TENS/Pain relief

TENS – TRANSCUTANEOUS ELECTRICAL NERVE STIMULATION


Electrode placements

Here are some examples of electrode placements for common indications. Note where the red and black electrodes go.

Tension headache

Program: High and/or low-frequency

In general, it doesn’t matter where the red or black pin is located. For high-frequency stimulation, we recommend a pulse duration of 60 µs.

High-frequency                low-frequency

Phantom pain

Program: High or low-frequency

High-frequency:
  1. Place the electrodes paravertebrally in the same segment as the pain.
  2. If sensitivity is normal, place the electrodes on the contralateral side, such as the foot.
Low-frequency:
Place the electrodes on the contralateral side in the same myotome as the pain.


High-frequency                 Low-frequency

Back pain

Lumbago

Program: High-frequency

In general, it doesn’t matter where the red or black pin is located. Big electrodes work well here. Place the electrodes in the painful area.

Pain from shingles

Postherpetic neuralgia
For example, at Th6–Th7 on the right.

Program: High or low-frequency

High-frequency: Place the electrodes where sensitivity is normal – within the dermatome just over or under the affected segment. Or the electrodes can be placed in the same segment on the contralateral side.

Low-frequency: The electrode must be positioned in such a way as to create strong contractions in the innervated intercostal musculature in the Th6–Th7 region, which can be difficult.

High-frequency                  Low-frequency

Neck and arm pain

Cervical rhizopathy
C6 area, right side. Upper-arm pain that radiates out to the thumb.

Program: High and low-frequency

High-frequency: If sensitivity is normal, stimulate in the painful area (dermatome).

Low-frequency: Stimulate over the muscles in the myotome, such as the biceps or carpal radial extensors.


High-frequency                  Low-frequency

Backache and sciatica

Lumbago with sacral rhizopathy and S1 spread to the right.

Program: High and low-frequency

High frequency in the lumbar region and low frequency on the leg where the sensitivity is reduced.

Upper placement: high-frequency. Lower placement: low frequency.

Sciatica

Lumbosacral rhizopathy
With L4 distribution on the right side.

Program: High or low-frequency

High-frequency: Over the L4 innervated skin if sensitivity is normal.

Low-frequency: Over the L4 innervated muscles. A diagonal position often gives good contractions.

Upper placement: low-frequency. Lower placement: high frequency.

Shoulder pain

Spreading into the left shoulder, laterally down over the deltoid insertion.

Program: High and possibly also low-frequency

Place one electrode over the joint space and the other over the deltoid insertion.
 

Central pain

Spreading to the right.

Program: High or low-frequency

Place the electrode pair preferably over major nerve stems where the pain is most pronounced. In some cases, placement on the opposite side can be tested. Central pain is often a difficult diagnosis to treat.

High-frequency/low-frequency

Fracture pain?

such as a rib fracture

Program: High-frequency

It is usually not necessary to determine the segmental innervation in the painful part of the skeleton.

Place the electrodes around the painful area. This usually provides good pain relief for injuries such as rib fractures or vertebral compression.

Hip pain?

Right side.

Program: High-frequency

Place one electrode at hip height or proximally and the other on the middle outside of the thigh. In general, it doesn’t matter where the red or black pin is located.

Knee pain?

Program: High-frequency

Place the electrodes on either side of the joint space to facilitate flexion.

Muscle pain?

Pain from muscular tension is most common in the neck and scapular areas. Usually you can find trigger points or extra-sensitive areas.

Program: High or low-frequency

Place the electrodes in the painful area, preferably over tender points. For intrascapular radiation, two pairs of electrodes are recommended.

High-frequency                 Low-frequency

Afterpains?

Program: High-frequency

Place the electrodes in the painful area – back or stomach or both.

Pubic symphysis pain?

Program: High-frequency

Place the electrodes in the painful area (in the L1 segment in the groin, or over the SI joint in the back). Avoid connecting an electrode pair over the symphysis.

Labor pain?

Program: High-frequency

Place two or four electrodes in the painful area, usually the sacral region. Large electrodes work well here. Later in the delivery, the pain often moves forward/down. Keep two electrodes on the back and add two over the hips/down towards the groin. Note: Avoid connecting an electrode pair over the uterus.

Menstrual pain?

Menstrual cramps

Program: High-frequency

Place the electrodes in the painful area – back or stomach or both. For acute ischemic pain, you can use high-frequency stimulation with very high amplitude for a short time (60 seconds). This is called high-intensity stimulation.

Angina pectoris?

Program: High-frequency

Place the electrodes over the painful area. In general, it doesn’t matter where the red or black pin is located. For acute ischemic pain, you can use high-frequency stimulation with very high amplitude for a short time (60 seconds). This is called high-intensity stimulation. This is usually tested out at a cardiology clinic.