TENS, or transcutaneous electrical nerve stimulation, is a non-invasive method of pain relief using a device that sends electrical pulses to nerves under the skin via electrodes. There are four parameters that can be adjusted: pulse shape, pulse width, frequency, and intensity. TENS is commonly used to treat both acute and chronic pain conditions like back pain, arthritis, and sports injuries. Electrodes are placed on or near painful areas or trigger points and treatment sessions typically last less than 40 minutes daily. High and low TENS frequencies have different common parameter settings. Precautions are taken to avoid electrolyte reactions or use of TENS on certain body areas or for people with medical contraindications.

1. TENS / TNS
transcutaneous electrical nerve stimulation

2. TENS DEFINATION:
Tens stands for transcutaneous electrical nerve stimulation
TENS is the application of a pulsed rectangular
wave current via surface electrodes on the
patient’s skin

3. PARAMETERS:
1. Pulse shape or waveform
2. Pulse width or duration
3. Frequency or rate
4. Intensity or amplitude

4. PARAMETERS:
There are 4 parameters
PULSE SHAPE rectangular
PULSE WIDTH 50 – 300 micro seconds
FREQUENCY 2 – 600 HZ (usually 150 HZ )
INTENSITY 0 – 60 mA

5. APPLICATION OF TENS

6. PLACEMENT OF ELECTRODE :
 Acupunture points
 Trigger point , motor points
 Dermatomes , Spinal segments
 Areas with greatest pain intensity
 Peripheral nerves
 May be horizontal or vertical
 Crossed or un crossed

8. High tens
(common parameter)
• FREQUENCY: 100- 150 Hz
• PULSE WIDTH: 100 -500 μs
• INTENSITY : 12 -30 mA
Low tens
(less common parameter)
• FREQUENCY : 1 – 5 Hz
• PULSE WIDTH: 100 – 150 μs
• INTENSITY : 30 mA

9. USES OF TENS:
 relief of acute and chronic pain
 Angina pectoris
 Neck and back pain
 Knee pain
 Sports injuries
 Arthritis

10. TREATMENT:
1. Single treatment session of max 40 mins daily
2. pt stay connected with portable tens ( the unit is on when required )

11. DANGER OF TENS :
Electrolyte reaction below the electrodes-
(high frequency(high TENS),long duration)
CONTRAINDICATIONS :
TENS is contraindicated in
 The region of a cardiac pacemaker
 Neurological conditions
 Malignancy
 Carotid sinus (in front of neck)
 Active infections , skin conditions

12. PROCEDURE:
1. Noting the pain:

13. 2. Keep a record of where the pain extends

14. 3. Decide whether the pain is shooting horizontally or
vertically

15. 4. Choosing Electrodes

16. 5.Attach the electrodes to the tens
6.Check the tens :

17. 7.Clean the skin

18. 8.Place electrode
9.Do not place directly on joint
Place it on soft tissues

19. For larger area
10. Turn on the tens