Transcutaneous Electrical Nerve Stimulation (TENS)

Introduction

TENS is a safe, non-invasive, non-pharmacological method of pain management (Poole 2007). A TENs machine is used to apply electrical stimulation to nerve fibres with the objective of bringing about a positive change in the patients’ experience of pain. The change takes the form of less pain or improved function. The stimulation of nerve fibres is via self-adhesive electrode pads placed on the skin. There is evidence of patients reporting less pain and/or improved function (Johnson, 2007) The development and use of TENS has been based on the Gate Control Theory (Melzack and Wall, 1965) Mild electrical pulses are applied to the skin to stimulate the underlying nerves in such a way that they prevent unwanted pain signals from reaching the pain centre in the brain (Tippey 2000).

It is generally accepted that TENS has an effect through three different mechanisms:

• Closing the ‘pain gate’ in the spinal cord
• The release of endogenous opioids – often known as endorphins
• May contribute to muscle relaxation

These mechanisms have been researched and accepted by those who provide clinical TENS application (Tippey 2000).

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