Remember the great capacity that an electro-stimulator has as an analgesic, and the function which pain has as an indicator of various types of illness! Most of the programmes in this section A1 to A16 are natural analgesics. Please read this manual before using an electro-stimulator. REMEMBER THAT PAIN IS A SIGNAL: before using an electro-stimulator identify the pathology with the help of a doctor. ‘TENS’ neuro-stimulation (an accronym that stands for Transcutaneos Electrical Nerve Stimulation) is a therapeutic technique used with the antalgic aim of contrasting the effects of pain, caused by the various pathologies. The efficiency of this type of current in the treatment of daily disfunctions which afflict humans has been demonstrated; cervical pain, degenerative osteoarthritis, myalgia, neuritis, back pain, periartritis, heaviness in the legs, muscular weakness, just to mention a few.
Academically speaking, the TENS is divided into many categories according to the mechanism which is used to achieve the reduction in the pain; conventional or rapid antalgic TENS, electro-acupuncture or delayed antalgic training, sweeping TENS where the stimulus parameters are variable during the treatment, TENS with the highest values possible so as to produce an analgesic and calming effect on the immediate area, and burst TENS which is a mix of the first two types of tens. The recovery function of TENS is obtained due to its capacity to reduce pain and, consequently, reestablishment of the physiological conditions. In most cases, this allows the patient to regain normal motor functioning.
Think about a patient afflicted by periartritis; they turn to analgesics, or they live with the pain which normally makes the most simple movements impossible. Immobility reduces metabolic activity and, consequently, makes the elimination of pain producing substances impossible. It is a vicious circle. The TENS, aside from reducing pain, provokes a stimulus which increases the metabolic activity, blood flow, and oxygenation of tissues and the transport of nutritive substances. If TENS is combined with muscular stimlus in the treated area, the positive effect will be all the greater. The intensity should be regulated between the perception and pain threshold; the maximum intensity limit will be represented by the moment the muscles surrounding the treated area begin to contract. Raising the intensity above this level will not increase efficiency and will only cause irritation, so it’s best to stop before said threshold.
Quick TENS. This is a medical programme; it is also referred to as ‘Conventional tens’ and is used with antalgic objectives. It acts by inducing a pain block in the spine of the organism, according to the ‘gate control theory of pain of Melzack and Wall’. The painful impulses which come from a particular point in the body, a hand for example, runs through the nerve canals, through nerve fibres with a small diameter, until it reaches the central nervous system where the impulse is interpreted as pain.
The conventional Tens activates large diametre nerve fibres which block the route of the small diametre fibres in the spine. Therefore, it is an action predominantly on the symptom, that is, the route which carries the pain information is blocked. The duration of the treatment shouldn’t be less than 30/40 minutes. The conventional tens is a current which can be used generally in the treatment of day to day pains. The average number of treatments required to experience benefits is 10 to 12 with daily frequency. There is no contraindication with using it two a day. The programme lasts 30 minutes per phase. If particularly insistent pain remains after a session, repeat the programme.
Electrode position: form a square on the area where the pain is experienced. There are other placement options; consult a physiotherapist.
Endorphin TENS. Medical programme. This type of stimulus produces two effects in relation to the placement of the electrodes: positioning them in the dorsal area, referring to photo 08 in the placement manual, causes the endogenous production of endorphins which have the abilitiy to raise the pain threshold. Positioning the electrodes in a square formation on the painful area, figure 1, produces a vascularising effect. The vascularising action produces an increase in the arterial blood, consequently causing a positive effect on the elimination of algogenic (pain producers) substances, and a reestablishment of normal physiological conditions. Treatment duration 20 minutes per phase, with daily frequency.
Do not place the electrodes near to inflamed areas. Intensity regulated so that a nice sensation is experienced in the stimulated area (between 10 and 20mA); the sensation should resemble a massage.
Sweeping TENS. Medical programme. The action is very similar to that of programme A01. In this programme the frequency and the width of the impulse vary during the stimulus, so avoid adaptation to the stimulus. Continued increases in intensity are not necessary. Select the intensity at the start of the programme and leave it at that level until the end. It may occur that the perception of the current disappears during the programme; in this case, do not raise the intensity and wait till the end; the TENS is developing its function. The duration is 20 minutes per phase. Intensity: barely above the perception threshold. Electrode position: form a square on the painful area.
TENS with highest values possible. Medical programme with a short duration; 3 minutes per phase. Produces a peripheral block of the painful impulses, causing a local calming effect. This is a stimulus that is suitable in traumatic situations or contusions when quick intervention is necessary. The selected intensity should be comfortably bearable, though higher than that of conventional TENS, causing a contraction of the muscles surrounding the treated area. For this reason the stimulus is less tolerable, but very efficient. This type of stimulus is not advised for particularly sensitive people. Do not place the electrodes on sensitive areas such as the face, genitals or near to wounds. Electrodes position: form a square around the painful area.
Burst impulse TENS. Medical programme. This causes a stimulus which produces tens training using conventional tens frequencies; often used in pain therapy. The action resembles the endorphins TENS, and lasts 15 minutes each phase. Electrodes position: form a square on the treated area.
Cervicalgia / Headache. Medical programme.
Specific programme for the treatment of pain in the cervical area. The intensity is regulated between the perception and the pain threshold; the maximum intensity limit is represented by the moment the muscles surrounding the treated area begins to contract. Going above this limit does not increase its effectiveness and will only cause irritation; it is best to stop before this threshold. The number of treatments necessary to achieve the first benefits is between 10 and 12, with daily frequency. Continue the treatment until the symptoms disappear.
Lower back pain. Medical programme. This programme is used specifically for the treatment of pain in the lower back or dorsal area, or both. The intensity is regulated between the perception and pain thresholds; the maximum limit is represented by the moment the muscles surrounding the treated areas begin to contract. Going above this limit does not increase the effectiveness of the stimulus and will only cause irritation; it is best to stop before this threshold. The number of treatments necessary to achieve the first benefits is between 12 and 15, with daily frequency. Continue until the symptoms disappear.
Sciatica. Medical programme; used specifically in the treatment of pain caused by the inflammation of the sciatic nerve. The intensity is regulated between the perception and pain thresholds; the maximum limit is represented by the moment the muscles surrounding the treated areas begin to contract. Going above this limit does not increase the effectiveness of the stimulus and will only cause irritation; it is best to stop before this threshold. The number of treatments needed to achieve the first benefits is between 15 and 20, with daily treatment. Continue until the symptoms disappear. Programme duration: 30 minutes per phase.
Sprain / Bruise. Medical programme; inhibits local pain after these types of accidents. Intensity regulated between the perception and pain thresholds. Number of treatments: until the pain is reduced, up to 2 or 3 times per day.
Anti-inflammatory. Medical programme; for usage on inflammation. Use until the inflammation has reduced; can be used twice in a row each day. Intensity is regulated at the perception threshold. Place the electrodes in a square on the area to be treated. Programme duration: 30 minutes per phase.
Vascularisation. Medical programme. Produces a vascularising effect on the treated area. The vascularising action produces an increase in blood flow, consequently affecting positively the elimination of algogenic substances and a re-establishment of normal physiological conditions. The suggested frequency of applications is daily; the number of applications is undefined and can be used until the pain is reduced. The suggested intensity is between the perception threshold and that of mild irritation. Programme duration: 20 minutes per phase.
Decontractation. Medical programme; suitable for the muscle functioning recovery process; causes immediate effects. Intensity regulated just above the perception threshold. Two daily treatments for three of four days.
Hematomas. Medical programme. Consult a doctor before treating the hematomas. The total duration of the programme is 20 minutes per phase; the applications should be few but close together after the contusion. Various types of impulses are combined; with the square wave a draining action is caused on the treated area. Impulses of various frequencies zones at various depths. Intensity is regulated between the perception and pain thresholds. Position of electrodes: form a square over the zone.
Regenerative Impulses. Medical programme; it has four phases with three different impulses which cause vascularisation and toning of the superficial muscles. It also causes a local analgesic effect. Intensity is regulated between the perception and pain thresholds. Programme description with electrode positioning:
Total programme duration: 40 minutes. Position of electrodes: forming a square on the treated area.
Atrophy prevention. Medical programme; used for the maintenance of muscular trophism. During the treatment, the main work is on the toning of the muscles, particularly on the slow muscle fibres. Particularly suitable for after a trauma, for people that have been immobilised for a long time, or after surgery. Combats the reduction of trophism in the muscles due to inactivity. The treated areas can be stimulated with daily low-intensity applications. If the intensity is raised, the muscles must be allowed a period to recover after the effort, leaving one day between applications.
Atrophy. Medical programme. This programme works selectively on the slow fibres and is ideal for the recuperation of muscular trophism after a long period of inactivity or an accident; to be used when the muscle tone has already been lost. Apply with caution (low intensity) with aim to produce light muscle contractions, 2 to 3 times per week in the beginning. Progressively raise the intensity over the following 3 or 4 weeks. Use on alternating days.