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Continuing Education in Anaesthesia, Critical Care & Pain Advance Access published online on June 26, 2009
Continuing Education in Anaesthesia, Critical Care & Pain, doi:10.1093/bjaceaccp/mkp021
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© The Author [2009]. Published by Oxford University Press on behalf of The Board of Directors of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournal.org

Transcutaneous electrical nerve stimulation

Iain Jones, MB ChB FRCA
Clinical Fellow Pain Management
Pain Management Services
Leeds Teaching Hospitals
Leeds, UK
Leeds Pallium Research Group
Leeds, UK

Mark I Johnson, PhD
Professor of Pain and Analgesia
Centre for Pain Research
Faculty of Health
Leeds Metropolitan University
Civic Quarter
Leeds LS1 3HE, UK
Tel: +44 113 2832600
Fax: +44 113 2833124
Leeds Pallium Research Group
Leeds, UK
E-mail: m.johnson@leedsmet.ac.uk

The first 150 words of the full text of this article appear below.


Key points

Transcutaneous electrical nerve stimulation (TENS) is an inexpensive, self-administered technique with no known potential for overdose.
TENS is used as a stand-alone treatment for mild to moderate pain and as an adjunct to pharmacotherapy for moderate to severe pain.
Pain relief is maximal when strong non-painful TENS paraesthesiae are experienced beneath the electrodes, so patients may need to administer TENS throughout the day.
TENS selectively activates low-threshold peripheral afferents (A-β) which inhibits ongoing nociceptive transmission in the central nervous system.

 

Transcutaneous electrical nerve stimulation (TENS) is a non-invasive analgesic technique that is used to relieve nociceptive, neuropathic, and musculoskeletal pain.1 During TENS, pulsed electrical currents are generated by a portable pulse generator and delivered across the intact surface of the skin via the self-adhering conducting pads called electrodes (Fig. 1). Patients can self-administer TENS and titrate dosage as required, as there is no potential for toxicity. In . . . [Full Text of this Article]


   Historical context
 

   Definition
 

   Postulated mechanisms of action
 
Segmental mechanisms

Extrasegmental mechanisms

Peripheral mechanisms

Neurotransmitters


   Clinical application
 

   Contraindications and precautions
 
Pacemakers and cardiovascular problems

Pregnancy

Epilepsy

Inappropriate electrode sites

Malignancy

Dermatological conditions or frail skin

Dysaesthesia


   Evidence for clinical effectiveness
 
Postoperative pain

Labour pain

Other acute pain conditions

Chronic pain


   Recent developments
 

   Conclusion
 

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