KnowHow: TENS - Differentiating Various Types bu Subin Solomen

TENS is the application of low frequency current through the surface electrode on the patient’s skin to reduce the pain.

  1. High Frequency TENS (Conventional TENS)

This type of application is High frequency low intensity TENS. It is used for relief of acute pain. The mechanism is blocking Aδ by stimulating Aβ fibres. Treatment has to be given for a minimum period of 40 minutes to one hour. By the applications of TENS, patient feels a soothing effect immediately. This effect is continued till the treatment is given. There is no carry over effect (the effect is lost when the treatment is stopped).

  1. Low Frequency TENS (Acupuncture TENS)

This type of application is low frequency high intensity TENS. It is mainly used for relief of chronic pain. This application is painful to the patient. Low TENS stimulate A α fibers (1-10Hz) which causes muscle contraction. Muscle twitch in a painful site produces an acute pain. This sensation is carried by Aδ fibers which block C fibers at spinal cord level. Another mechanism of pain relief is by directly stimulating Aδ by keeping 25-40Hz which blocks C – fibers or by keeping 10-15 Hz which stimulates C fibers which goes through descending pathway which blocks C fibers transmission. Treatment time of low TENS application is generally for 20 minutes. There is no immediate effect with this technique and no effect during the treatment session. But there is a carryover effect which last longer.

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