How Does TENS Help Back Pain?
In order to understand how a TENS unit can decrease your back pain, you need to understand how the mechanism of action works.
TENS stands for Transcutaneous electrical nerve stimulator. The machine is about the size of your cell phone, lightweight and easy to use.
There are various models on the market, but they all have the same main components. You have the main machine which is usually run on batteries. There are wires that come out of the machine that attach to small electrodes.
There are usually 2 wires that branch out into 4 electrodes. Those 2 wires are known as channels. We will discuss that later when we talk about electrode placement.
Some electrodes are one time use and others are reusable, but they should never be shared between users.
One side of those electrodes are sticky and is applied to the skin at specific landmarks depending on the kind of pain you have and where it is located. The unit will have buttons for on/off as well as to manage the intensity of the stimulation as well as the treatment time.
TENS can be used for many different types of chronic pain, but can also be used for new onset pain like an ankle sprain or muscle spasm. Types of chronic pain would include low back pain, arthritis pain, sciatica, neuropathic pain and/or fibromyalgia.
The scientific rationale behind TENS units is a two fold explanation. Let's take a deeper look at that information so that you can have a well educated understanding of TENS.
One of those explanations is called the Gate Control Theory. Essentially, it suggests that the electrical pulses from the TENS unit shut down the pain receptors in the spinal cord that were previously feeling pain from an injury.
You know the old adage, "Let me stomp on your foot and I bet your back won't hurt anymore!”? Yeah, it is that idea. TENS provides current to the pain receptors and essentially gives them something else to think about so they aren't thinking about the chronic back pain anymore.
The other explanation is called The Endorphin Release. This suggests that the electrical impulses sent out by the TENS unit actually increase the endorphins released by the body. These are our natural pain killers and block the pain messages from getting to the brain.
Both of these rationales are based in scientific theory and help to prove the benefits of TENS as compared to more invasive treatments for low back pain or the use of pain medication.
Benefits of TENs Unit Back Pain
The main benefit of a TENS unit for back pain is of course to decrease back pain! That is the main goal and it can be accomplished by using this machine.
Another way to assess the benefit is to compare it to the risk, and with a TENS unit, there is very little risk. It is not an invasive procedure like surgery or injections, so there is no risk of infection or long term complications.
It is not like pain medications which can be addictive or mask the pain. Also, a TENS unit can be used at home which is much easier than going out somewhere to get a treatment.
You can even wear your TENS unit while you are doing things around the house like cleaning or cooking which makes it a great option for everyday life! A TENS unit is a minimal risk option to decrease your low back pain effectively and efficiently.
How Does a TENS Unit Work for Back Pain?
As we have discussed, the science behind a TENS unit is actually pretty simple. Either way you look at it, the TENS unit is using your body's natural responses to decrease pain and hopefully, improve your quality of life.
A TENS unit will hopefully decrease your back pain very quickly during the session. The pain relief can also last up to 4 hours after the session is over, so that gives you time to do your daily activities and be less limited by your pain.
Read More: 7 Best Tens Unit For Back Pain & Sciatica Relief
What does TENS Feel Like?
First and foremost, TENS should NOT hurt. It should feel like a tingling, buzzing, tapping or tiny muscle twitch. Again, there should be no pain associated with it. It might be a weird or new sensation, but it should feel good throughout the session.
Also, as the session goes on, you might feel like the impulses are getting lighter. That is your body attenuating (or acclimating) to the electrical impulses.
It is okay to increase the pulse intensity as the session goes on to maximize your treatment time. If you can barely feel the impulse, it is probably not strong enough to be getting an actual benefit. You need to be able to feel it, but again, it should not be painful.
How to Use a TENS Unit for Back Pain and Sciatica
How Often?
You can use your TENS unit up to 4 times per day. Each session can last somewhere between 30 and 60 minutes. Keep reading to learn when you can and can not use your TENS until throughout the day.
If you start to feel like you are not receiving the maximal benefits of your TENS unit, it is okay to decrease how often you use it or even take a day or two off to let your body reacclimate. Then, you can start again.
TENS Unit Placement for Lower Back Pain
In general, TENS unit electrodes can either be placed in a criss cross X pattern over the worst area of pain or run in two parallel lines by the area of worst pain. Either option is okay and you might have to play around with the configuration for a few sessions and see what works best for you to address your specific pain.
For low back pain, there are two configurations that would work as depicted below.
In the photo, you will see different colored squares that represent the electrodes. The black electrodes represent channel one so they would be attached to the same lead wire coming out of the machine. The white ones would represent channel two so they would be attached to the same lead wire coming out of the machine. The red area represents the area of most pain in this example.
TENS Unit Placement for Sciatica
Sciatica is a little harder to depict because it would depend on the area of your most pain. For instance, you would want to move the electrodes over the hip area if that is where you feel the pain, but you could move them down in the buttocks region if you feel the most pain there.
In the end, the criss cross X or parallel pattern still applies, it is just a matter of shifting the electrodes to be over/around your pain area of pain.
TENS Unit Placement for Upper Back Pain
Placement for upper back pain would be almost identical to low back pain except you would move the electrodes up more near your shoulder blades. This might be an area that you could need help applying the electrodes so that you get them in the correct position for a great treatment session.
With any placement, you should focus on getting the electrodes placed around the area of pain and on an area that is muscular or connective tissue. Stay away from bony areas close to the skin to maximize effectiveness of the treatment.
Are TENS Machines Good for Muscle Spasms?
Yes, muscle spasms can be quite painful and as we have discussed, TENS units are great to battle pain!
You should apply the electrodes in a criss cross X pattern over the area that is most affected by the spasm. So let's say that it is your right calf that is in a severe spasm.
You can place electrodes from channel one at the top of the calf near the back of the knee and at the bottom of the calf near your Achilles tendon. Then, place the electrodes from channel two on either side of the bulk of your calf muscle.
This will give you great relief from your muscle spasm. You can recreate this set up over other areas of common muscle spasms like in the low back or arm.
When and Where Should you NOT Use a TENS Unit?
You definitely should not use a TENS unit if you have a cardiac pacemaker or defibrillator. The electrical impulses from the TENS unit could cause this to malfunction and be life threatening.
You should also avoid TENS if you have a spinal cord stimulator, internal pumps or monitors or internal electrical devices.
If you have implanted metallic devices in your body like a knee replacement, pins/screws, etc, you should not use a TENS unit directly over or near to that area. If you have pins in your ankle, but want to use a TENS unit on your upper back, you would be fine to do that.
Avoid using your TENS unit near water like a bath or shower or while you are sleeping.
Don't use a TENS unit if you are allergic to any of the materials on the electrodes. This could cause skin irritation.
Don't use TENS over any broken skin like a cut, rash or infection.
Don't use a TENS unit without speaking to your doctor if you have a history of cancer, diabetes or epilepsy. Speak to your OB before you use a TENS unit if you are pregnant.
TENs units should not be used by anyone with a cognitive impairment because they would be unable to provide reliable information about the intensity of the electrical pulses they feel and how that is affecting their pain.
TENS is designed to be used over muscle and connective tissue. Do not use TENS directly over your spine, head, face, throat or chest as these are more bony areas with vital organs.
As we have discussed, the risks with TENS are very low, but it is always better to be safe than sorry. Keep the unit focused on muscular areas of pain and you will be safe.
Read More: 7 Best Tens Unit For Back Pain & Sciatica Relief
Final Word
In the end, TENS units are a non-invasive and effective way to treat pain. You can use it for chronic pain like in your low back, or acute pain like a muscle strain and spasm. There are minimal risks to using TENS if you are being cognizant of the risks and how they pertain to you.
TENS units are readily available online for purchase and you do not need a doctor's order to get one; however, it is recommended that you speak to your doctor about a TENS unit before you start using it, just in case.
But once you get their go ahead, pick one up and try it for yourself! You will be pleasantly surprised by the results!