TENS (Transcutaneous Electrical Nerve Stimulation) Therapy in Holland Park, Brisbane

Are you exploring different non-pharmacological options for managing pain in the Holland Park area? You might have come across TENS, or Transcutaneous Electrical Nerve Stimulation, a therapy that uses low-voltage electrical currents applied through the skin. TENS is a modality sometimes utilised by healthcare professionals, including chiropractors and physiotherapists, as part of a broader strategy for managing certain types of pain. At Silky Oak Chiropractic, TENS therapy may be considered as an adjunctive treatment – meaning it’s used alongside other primary therapies like manual techniques and exercise – when clinically indicated based on your specific condition and assessment. This page provides information about TENS therapy.

What is TENS Therapy and How is it Thought to Work?

TENS therapy involves a small, usually portable, battery-operated device connected by wires to adhesive electrode pads. These pads are placed on the skin over or near the area where pain is experienced. The device delivers controlled, low-voltage electrical impulses through the electrodes to the underlying nerves.

The primary goal of TENS is to modulate or change the perception of pain. While the exact mechanisms are still studied, the main theories proposed are:

1. Gate Control Theory of Pain (Primary Theory): This is the most widely accepted theory for conventional, high-frequency TENS. It suggests that the electrical impulses stimulate specific non-pain-transmitting sensory nerves (A-beta fibres) in the skin and superficial tissues. This increased non-painful sensory input travels to the spinal cord and is thought to effectively ‘close a gate’, inhibiting the transmission of pain signals travelling along smaller nerve fibres (A-delta and C fibres) from reaching the brain. Essentially, the tingling or buzzing sensation from the TENS may override or block the perception of the underlying pain signal. (Reference 1).

2. Endorphin Release (Theory for Low-Frequency TENS): It is proposed that using different TENS settings, typically lower frequency (acupuncture-like TENS), may stimulate the body’s own pain-relief system. This could involve triggering the release of endorphins and encephalins – natural opioid-like chemicals produced in the brain and spinal cord – which can provide more widespread or longer-lasting pain relief. The evidence supporting this mechanism is generally considered less robust than for the Gate Control Theory.

3. Dependence on Parameters: The physiological effects of TENS are highly dependent on the specific settings used, including:

  • Frequency (Hz): Pulses per second (high frequency for Gate Control, low for potential endorphin release).
  • Pulse Width (μs): Duration of each electrical pulse.
  • Intensity (mA): Strength of the current, adjusted to patient tolerance (usually a strong but comfortable tingling).

Important Note: TENS primarily aims to provide symptomatic pain relief. It does not typically address the underlying cause of the pain or heal injured tissues directly. It’s a tool for modulating the pain experience.

Potential Role of TENS in Musculoskeletal Care

TENS is considered a passive modality, meaning it’s applied to the patient rather than requiring active participation like exercise. Its role is generally supportive and adjunctive within a comprehensive management plan.

1. Adjunctive Symptom Management: TENS may be considered as one component of a pain management strategy, used alongside core treatments such as exercise, manual therapy (adjustments, mobilisation, soft tissue work), education, and self-management techniques. It is not typically used as a standalone treatment for most musculoskeletal conditions.

2. Conditions Where TENS May Be Considered: Practitioners may consider using TENS for temporary pain modulation in various situations, including:

  • Acute musculoskeletal pain (e.g., following an injury, alongside other first aid).
  • Chronic pain conditions (e.g., chronic low back pain, osteoarthritis – particularly knee OA).
  • Certain types of neuropathic (nerve-related) pain. (Note: TENS is also used in other settings like labour pain management, which is outside the typical scope here).

3. Evidence Considerations: It is crucial to understand that the scientific evidence for the effectiveness of TENS is highly variable and often inconsistent. Systematic reviews and clinical guidelines provide mixed conclusions:

  • Some studies suggest short-term pain relief for certain acute pain conditions or knee osteoarthritis (Reference 2).
  • For chronic low back pain, high-quality evidence often shows little to no significant difference between TENS and placebo/sham TENS for pain intensity or function (Reference 3, 4).
  • Effectiveness can depend greatly on the condition being treated, the parameters used, electrode placement, treatment duration, and individual patient factors.
  • Many studies are hampered by methodological limitations.

Given this variability, TENS is offered at Silky Oak Chiropractic on a case-by-case basis where it might provide subjective symptomatic relief for an individual, potentially helping them to better engage with more active therapies. It is not presented as a primary or curative treatment based on current high-level evidence for many chronic conditions.

4. Facilitating Active Rehabilitation: In some instances, by temporarily reducing pain perception, TENS might make it easier for an individual to perform prescribed exercises or participate more fully in active rehabilitation programs, which are crucial for long-term recovery.

The TENS Application Process at Silky Oak Chiropractic

If TENS is considered potentially beneficial and appropriate for you, the process involves:

1. Assessment of Suitability & Contraindications: A thorough assessment is conducted first to understand your condition and, importantly, to screen for any contraindications or precautions that would make TENS unsafe (see Safety section below).

2. Electrode Placement: Self-adhesive electrode pads are placed on clean, dry skin. Placement is strategic – often bracketing the painful area, placed over specific nerve pathways related to the pain, or sometimes over related muscle trigger points. Correct placement is important for potential effectiveness.

3. Parameter Selection and Intensity Adjustment: Dr. Jones selects the appropriate TENS settings (frequency, pulse width) based on the therapeutic goal (e.g., pain gating). The intensity (strength) of the current is then gradually increased until you feel a definite but comfortable tingling, buzzing, or potentially muscle-tapping sensation (for low-frequency settings). It should not be painful.

4. Treatment Duration: A typical clinical application of TENS might last for 15-30 minutes during your appointment, often while you are resting or potentially combined with other modalities like heat/cold packs if appropriate.

5. Integration with Other Care: TENS is usually applied alongside or preceding other chiropractic interventions planned for that session, such as manual therapy or exercise instruction.

6. Guidance for Home Use (If Applicable): While TENS units are available for purchase for home use, it’s important to receive professional guidance on appropriate electrode placements, settings, duration of use, and safety precautions before using one independently.

Safety Considerations and Contraindications for TENS Therapy

While generally considered safe when used correctly, TENS involves electrical currents and has important contraindications and precautions:

Contraindications (TENS should NOT be used):

  • On individuals with cardiac pacemakers, implanted defibrillators (ICDs), or other implanted electronic devices.
  • Over the carotid sinus area (front/side of the neck).
  • Over the eyes or mouth.
  • During pregnancy (especially over the abdomen, pelvis, or low back).
  • Over areas of active cancer/malignancy.
  • In individuals with epilepsy (avoid head/neck placement).
  • Over broken, infected, or numb skin.
  • Near or over thrombophlebitis or arterial thrombosis.

Precautions (Use with caution and professional guidance):

  • Individuals with cognitive impairments who cannot provide feedback.
  • Areas of impaired sensation.
  • Known skin allergies or sensitivities to electrode gel/adhesive.
  • Heart conditions (consultation with GP/cardiologist advised).

Potential Side Effects: Minor skin irritation under the electrodes is the most common side effect. Burns are possible but rare if intensity is too high or equipment is faulty.

It is essential to inform Dr. Jones of your full medical history before using TENS.

References:

(Note: These references reflect the variable evidence for TENS, particularly the often limited support for chronic conditions like LBP.)

  1. Mechanism Overview (Gate Control): Melzack R, Wall PD. Pain mechanisms: a new theory. Science. 1965;150(3699):971-979. (Original paper describing the Gate Control Theory).
  2. TENS for Knee Osteoarthritis (Cochrane Review Example): Rutjes AWS, Nüesch E, Sterchi R, et al. Transcutaneous electrostimulation for osteoarthritis of the knee. Cochrane Database Syst Rev. 2009;(4):CD002823. (Example review, findings on effectiveness can vary and require updates).  
  3. TENS for Chronic Low Back Pain (Cochrane Review Example): Khadilkar A, Odebiyi DO, Brosseau L, Wells GA. Transcutaneous electrical nerve stimulation (TENS) versus placebo for chronic low back pain. Cochrane Database Syst Rev. 2008;(4):CD003008. (Updated by: Wu LC, Weng PW, Chen CH, Huang YY, Tsuang YH, Chiang CJ. Literature Review and Meta-Analysis of Transcutaneous Electrical Nerve Stimulation in Treating Chronic Back Pain. Reg Anesth Pain Med. 2018;43(4):425-433.) (Reviews often find limited high-quality evidence for clinically significant benefits over placebo).  
  4. TENS Overview & Evidence Summary (Example): Johnson MI, Paley CA, Howe TE, Sluka KA. Transcutaneous electrical nerve stimulation for acute pain. Cochrane Database Syst Rev. 2015;(6):CD006142. (Updated reviews exist). (Summarises evidence across different acute pain conditions, often finding low-quality evidence or need for more research).  

Disclaimer: The information provided on this page describes TENS (Transcutaneous Electrical Nerve Stimulation) Therapy and its potential adjunctive use within our practice. It is for general informational purposes only and does not constitute medical or chiropractic advice or guarantee specific outcomes. The effectiveness of TENS therapy is variable and scientific evidence for significant, long-term benefits is often limited or inconsistent for many conditions. TENS is primarily a symptom-modulating modality and does not address the underlying cause of pain. It should only be used following a thorough assessment by a qualified healthcare professional to determine suitability and rule out contraindications. Always consult with your registered chiropractor or GP regarding any health concerns or before starting any new treatment. Do not disregard professional advice or delay seeking it because of something you have read on this website. Treatment outcomes vary between individuals.