Transcutaneous electrical nerve stimulation ( TENS or TNS ) is the use of electric current generated by a device to stimulate nerves for therapeutic purposes. TENS, by definition, includes a complete range of transcutaneously applied currents used for nerve excitation although this term is often used with a more limited purpose, ie to describe the type of pulse generated by a portable stimulator used to treat pain. This unit is usually connected to the skin using two or more electrodes. A battery operated TENS unit is able to modulate the width, frequency, and pulse intensity. Generally TENS is applied to high frequencies (& gt; 50 Hz) with intensity below motor contraction (sensory intensity) or low frequency (& lt; 10 Hz) with intensity resulting in motor contraction. While the use of TENS has proved effective in clinical studies, there is controversy over the conditions under which the device should be used to treat.
Video Transcutaneous electrical nerve stimulation
Medical use
Pain
TENS devices available for the domestic market are used as non-invasive nerve stimulation intended to reduce acute and chronic pain. One review from 2007 felt that evidence supported the benefits in chronic musculoskeletal pain while another review (from Cochrane Collaboration in 2008) was considered to be evidence of poor quality and thus no possible conclusions regarding chronic pain. Results from the task force on neck pain in 2008 found no clinically significant benefit for TENS for the treatment of neck pain when compared with placebo treatment. The 2010 review found no evidence to support the use of TENS for chronic back pain. There is tentative evidence that may be useful for painful diabetic neuropathy. By 2015, the efficacy of TENS therapy for ghost pain is not known because no randomized controlled trial was performed.
In principle, adequate stimulus intensity is required to achieve pain relief with TENS. Treatment loyalty analysis (meaning that delivery of TENS in the experiments according to current clinical advice, such as using "strong but comfortable sensation" and appropriate, frequent treatment duration) suggests that higher loyalty tests are likely to have positive outcomes.
Several studies have shown objective evidence that TENS can modulate or suppress pain signals in the brain. One used generates cortical potential to show that electrical stimulation of peripheral A-beta sensory fibers is capable of suppressing the processing of nociceptive A-delta fibers. Two other studies used functional magnetic resonance imaging (fMRI): one showed that high frequency TENS resulted in decreased cortical activation-related pain in patients with carpal tunnel syndrome, while others indicated that low frequency TENS decreased the pain of shoulder slowing and modulated pain activation in the brain.
The head-mounted TENS tool called Cefaly has been approved by the US Food and Drug Administration on March 11, 2014, for migraine prevention. The Cefaly tool was found to be effective in preventing migraine attacks in randomized controlled trials. This is the first FDA-approved TENS tool for pain prevention, not pain suppression.
Pain of labor
A large number of TENS machine brands have been targeted for use in labor pain, although a 1997 research report by the University of Oxford says that TENS "has proven to be ineffective in postoperative and delivery pain." Usage is documented in the attached reference: in obstetric care, particularly in labor.
Dentistry
TENS has been widely used in non-odontogenic orofacial pain relief. In addition, ultra low frequency TENS and TENS (ULF-TENS) are commonly used in the diagnosis and treatment of temporomandibular joint dysfunction (TMD). Further clinical studies are needed to determine its efficacy.
Maps Transcutaneous electrical nerve stimulation
History
Electrical stimulation for pain control was used in ancient Rome, 63 A.D. It was reported by Scribonius Largus that the pain disappeared by standing on an electric fish on the shore. In the 16th century to the 18th century various electrostatic devices were used for headache and other pain. Benjamin Franklin is a supporter of this method for pain relief. In the 19th century a tool called electreat, along with many other devices used to control pain and cure cancer. Only electreat survived until the 20th century, but was not portable, and had limited control of the stimulus. The development of modern TOD units is generally credited to C. Norman Shealy.
Modern
The first modern, patented patient-wearable TENS in the United States in 1974. Originally used to test the patient's chronic pain tolerance to electrical stimulation before implantation of electrodes in the dorsal columns of the spine. The electrode is mounted on the planted receiver, which receives its power from the antenna used on the surface of the skin. Although intended only to test tolerance to electrical stimulation, many patients say they receive so much help from the TENS itself that they never return for implants.
A number of companies began to produce TENS units after the commercial success of Medtronic devices became known. Medtronic's neurological division, founded by Don Maurer, Ed Schuck and Charles Ray, developed a number of applications for electrical stimulation devices grown for the treatment of epilepsy, Parkinson's disease, and other disorders of the nervous system.
Today many people confuse TENS with electrical muscle stimulation (EMS). EMS and TENS devices look similar, using long cable and electrode electrodes. TENS is to block the pain, where the EMS is to stimulate the muscles.
Research
As reported, TENS has different effects on the brain. Recent RCTs show that ULF-TENS sensors are applied to the skin proximal to the trigeminal nerve, reducing the effects of acute mental stress assessed by heart rate variability (HRV).
Security
There are several anatomical locations where TENS electrodes are contraindicated:
- Above the eye due to increased risk of intraocular pressure
- Transcendental
- At the front of the neck due to the risk of acute hypotension (via vasovagal response) or even laryngeal spasms
- Through the chest using anterior and posterior electrode positions, or other transthoracic applications understood as "crossing the thoracic diameter"; this does not block the coplanar app
- Internally, except for specific gear, vaginal and rectal stimulation apps that use special TENS units
- In damaged areas or skin lesions, although they may be placed around the wound.
- Experiencing tumors/malignancy (based on in vitro experiments in which electricity encourages cell growth)
- Jump above the spine
The tens used in artificial pacemakers (or other in-body stimulators, including throughout the lead) can cause disturbance and failure of the device to be planted. Serious accidents have been recorded in cases where this principle is not observed. A 2009 review in this field shows that electrotherapy, including TENS, is "best avoided" in patients with pacemakers or implanted cardioverter-defibrillators (ICDs). They added that "there is no consensus and it is possible to transmit this modality safely in the proper settings with the device and monitoring of patients", and recommend further research. The review found several ICD reports that governed inappropriate treatment due to disruption of TENS devices, but noted that reports of pacemakers mixed: some unplanned pacemakers were inhibited by TENS, but others were unaffected or re-programmed automatically.
Source of the article : Wikipedia
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