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Other common
name(s): TENS
Scientific/medical
name(s): none
Description
Transcutaneous electrical nerve stimulation (TENS) is a method
of pain relief in which a special device transmits low-voltage
electrical impulses through electrodes on the skin to an area of the
body that is in pain.
Overview
There is some evidence that TENS may help reduce certain types
of pain, especially mild pain, for a short period of time. However, it
does not appear to reduce chronic pain.
How is it promoted for use?
Supporters claim that transcutaneous electrical nerve
stimulation (TENS) is an effective method for relieving acute and
chronic pain caused by surgery, childbirth, migraine headaches, tension
headaches, injuries, arthritis, tendonitis, bursitis, chronic wounds,
cancer, and other problems. Some practitioners claim that TENS
stimulates the production of endorphins, the body's natural
painkillers. Most TENS practitioners do not claim the therapy cures the
underlying causes of pain. There is some evidence that it may offer
short-term pain relief for some people, but the long-term benefits have
not been proven.
What does it involve?
A TENS system consists of an electrical power unit connected
by wires to a pair of electrodes. The electrodes are attached to the
patient's skin near the source of pain. When the unit is switched on, a
mild electrical current travels through the electrodes into the body.
Patients may feel tingling or warmth during treatment. A session
typically lasts from five to fifteen minutes, and treatments may be
applied as often as necessary, depending on the severity of pain. Some
practitioners refer to TENS as a sort of "electrical massage."
TENS is used widely by physical therapists and other medical
practitioners but can also be performed at home by patients using a
portable TENS system. There are more than a hundred types of TENS units
approved for use by the U.S. Food and Drug Administration. A
prescription is needed to obtain a system. In a variation of TENS
called percutaneous electrical nerve stimulation, the electrical
impulses are sent through acupuncture needles (see our document, Acupuncture).
What is the history behind it?
Dr. Ronald Melzac and Dr. Patrick Wall developed the Gate
Control Theory in 1965, which claims that when nerves are electrically
stimulated, a gate mechanism is closed in the spinal cord, thereby
preventing the awareness of pain. After the introduction of their
theory, TENS was widely used to treat pain. TENS became a relatively
common therapy in the early 1970s. It is still widely used by physical
therapists and physiotherapists.
What is the evidence?
Research on the effectiveness of TENS therapy for cancer pain
is somewhat conflicting and is limited to small clinical studies and
case reports. Some cancer patients, particularly those with mild
neuropathic pain (pain related to nerve tissue damage), may benefit
from TENS for brief periods of time. TENS may also work better when
used with pain medicines.
One review of TENS reported that many studies have found it
useful in easing pain related to acute injuries of the muscles and
bones, pain after surgery, and some other types of pain. A second
review of fifteen years of TENS research found some evidence to suggest
that it is a useful addition to pain relief, although a number of the
studies under review failed to show TENS was helpful in pain control.
One study found that TENS was not effective for relieving pain after
surgery or during labor. Another study found that percutaneous
electrical nerve stimulation—in which electrical current is
transmitted through acupuncture needles instead of surface
electrodes—was more effective than TENS for relieving lower
back pain.
A 2005 review of studies that looked at the effectiveness of
TENS in relieving lower back pain found very few high-quality studies.
Of the two studies that met all criteria for scientifically sound
research, one showed significant relief of lower back pain in the TENS
group, while the other study showed no difference in pain relief
between the TENS group and the control group.
Overall, there is limited evidence to show TENS effectively
decreases chronic pain. More clinical studies are needed to determine
what benefit TENS may have for people who have cancer in managing
cancer-related pain. At present, it is usually prescribed to be used
with pain medicines.
Are there any possible problems or
complications?
TENS is generally considered safe. However, electrical current
that is too intense or that is used incorrectly can burn or irritate
the skin. The electrodes should not be placed over the eyes, heart,
brain, or front of the throat. People with heart problems should not
use TENS. The effects of long-term use of TENS on fetuses are unknown,
and pregnant women should not undergo the therapy. People with
allergies to adhesives may react to the electrode pads. Those with
implanted pacemakers, defibrillators, infusion pumps, and other such
devices should avoid exposure to electric current. Relying on this
treatment alone and delaying or avoiding conventional medical care for
cancer may have serious health consequences.
Additional Resources
More information from your American Cancer
Society
The following information on complementary and alternative
therapies may also be helpful to you. These materials may be found on
our Web site (www.cancer.org)
or ordered from our toll-free number (1-800-ACS-2345).
References
Barrett D. Ten tips on living with fibromyalgia syndrome.
Quackwatch Web site. Accessed at
http://www.quackwatch.org/03HealthPromotion/fibromyalgia/fms02.html
Accessed May 30, 2008.
Ghoname EA, Craig WF, White PF, Ahmed HE, Hamza MA, Henderson
BN, Gajraj NM, Huber PJ, Gatchel RJ. Percutaneous electrical nerve
stimulation for low back pain: a randomized crossover study. JAMA.
1999;281:818-823.
Khadilkar A, Milne S, Brosseau L, Robinson V, Saginur M, Shea
B, Tugwell P, Wells G. Transcutaneous electrical nerve stimulation
(TENS) for chronic low-back pain. Cochrane Database Syst Rev.
2005;(3):CD003008.
Long DM. Fifteen years of transcutaneous electrical
stimulation for pain control. Stereotact
Funct Neurosurg. 1991;56:2-19.
McQuay HJ, Moore RA, Eccleston C, Morley S, Williams AC.
Systematic review of outpatient services for chronic pain control. Health Technol Assess.
1997;1: i-iv,1-135.
Spencer JW, Jacobs JJ. Complementary/Alternative
Medicine: An Evidence-Based Approach. St. Louis, MO:
Mosby; 1999.
Sykes J, Johnson R, Hanks GW. ABC of palliative care.
Difficult pain problems. BMJ.
1997;315:867-869.
Transcutaneous electrical nerve stimulation. Aetna
InteliHealth Web site. Accessed at
http://www.intelihealth.com/IH/ihtIH/WSIHW000/8513/34968/363973.html on
June 2, 2008.
Note: This information may not cover
all possible claims, uses, actions, precautions, side effects or
interactions. It is not intended as medical advice, and should not be
relied upon as a substitute for consultation with your doctor, who is
familiar with your medical situation.
Last Medical Review: 11/01/2008
Last Revised: 11/01/2008
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