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Pain Relief with Electrical Nerve Stimulation
A relatively low-cost treatment for pain that does not result in addiction, has few side effects and can reduce the need for other potent medications? Is TENS (transcutaneous electrical nerve stimulation) too good to be true? Or could it provide you with the analgesia you need, without all the side effects you don’t?
What Is TENS?
TENS stands for transcutaneous electrical nerve stimulation. It is a therapy that uses small electrical currents to stimulate certain nerves, reducing levels of pain.
People using TENS affix small electrodes around the area of pain. These electrodes are attached to a TENS unit box, which is a small and portable electrical device. Once activated, the TENS electrodes stimulate nerves around the point of pain using either high- or low-frequency wavelengths of low voltage.
People can easily self-administer TENS at home or on the go. TENS sessions typically last 20 to 45 minutes in duration and are repeated a few times each day. The device is portable enough that patients can continue with everyday activities while receiving TENS.
TENS provides pain relief that lasts beyond the administration of the electrical current. A few sessions a day offers full-day relief.
Why Does TENS Provide Analgesia?
No one can say exactly why TENS works. There are two prevailing theories that attempt to explain why and how TENS creates pain relief:
1. The Gate Theory: TENS activates touch reception nerves that cause the closure of pathways to the brain for pain-relaying nerves. With the “gate” open for touch nerves, the “gate” stays closed for pain nerves, meaning signals of pain do not reach the brain.
2. The Neurochemical Release Theory: TENS causes the release of endorphins in the brain. These endorphins are the body’s natural pain relievers. An endorphin release is associated with an accompanying reduction in pain sensations.
Both of these explanations remain only theories. No one can say with certainty why TENS relieves pain.
Which Conditions Is TENS Appropriate For?
TENS is used to provide analgesia for people with a wide range of conditions, both acute and chronic, including the following:
• Fibromyalgia
• Osteoarthritis
• Back pain
• Recovery from surgery
• Labor pain
• Migraines
• Tendonitis
• Bursitis
• Dental pain
• Phantom limb
• Pelvic disorder pain
• Trauma
• Cancer pain (though The American Cancer Society warns against TENS as a substitute for conventional cancer treatments; pain relief does not necessarily imply remission)
Is TENS Dangerous or Addictive?
Although TENS may stimulate the release of opiate-like chemicals in the brain, TENS is not addictive and will not cause any form of withdrawal symptoms upon discontinuation of use.
TENS is very safe for the vast majority of people. TENS should not be used by people who:
• Have pacemakers or other implanted electrical devices, such as implanted hearing aids or diffusion pumps
• Have irregular heartbeats or other forms of heart disease
• Have pain caused by an undiagnosed condition
• Are pregnant
• Have epilepsy
The electrical current from the device can cause skin irritation or minor burns. Electrodes should not be affixed to the front of the neck, the temples, the eyes, over the heart, in the mouth or near open wounds.
How Well Does TENS Work?
While some studies have found good efficacy, other studies have not shown TENS to work better than placebo.
Most practitioners do not endorse TENS as a primary method of pain control, but rather as a complementary therapy that may help some people. TENS is most commonly prescribed for use as an adjunct to analgesic medications.
A recent Cochrane Review of studies done on TENS could not draw any conclusions about the technique’s efficacy as a treatment for acute pain, due to a lack of useable data.
Is TENS Right for You?
Studies do not conclusively prove that TENS works, but anecdotal evidence and some study data indicate that many people find pain relief through TENS. Talk to your doctor about your eligibility for TENS therapy and see whether you might benefit from an attempt with TENS.
Though it doesn’t work for everyone, it does little harm to try it (unlike certain medications) and it might just work for you.
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