tens-transcutaneous electrical nerve stimulation

5/27/2018 Tens-transcutaneous Electrical Nerve Stimulation

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TENS-TRANSCUTANEOUSELECTRICAL NERVSTIMULATIONTAMILVANAN MANI


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CONTENTS

INTRODUCTION DEFINITION

PHYSIOLOGICAL BASIS

GATE CONTROL THEORY OF PAIN

OPIOID SYSTEM THEORY

MODES OF TENS

PARAMETERS OF TENS MODES

ELECTRODE PLACEMENT


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INTRODUCTION

Primarily used for pain reduction

Any stimulation in which a current is applied acrossthe skin to stimulate nerves

1965 Gate Control Theory created a great popularityof TENS

TENS has 50-80% efficacy rate


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Only alters perception of pain Little effect on the underlying pathology

Use with other therapies that attempt to treat source of pain

Manual exercise


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DEFINITION

A LOW FREQUENCY ,PULSED RECTANGULAR CURRENTAPPLIED THROUGH THE SURFACE ELECTRODES ON THE SKINTO RELIVE PAIN.

FREQUENCY-1-600 HZ-COMMOMLY USED FREQUENCY IS 150 HZ

PULSE SHAPE - RECTANGULAR

PULSE WIDTH-50 - 500 MS-MEASURED IN MICROSECONDS

INTENSITY-UPTO TINGLING SENSATION FELT BY THE PATIENT


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PHYSIOLOGICAL BASIS

Gate control theory postulated by Melzack and Wall in1965,says,that pain perception is regulated by a gatewhichmay be opened or closed, thus increasing or decreasing thepain perceived by means of other inputs from peripheralnerves.


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PAIN GATE THEORY

Pain signals can be

blocked at the spinal cordbefore they are transmitted

to the brain. TENS

stimulates large Ia

myelinated afferent nerve

fibers that stimulate the

substantia gelatinosa in thespinal cord, closing the gate

on pain transmission to the

thalamus


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OPIOID THEORY stimulation of A-delta & C neurons, which Cause release of enkephalins

(PAG). & RAN

Stimulation of A-delta & C fibers causes release of B-endorphins from the PAG

Mechanism of action similar to encephalin to blockascending nerve impulses

Examples: TENS (low freq. & long pulse duration)

MODES OF TENS


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MODES OF TENS CONVENTIONAL TENS/HF TENS- High-frequency low-intensity stimula

ACCUPUNCTIRE TENS /LF TENS-Low frequency high intensity stimula

BURST TENS- High frequency stimulation bursts at low frequency interva

BRIEF,INTENSE TENS- High frequency high intensity stimulation

COMBINED-Impulses vary in intensity and frequency

Attempts to avoid neuro-habituation


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PARAMETERS OF TENS MODESPARAMETER CONVENTIONAL

TENS/HF TENS

ACCUPUNCTIRE

TENS /LF TENS

BURST TENS

INTENSITY SENSORY MOTOR MOTOR

PULSEFREQUENCY

50-100HZ 1-5 HZ 70-100HZ

PULSE WIDTH 60 MS 200-300 MS 100-200 MS

MODE MODULATED RATE MODULATED

BURST

MODULATED BURST

TREATMENT

DURATION

30-60 MINS

1/8/24 HOUR/DAY

20-30 MINS/DAY

ONSET OF

RELIEF

LESS THAN 10 MINS 20-40 MINS

DURATION OF

RELIEF

MINUTES TO HOURS HOURS


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ELECTRODE PLACEMENTELECTRODE PLACEMENT STIMULATING PARAMETER/MODE

SITE OF PAIN CONVENTIONAL TENS

DERMATOME & MYOTOME ACCUPUNCTURE TENS

TRIGGER POINT,ACCUPUNCTURE POINT &

MOTOR POINT

BURST TENS

PERIPHERAL NERVES MODULATED TENS

DERMATOME


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DERMATOME A DERMATOME IS AN AREA

OF SKINTHAT IS MAINLY SUPPLIED BYA SINGLE SPINAL NERVE.

EACH OF THESE NERVES RELAYSSENSATION (INCLUDING PAIN) FROM A

PARTICULAR REGION OF SKIN TOTHE BRAIN.
http://en.wikipedia.org/wiki/Skinhttp://en.wikipedia.org/wiki/Spinal_nervehttp://en.wikipedia.org/wiki/Brainhttp://en.wikipedia.org/wiki/Brainhttp://en.wikipedia.org/wiki/Spinal_nervehttp://en.wikipedia.org/wiki/Spinal_nervehttp://en.wikipedia.org/wiki/Spinal_nervehttp://en.wikipedia.org/wiki/Skin


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MYOTOME EACH NERVE ROOT COMING FROM THE SPINAL CORD SUPPLA SPECIFIC GROUP OF MUSCLES .


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ACCUPUNCTURE POINT

ARE LOCATIONS ON THE BODYTHAT ARE THE FOCUS OF

ACUPUNCTURE,ACUPRESSURE,
http://en.wikipedia.org/wiki/Acupuncturehttp://en.wikipedia.org/wiki/Acupressurehttp://en.wikipedia.org/wiki/Acupressurehttp://en.wikipedia.org/wiki/Acupuncture


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MOTOR POINTA POINT AT WHICH A MOTOR NERVE ENTERS A

MUSCLE


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TRIGGER POINT TRIGGER POINTS, ALSO KNOWN AS TRIGGER SITES OR MU

ARE DESCRIBED AS HYPERIRRITABLESPOTS IN SKELETAL ARE ASSOCIATED WITH PALPABLE NODULESIN TAUTBANDFIBERS.
http://en.wikipedia.org/wiki/Irritabilityhttp://en.wikipedia.org/wiki/Skeletal_musclehttp://en.wikipedia.org/wiki/Nodule_(medicine)http://en.wiktionary.org/wiki/tauthttp://en.wikipedia.org/wiki/Muscle_fiberhttp://en.wikipedia.org/wiki/Muscle_fiberhttp://en.wiktionary.org/wiki/tauthttp://en.wikipedia.org/wiki/Nodule_(medicine)http://en.wikipedia.org/wiki/Skeletal_musclehttp://en.wikipedia.org/wiki/Skeletal_musclehttp://en.wikipedia.org/wiki/Skeletal_musclehttp://en.wikipedia.org/wiki/Irritability


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INDICATIONS ACUTE AND CHRONIC PAIN

REMODELLING OF BONE AND TISSUE

ANTIEMETIC EFFECT - Effective against vomitingand nausea

LABOR AND DELIVERY

INCESION AND SCAR PAIN
http://en.wikipedia.org/wiki/Vomitinghttp://en.wikipedia.org/wiki/Nauseahttp://en.wikipedia.org/wiki/Nauseahttp://en.wikipedia.org/wiki/Vomiting


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ACUTE AND CHRONIC PAINACUTE & CHRONIC PAIN

ACUTE, NEUROGENIC,POSTOPERATIVE, OBSTETRIC PAIN AND CHRON


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ANTIEMETIC EFFECT ANTIEMETIC EFFECT-MORNING SICKNESS(VOMITING & NAUSEA)-CHEMOTH

PLACEMNT OF ELECTRODES -RIGHT SIDE ONLY

ACROMION TIP AND HOKU(WEB SPACE BETWEEN THUMB AND INDEX

FREQUNCY 80-120 HZ

PULSE WIDTH- 150MS

MIMIMAL INTENSITY

30 MIN EVERY MORNING


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BONE HEALING REMODELLING OF BONE AND TISSUE

NON UNITED FRACTURE PLACEMENT OF ELECTRODES

POP-PROXIMAL AND DISTAL TO THE CAST

2 ELECTRODES PLACED WITH 15 CM APART

4 ELECTRODES CROSS PATTERN

2 ELECTRODES SANDWITH PATTERN

FREQUENCY-120HZ

PULSE WIDTH 300MS

INTENSITY LOWEST BARELY SENSED BY PATIENT

TIME DURATION - 1 HOUR


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LABOR AND DELIVERY DURING LABOR

PROXIMAL 2 ELECTRODE AT LEVEL OF T8

DISTAL 2 ELECTRODE PLACED AT THE LEVEL OF T8 TO L1

FREQUENCY-80-120HZ

PULSE WIDTH 150 MS

INTENSITY LOWEST

POST CESAREAN PAIN


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INCISIONAL AND SCAR PAIN TREATED AS ACUTE PAIN

PLACEMENT OF ELECTRODE -2.5 CM AWAY FROM THE INCESIONAREA

4 ELECTRODES CROSS PATTERN

FREQUENCY-80-120HZ

PULSE WIDTH 150 MS

INTENSITY MINIMAL


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CONTRAINDICATIONS & PRECAUTIONSPACEMAKER-Contracting the heart muscles, to regulate the beatinthe heart

HEART DISEASE OR DYSRHYTHMIAS-irregular heartbeat

UNDIAGNOSED PAIN

EPILEPSY -Epileptic seizures(colloquially a fit) are brief episode"abnormal excessive or synchronous neuronal activityin the brain

PLACEMENT OVER CAROTID SINUS

PLACEMENT OVER PHARYNGEAL AREA

FIRST THREE MONTHS OF PREGNANCY

ANESTHETIC SKIN & OPEN SKIN LESION
http://en.wikipedia.org/wiki/Hearthttp://en.wikipedia.org/wiki/Neural_oscillationhttp://en.wikipedia.org/wiki/Neural_oscillationhttp://en.wikipedia.org/wiki/Heart


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ELECTRODE PLACEMNTS ANKLE LIGAMNET INJURY


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KNEE PAIN

BACK PAIN AND SCAITICA


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BACK PAIN AND SCAITICA


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WRIST PAIN


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CARPAL TUNNEL SYNDROME


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UPPER EXTREMITY PAIN


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ELBOW PAIN

tens-transcutaneous electrical nerve stimulation

Documents

tens low

great popularityof tens

pain reductionany stimulation

opioid theory stimulation

frequency attempts

pain perception

low frequency interva

hz pulse width