Transcutaneous Electrical Nerve Stimulation TENS

TENS consists of a pulse generator or stimulator attached to the patient via Ap-fibers to modulate onward pain transmission in the spinal cord. The pulse generator has controls for frequency (2-250 Hz), pulse width and for selecting the type of TENS required. The main variants of TENS are:

Continuous. This is a continuous high-frequency/low-intensity stimulation. Patients should experience a strong but comfortable sensation, akin to non-painful paresthesiae in the affected area.

Pulsed. This results in stimulation as above, with the stimulus coming in bursts. Acupuncture-like. This is low-frequency/ high-intensity TENS. Patients should experience muscle twitching when utilizing this mode.

Most devices allow modification of the above modes by varying the amplitude and pulse-width. There is no correct setting for TENS. Patients should receive initial instruction on how to use the unit, before experimenting at home with pad position, type and intensity of stimulation. It is important that the machine is worn for at least an hour for benefit to occur and can be worn throughout the day. Side effects are few, allergy to the electrodes being the commonest. The effect tends to wane with time but, if a useful benefit is maintained to 3 months or so, long-term benefit is likely.

TENS should not be given to patients with pacemakers (unless a cardiologist is consulted), pregnant women (unless in labor) or to patients who have difficulty understanding the machine. Patients may experience minor skin irritation from the pads and burns have been reported.

There are no clear indications for this therapy. For every series purporting to show benefit, one can find one showing no effect.

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Cure Your Yeast Infection For Good

The term vaginitis is one that is applied to any inflammation or infection of the vagina, and there are many different conditions that are categorized together under this ‘broad’ heading, including bacterial vaginosis, trichomoniasis and non-infectious vaginitis.

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