Enraf Nonius TensMed S84, Руководство по эксплуатации, Страница: 57 / 71

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16 INTRODUCTION TO TENS
TENS is used for both acute and long-term pain conditions, particularly when the pain originates
in joints, skeleton, muscles, skin, viscera or the nervous system – both nociceptive and neuro-
genic pain. TENS may be sufficient as the only treatment form, but it is also a valuable
complement to other pharmacological and/or physical treatments. TENS has also proven to
relieve pain and improve the healing of wounds in patients with peripheral circulation disorders,
and is effective in treating nausea.
TENS uses the nervous system’s own analgesic mechanisms in two ways:
High-frequency TENS (also called Conventional TENS) is based on the gate control theory, where
inward-leading nerve fibres inhibit the transfer of impulses in the pain pathways on the spinal
level. High-frequency TENS uses a frequency of 50–120 Hz.
Low-frequency, acupuncture-like TENS (also called Burst TENS) stimulates motor efferents to
create muscle contractions. This releases the body’s own morphine-like substances – endorphins.
Low-frequency TENS uses a frequency of 2–10 Hz.
Mixed frequency stimulation means that high and low-frequency TENS are integrated in the same
program. The stimulation switches between 2 Hz and 80 Hz every three seconds. This provides a
combination of high-frequency and low-frequency stimulation, which can lead to more efficient
treatment.
16.1 Placement of electrodes
High-frequency TENS: the electrodes are preferably placed over or near the painful region. You
can also place the electrodes in the same dermatome as the pain (see the dermatome chart on
page 68), paravertebrally (on both sides of the spine) or on the opposite side of the body. Place
the negative electrode – the cathode (black pin) – over the most painful area. Select the electrode
size according to the area to be treated.
Low-frequency TENS: place the electrodes over the muscle or muscle group you want to treat.
Place the negative electrode over the motor point (where the nerve is closest to the surface).
You can also place the electrodes in the related myotome (see the myotome chart on page 69) or
on acupuncture points. Select the electrode size according to the muscle group to be treated.
Never place the electrodes closer than 3 cm from each other or father apart than 30 cm.
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16.1.1 Stimulation
High-frequency TENS: Adjust the current so that the stimulation gives strong, but pleasant
paraesthesia – tingling. The patient often adapts to the amplitude, so that it needs to be adjusted
after 5 to 10 minutes. Treatment time: Usually a session of 30–60 minutes. You can repeat the
treatment many times a day according to how strong the pain is.
Low-frequency TENS: Adjust the
current so that the stimulation gives visible muscle contractions without pain. Treatment time: 20–
45 minutes. Don’t repeat the treatment more than three times a day, to assure that you avoid
muscle fatigue.