Cefar Basic Tips for TeNS Treatment

To achieve the best results the method needs to be carefully tested with each patient. We strongly recommend that treatment should be prescribed and tested by a Medical Professional.

Commencing Treatment:
The various methods of stimulation should be tried one at a time.  We recommend starting with Conventional Stimulation followed by Burst Stimulation. 

For long term pain 5 to 10 treatments may be required before any significant results are obtained.

Electrode Placement:
Each individual positioning of electrodes should be evaluated after 30 minutes of stimulation - Sometimes different electrode positions achieve optimum results.  Often the most effective position or positions are to be found in/or adjacent to the painful areas.  N.B. The distance between the electrodes should be at least 3 cm and a maximum of 30 cm.

Conventional Stimulation:
Experience shows that conventional stimulation often is the most effective with neuralgia, arthrosis, arthritis, lumbago, cervalgia, with CNS injuries, pregnancy-related back and pelvic cramps, labour pains, menstrual cramps and postoperative pain.

The electrodes should generally be placed above, or adjacent to, the painful area, or over nerve branches from the same level of the spinal cord as the painful area. The negative electrode should be placed, if possible, above the most painful point. Current strength will give strong, but pleasant, paresthesias, tingling, within the area of pain.

Note that with treatment with conventional stimulation it is important that the patient has a normal sense of touch in the area where the electrodes are placed.

Burst Stimulation:
Burst Stimulation is often the most effective with radiating (projecting) pains in arms or legs (rhizopathy), in conditions with reduced or altered sense of touch, with deep muscle pain, ischemic extremity pain, or when the after-effects from conventional TeNS are short. The aim is to achieve contractions in the muscles innervated from the same segment of the spinal cord as the painful area.

The electrodes should be placed above motor nerves or large groups of muscles. When motor nerves are stimulated the lectrodes should be placed over the bulk of the muscle with the negative electrode over the motor point. This will achieve the best possible contraction at a pleasant current strength.

 

  

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

How Long and How Often is Stimulation Required?:
As with pain-killing medicines, TeNS provides temporary pain relief which often lasts up to 4 hours after treatment. Treatment usually lasts 30-60 minutes, 2-4 times daily.

The induction time to achieve pain relief varies from immediate effect up to about an hour. Some patients prefer continuous stimulation while others prefer intermittent stimulation with different intervals.

Adaptation:
The degree of pain relief declines in some cases with time -TeNS may have less effect after extended use. To reduce the risk of development of tolerance, the following measures may be taken:

        • Frequent follow-ups
        • Teach the patient to use burst, modulated and conventional stimulation
        • Vary electrode placement

If, despite this, the patient should experience lessened, or no effect, from TeNS, take a break from the TeNS treatment for 1-2 weeks and then resume treatment.

 Trial Procedures:
  1.  Establish the nature, extent and, if possible, the cause of the pain.
  2. Test the sense of touch with a bruch or cotton ball.
  3. Conduct a pain evaluation with VAS or similar before and after stimulation.
  4. Make a pain diagram.
  5. Give careful information about TeNS treatment and the care and operation of the stimulator.
  6. Demonstrate the stimulator by trying conbventional and burst stimulation on a non-painful limb, such as the patient's arm.
  7. Wash the skin with soap and water.
  8. Choose stimulation method.
  9. Use carbon rubber electrodes with plenty of gel to be able to glide around with the electrodes in order to find optimal electrode placement.
  10. Start stimulation - let the patient turn up the amplitude.
  11. Try for at least 30 minutes - evaluate.
  12. If pain relief is not achieved, change electrode placement and stimulation method

Remember that it is always the patient who decides the correct electrode placement, stimulation method, treatment time and intensity.


 

 

 

 

 

 

 

 

 

Follow Up:
Follow Up will take place at frequent intervals.  If the patient can handle the stimulator after the first instructions, follow up within 1 week. After that, follow up after 1 month, 3 months, 6 months and 1 year.  Normally the care provider is responsible for ensuring that follow up takes place.

 Contra-Indications for TeNS Treatment:
  • WARNING - Patients with pace-makers may NOT be treated with TeNS
  • Exercise caution during the first 3 months of pregnancy
  • Electrode placement over arteria sinus caroticus
  • Unwilling, frightened patients, reduced level of awareness, dementia
  • Caution with damaged lymphatic system