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Other common name(s):
TENS
Scientific/medical name(s):
none
DESCRIPTION
Transcutaneous electrical nerve stimulation (TENS) is a
method of pain relief in which a special device transmits low-voltage
electrical impulses through electrodes on the skin to an area of the
body that is in pain (see Electromagnetic
Therapy).
OVERVIEW
There is some evidence that TENS may help reduce certain
types of pain, especially mild pain, for a short period of time.
However, it does not appear to reduce chronic pain.
How is it promoted for use?
Supporters claim that TENS is an effective method for
relieving acute and chronic pain caused by surgery, childbirth,
migraines, tension headaches, injuries, arthritis, tendonitis,
bursitis, chronic wounds, cancer and other sources. Some practitioners
claim that TENS stimulates the production of the body's natural
painkillers. Most TENS practitioners do not claim the therapy cures the
underlying causes of pain. There is some evidence that it may offer
short-term pain relief for some people, but the long-term benefits have
not been proven.
What does it involve?
A TENS system consists of an electrical power unit connected
by wires to a pair of electrodes. The electrodes are attached to the
patient's skin near the source of pain. When the unit is switched on, a
mild electrical current travels through the electrodes into the body.
Patients may feel tingling or warmth during treatment. A session
typically lasts from 5 to 15 minutes and treatments may be applied as
often as necessary, depending on the severity of pain. Some
practitioners refer to TENS as a sort of "electrical massage."
TENS is used widely by physical therapists and other medical
practitioners but can also be performed at home by patients using a
portable TENS system. There are more than 100 types of TENS units
approved for use by the FDA. A prescription is needed to obtain a
system. In a variation of TENS called percutaneous electrical nerve
stimulation, the electrical impulses are sent through acupuncture
needles (see Acupuncture).
What is the history behind it?
Drs. Ronald Melzac and Patrick Wall developed the Gate
Control Theory in 1965, which claims that when nerves are electrically
stimulated, a gate mechanism is closed in the spinal cord preventing
the awareness of pain. After the introduction of the theory, TENS was
widely used to treat pain. TENS became a relatively common therapy in
the early 1970s. It is still widely used by physical therapists and
physiotherapists.
What is the evidence?
Research on the effectiveness of TENS therapy for cancer pain
is limited to small clinical studies and case reports and is somewhat
conflicting. Some cancer patients, particularly those with mild
neuropathic pain (pain related to nerve tissue damage), may benefit
from TENS for brief periods of time. TENS may also work better when
used along with pain medicines.
One review of TENS reported that many studies have found it
useful in easing pain related to acute injuries of the muscles and
bones, pain after surgery, and some other types of pain. A second
review of 15 years of TENS research found some evidence to suggest that
it is a useful addition to pain relief, although a number of the
studies under review failed to show TENS was helpful in pain control.
One study found that TENS was not effective for relieving pain
after surgery or during labor. Another study found that percutaneous
electrical nerve stimulation (in which electrical current is
transmitted through acupuncture needles instead of surface electrodes)
was more effective than TENS for relieving low-back pain.
A 2005 review of studies that looked at TENS' effectiveness in
relieving low back pain found very few high-quality studies. Of the 2
studies that met all criteria, one showed significant relief of the low
back pain in the TENS group, while the other study showed no difference
in pain relief between the TENS group and the control group.
Overall, there is limited evidence to show TENS effectively
decreases chronic (long-term) pain. More clinical studies are needed to
determine what benefit TENS may have for people with cancer in managing
cancer-related pain. At present, it is usually prescribed to be used
along with pain medicines.
Are there any possible problems
or complications?
TENS is generally considered safe. However, electrical
current that is too intense or used incorrectly can burn or irritate
the skin. The electrodes should not be placed over the eyes, heart,
brain, or front of the throat. People with heart problems should not
use TENS. The effects of long-term use of TENS on fetuses is unknown,
therefore pregnant women should not undergo the therapy. People with
allergies to adhesives may react to the electrode pads. Those with
implanted pacemakers, defibrillators, infusion pumps, and other such
devices should avoid being exposed to electric current.
Additional Resources
More Information From Your
American Cancer Society
The following information on complementary and alternative
therapies may also be helpful to you. These materials may be ordered
from our toll-free number (1-800-ACS-2345).
References
Aetna InteliHealth. Transcutaneous Electrical Nerve
Stimulation. Available at:
http://www.intelihealth.com/IH/ihtIH/WSIHW000/8513/34968.
Accessed
4/3/07.
Barrett D. Ten tips on living with fibromyalgia syndrome.
Available at: http://www.quackwatch.org. Accessed 4/3/07.
Ghoname EA, Craig WF, White PF, et al. Percutaneous
electrical nerve stimulation for low back pain: a randomized crossover
study. JAMA. 1999;281:818-823.
Khadilkar A. Milne S. Brosseau L. et al. Transcutaneous electrical
nerve stimulation (TENS) for chronic low-back pain. Cochrane
Database of Syst Rev. 2005. (3):CD003008.
Long DM. Fifteen years of transcutaneous electrical
stimulation for pain control. Stereotact Funct Neurosurg.
1991;56:2-19.
McQuay HJ, Moore RA, Eccleston C, Morley S, Williams AC.
Systematic
review of outpatient services for chronic pain control. Health
Technol
Assess. 1997;1:1-135.
Spencer JW, Jacobs JJ. Complementary/Alternative Medicine: An
Evidence-Based Approach. St. Louis, MO: Mosby, Inc; 1999.
Sykes J, Johnson R, Hanks GW. ABC of palliative care.
Difficult pain
problems. BMJ. 1997;315:867-869.
Note: This information may not
cover all possible claims, uses, actions, precautions, side effects or
interactions. It is not intended as medical advice, and should not be
relied upon as a substitute for consultation with your doctor, who is
familiar with your medical situation.
Revised: 05/23/2007
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