TENS Transcutaneous electrical nerve stimulation

TENS (transcutaneous electrical nerve stimulation)

TENS describes the application of electrical impulses that act on the nerves through the skin. TENS therapy has been a recognized pain therapy method for the relief of acute and chronic pain for over 25 years.

Handy, battery-operated digital 2-channel devices are used to reach and stimulate specific nerves on the body with electrical impulses. In many cases, this stimulation will significantly reduce or even completely eliminate the patient’s perception of pain.

The TENS method is a very practicable form of non-invasive electrotherapy using special stimulation current, electrode and application criteria. Therapeutic electrical stimulation triggers nerve reactions and neuro-modulatory regulation, and is therefore one of the targeted reflex and stimulation therapies. The main aims of the therapy are pain suppression, circulation optimization, muscle relaxation, as well as the reflex effect on visceral organ systems and endocrine glands or reflex therapeutic effects.

TENS therapy also leads to the optimization of central endogenous regulation and impulse control systems. TENS impulses block transmission to the brain and stimulate the body’s natural release of endorphins, which can also reduce pain. TENS treatment can be used to harmonize (or eutonize) the psychovegetative tone, to increase performance and thus for prophylaxis.

TENS (transcutaneous electrical muscle stimulation) with electrodes

TENS principles of action

Gate control theory "continuous pulse train"

The transmission of nociceptive information is inhibited via the stimulated nerves at the dorsal horns of the spinal cord, as a result of which the pain is no longer perceived. The continuous pulse sequence or conventional stimulation works with constant frequencies and pulses. The fixed frequency can be up to 150 Hz and the pulse duration up to 300 µs. The intensity is adjusted so that the stimulation causes strong but pleasant paraesthesia (tingling) in the area of pain. This form of treatment is indicated for most applications at the beginning, especially for acute pain.

Endorphin theory "Burst"

Stimulation of the posterior cord fibers or certain subcortical brain structures can cause inhibition via serotonin and noradrenaline, and endorphins are also released.

The burst mode stimulates with 2 – 4 pulse blocks per second at a frequency of 0.5 to 5 Hz and a pulse duration of 100 to 300 µs. The intensity is adjusted so that the stimulation causes visible but painless muscle contractions. This form of treatment releases β-endorphins centrally.

TheoryGate control effect (continuous pulse sequence)Endorphin release (burst)
Mode of actionvia motor nervesvia sensory nerves
Intensitylow, slight tinglinghigh, just bearable
Pulse duration (pulse width)short (30 – 300 µs)long (150 – 300 µs)
Pulse frequency50 – 150 Hz0.5 – 5 Hz
Muscle contractionnoyes
Onset of pain relieffastslow (20 – 60 min.)
Duration of pain reliefshort (5 – 15 min.)long (20 min. – 12 hours)
Duration of treatmentStart with 3 x 20 – 30 minutes (later increase as required) 30 min. 2 – 3 x daily

Frequency and pulse modulation

Modulated stimulation works with regularly fluctuating frequencies. The settings correspond to conventional stimulation (standard values 100 Hz / 200 µs), whereby the frequency (Hz) or the pulse duration (µs) is continuously changed between 40 and 70 %. This form of therapy prevents accommodation or counteracts habituation tendencies of nerves and muscles and is particularly indicated for longer therapy durations and chronic pain conditions.

Pulse parameters

By varying the carrier pulse duration, pulse frequency and pulse modulation, different analgesic and motor effects can be achieved. innoTENS devices contain sufficient variability of pulse parameters to trigger differentiated effects for different indications.

Rules of thumb for TENS

Higher frequencies

  • stimulate blood circulation and strengthen muscles
  • higher frequencies (50 – 150 Hz) mean lower intensity
  • tend to work via the gate control effect (Wall, Gunnick, Devor)
  • cannot be blocked by naloxone

Lower frequencies

  • have an analgesic, calming, vasodilating and endorphin-stimulating effect
  • Low frequencies (1 – 5 Hz) allow high intensity (needle acupuncture)
  • More of a humoral effect (endorphins)
  • can be partially blocked by naloxone (Pommeranz, 1987)
  • Receptor, performance pain, central pain processing disorder
  • stronger analgesia
  • Longer survival effect

Historical overview

  • ca. 2500 BC: “Electrical” treatment of various pain conditions with the electric electric electric ray found in the Nile (Egypt)
  • ca. 45 AD: Scribonius Largus reports in the classical literature on this electrotherapy with live electric rays (Torpedo marmorata).
  • 1646: Physicist Sir Thomas Brown coins the term “electricity”.
  • 1850: W.G. Oliver (USA) uses electricity for local anesthesia during surgical procedures.
  • 1965: Melzack and Wall publish the Gate Control Theory, thus laying the foundations for the neurophysiological understanding of stimulation analgesia.
  • 1967: Wall and Sweet use TENS of the high-frequency type for the first time in its current form for pain therapy.
  • 1979: Sjölund and Eriksson develop the acupuncture-like TENS “endorphin theory” (Burst).
  • Since 1980: Worldwide distribution and use of TENS for acute and chronic pain conditions
  • 1987: Recognition as a health insurance service (code 30712).

How is a TENS unit used correctly?

For correct application, the self-adhesive electrodes must be attached correctly. Before attaching the electrodes, carefully remove any dirt, grease, make-up or similar from the skin. Connect the electrode cables ( + red / – black ) to the electrodes. The polarity (+ anode / – cathode) is usually irrelevant. Remove the self-adhesive electrodes from the protective film and stick them to the treatment area. Do not throw away the backing film!

Removing the electrodes, storage and care

Pull on one corner of the electrodes to remove them from the skin. Please do not pull on the cables when doing this! This procedure can damage the electrodes and the electrode cable. After removing the electrodes, please stick them back onto the carrier foil. If the adhesive properties and conductivity deteriorate, it is advisable to moisten the electrodes with a few drops of water after use.

How often can I use a TENS?

The recommended duration and frequency of use of a TENS unit depends on the type and severity of the symptoms. Regular use is recommended for the best possible results. However, medical or therapeutic advice should be sought before using the device for the first time in order to ensure an individually tailored application and dosage.

What pain can TENS therapy be used for?

  • Back pain in the cervical spine, thoracic spine or lumbar spine area
  • Slipped disc / sciatica
  • Muscle relaxation
  • Re-mobilization after injury
  • Postoperative muscle building
  • Cranio Mandibular Dysfunction (CMD)
  • Polyneuropathies
  • Carpal tunnel syndrome
  • Tennis elbow
  • Promoting blood circulation
onnoSTIM TE Tens/EMS

For which areas of the body is the use of a TENS unit suitable?

Shoulder
  • Delta muscle (deltoid muscle)
  • Infraspinatus muscle (infraspinatus muscle)
  • Supraspinatus muscle (M. supraspinatus)
  • Round muscles (M. teres minor)
Upper arm
  • Upper arm muscle (brachialis muscle)
  • Arm flexor / biceps (biceps brachii muscle)
  • Arm extensor / triceps (triceps brachii muscle)
Forearm
  • Hand flexor (M. flexor carpi)
  • Hand extensor (M. extensor carpi)
  • Upper arm radial muscle (brachioradialis muscle)
Hip
  • Large gluteal muscle (gluteus maximus)
  • Outer hip muscles (M. tensor fasciae latae)
Back / torso
  • Back extensors (erector spinae muscle)
  • Large and small pectoral muscle (pectoralis major)
  • Large back muscle (latissimus dorsi muscle)
  • Abdominal muscles (M. abdomini)
Thigh
  • Leg flexors (biceps femoris muscle)
  • Leg extensor / lower leg extensor (quadriceps femoris muscle)
Lower leg
  • Anterior tibial muscle (M. tibialis anterior)
  • Posterior tibial muscle (M. tibialis posterior)
  • Calf muscle (gastrocnemius muscle)
Cookie Consent with Real Cookie Banner