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If I am asked to use TENS, how can I decrease the chance of side effects?

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THIS ARTICLE WILL TELL YOU ABOUT:

  • How Transcutaneous Electrical Nerve Stimulation (TENS) works
  • Some of the evidence supporting and not supporting its use, and why there is a lot of debate
  • How to prevent habituation in patients using TENS
  • In what situations TENS should and should not be used

YOU WOULD BE LIKELY TO REFERENCE THIS ARTICLE IF YOU WERE RESEARCHING:

  • Non-pharmacological methods of pain relief
  • Gate-control theory
  • Habituation

IN WHAT SITUATIONS WILL THIS ARTICLE BE USEFUL TO ME?

This article looks at a popular method of pain relief.  It will be useful in helping you understand how it works and when it should and should not be used. The discussion on the quality of the evidence can help you understand why there is so much debate about the effectiveness of TENS. Practically the discussion on habituation will be helpful to you with tips on how to maximise the effectiveness of TENS.

QUESTIONS FOR YOUR MENTOR/TUTOR:

  • When I use TENS, how should I vary the location of electrodes and the electrical settings?
  • If I am asked to use TENS to patients with decreased sensitisation, infection or epilepsy, how can I decrease the chance of side effects?

STUDENT NT DECODER:

  • Transcutaneous Electrical Nerve Stimulation (TENS): an electrical analgesic—that is, a pain reliever that works by electrical impulses. Since these impulses pass through the skin, they are “transcutaneous”. TENS works by hindering the transfer of pain impulses in the nerves and by stimulating the release of endorphins. Experts suggest there are no direct side effects, but TENS can make certain conditions, like epilepsy, worse. Most evidence about TENS is inconclusive so it should be used with caution and in combination with other pain relievers.
  • Habituation: the process by which pain relievers become less effective with long term use. Habituation to TENS can be decreased by managing time between sessions, rotating electrode locations and changing electrical settings.
  • Level A and level B evidence: In the UK, evidence is rated from levels A-D according to how authoritative it is.  This rating is based on a number of qualifications, including the type of trial and the range of the population that was tested.  Level A evidence is the most authoritative evidence; level B is the next most. 

 

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