the blood stream and CSF

CNS- Spinal Cord- activates delta opiod receptors; enhances release of NT GABA

Peripheral NS- reduce substance P
activate alpha adrenergic receptors

Question 12

Conventional TENS Parameters

Answer 12

Short Pulse Duration <150 usec
High Frequency >80Hz
current amplitude- sensory
stimulate- a beta fibers
sensation- tingling
Analgesia- rapid onset, brief duration

Question 13

Acupuncture TENS

Answer 13

Long pulse duration >150 usec
Low frequency <10 Hz
Current Amplitude- sensory and motor
Fibers- A beta and motor
Sensation- tingling & visible muscle contraction
Pain modulation- opiate system
Analgesia- slow onset, sustained, relatively long duration
Carry over relief after stimulation is removed
30 min max

Question 14

Brief Intense TENS

Answer 14

Long pulse duration >150 usec
High frequency >80 Hz
Current amplitude- sensory, motor, noxious
fibers- a beta, a delta, c fibers
sensation- mixed sensation, strong muscle contraction with max tolerable pain
Analgesia= rapid onset,, sustained for long time

Question 15

Burst TENS

Answer 15

Bursts of pulses instead of individual pulses
Low frequency <10 Hz
current amplitude- sensory motor
fibers- a beta, motor
mixed sensation with moderate motor contraction
Analgesia- slow onset, sustained for relatively long period of time

Question 16

Modulation TENS

Answer 16

variable; random parameters to stimulate the same time to decrease habituation

Question 17

Contraindications

Answer 17

Over pelvis, abdomen, trunk and low back area during pregnancy
Over carotid sinus
Demand pacemaker or unstable arrythmia
Venous/ arterial thrombosis

Question 18

Additional Contra

Answer 18

Epileptic pt
Over metal implants
Over eyes
Mucosal membranes
Undiagnosed pain
Implanted defib
Thoracic and cranial

Question 19

Precautions

Answer 19

Cardiac disease/ mocardial infarction
impaired mentation/ sensation
skin irritation or open wounds
TENS units at least 10 ft from SWD
active epiphyseal regions
no children

Question 20

Opioids and TENS

Answer 20

Opioid drug users are non responders to low frequency tens

Question 21

Caffeine and TENS

Answer 21

Caffeine can affect TENS effectiveness

Question 22

Electrode Placements

Answer 22

on or around painful area
over specific dermatomes, myotomes, or sclerotomes that correspond to painful area
over sites where peripheral nerves that innervate the painful area becomes superficial and can be easily stimulated

Question 23

Close Electrode Proximity

Answer 23

Close Placement
superficial current flow
Low number of parallel paths

at least 1 inch apart

Question 24

Distant Placement

Answer 24

current reaches deeper and higher number of parallel paths