Transcutaneous Electrical Nerve Stimulation (TENS) for Pain Management
Danette C. Taylor, DO, MS, FACN
Dr. Taylor has a passion for treating patients as individuals. In practice since 1994, she has a wide range of experience in treating patients with many types of movement disorders and dementias. In addition to patient care, she is actively involved in the training of residents and medical students, and has been both primary and secondary investigator in numerous research studies through the years. She is a Clinical Assistant Professor at Michigan State University's College of Osteopathic Medicine (Department of Neurology and Ophthalmology). She graduated with a BS degree from Alma College, and an MS (biomechanics) from Michigan State University. She received her medical degree from Michigan State University College of Osteopathic Medicine. Her internship and residency were completed at Botsford General Hospital. Additionally, she completed a fellowship in movement disorders with Dr. Peter LeWitt. She has been named a fellow of the American College of Neuropsychiatrists. She is board-certified in neurology by the American Osteopathic Board of Neurology and Psychiatry. She has authored several articles and lectured extensively; she continues to write questions for two national medical boards. Dr. Taylor is a member of the Medical and Scientific Advisory Council (MSAC) of the Alzheimer's Association of Michigan, and is a reviewer for the journal Clinical Neuropharmacology.
William C. Shiel Jr., MD, FACP, FACR
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
- Electrical nerve stimulation history
- What is a transcutaneous electrical nerve stimulation (TENS) unit?
- How does transcutaneous electrical nerve stimulation work?
- Who is a good candidate for transcutaneous electrical nerve stimulation?
- Patient Comments: Transcutaneous Electrical Nerve Stimulation - Side Effects
Electrical nerve stimulation history
For several thousand years, people have recognized that electrical stimulation can have an impact on pain. Hippocrates, the father of medicine, is said to have used electric fish to cause numbness, and a report of gout being “cured” by accidental contact with a fish called an electric ray dates back to the first century. Later reports also described pain resolution that occurred when similar types of “electric” fish were placed on afflicted body parts.
It wasn't until the 18th century when a more formal device to deliver electricity to decrease pain was created. Although initially developed in Europe, Benjamin Franklin is credited with reforming the original electric condenser, which was used to shock patients in an effort to treat various ailments. (While the device developed by Franklin is often referred to as a “magic square,” it should not be confused with the other type of magic square credited to Franklin, which is a square grid filled with numbers adding to a specific sum whether totaled vertically, horizontally, or diagonally.)
What is a transcutaneous electrical nerve stimulation (TENS) unit?
Today, transcutaneous electrical nerve stimulation units, or TENS units, are commonly used to treat many types of pain, including chronic back and neck pain. Unlike the early devices, where the amount of electricity delivered might vary, TENS units supply a controlled electrical current to stimulate nerve endings through surface electrodes, which are placed over the affected region.
How does transcutaneous electrical nerve stimulation work?
The rationale for using a TENS unit for pain control is based on the inability of the spinal cord and peripheral nerves to multi-task -- that is, impulses that are being carried along a pathway within the nervous system effectively block that pathway from transmitting other signals. In essence, flooding a pathway with low-level stimulation keeps pain signals from reaching the brain.
TENS units are reported to work rapidly, although it can take some adjustment to find the correct level of stimulation. Additionally, TENS units are portable, which can improve the mobility of a patient experiencing chronic pain. However, not all types of pain respond to this method of treatment and any effect tends to be short-lived; pain quickly recurs once the stimulator is removed.
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