Around 125 million Americans suffer from one or more musculoskeletal pain disorders. Because pain is experienced differently for each individual, some people require different treatment than others. Many people find TENS unit placement for neck pain an effective option. Other treatments involve electric nerve stimulation, physical therapy, or cognitive-behavioral therapy (CBT).
Electric nerve stimulation is not new. Back in ancient Rome, electric eels were used in early medical treatments. And the study of electrical currents by Ben Franklin in the 1700s brought electrical currents as a possible treatment for pain.
Pain can be debilitating and even the slightest pain brings annoying discomfort. The total costs of healthcare for managing pain reached $300 billion. For this reason, the healthcare industry is promoting the study of treatments and interventions to manage and prevent pain.
Below are the three major goals of pain management.
- Reduce pain as quickly as possible
- Restore the daily functioning of individuals
- Cope with and monitor the side effects of therapy or treatment
One of the interventions that can reduce pain and restore an individual’s capacity to do activities of daily living (ADLs) almost immediately is the use of a TENS unit.
What exactly does a TENS unit do?
A Transcutaneous electrical nerve stimulation or TENS therapy uses a low voltage electrical current to manage pain. A TENS unit consists of a battery-powered device that delivers pulses of electricity through electrodes placed on the skin surface. These electrodes are usually placed at key locations:
- At or near nerves where the pain is located
- At trigger points
A TENS unit is generally safe. This treatment is nonpharmacological, noninvasive, inexpensive, and easy to use.
This device produces different effects on the body. The use of a low frequency of less than 10 Hz with high intensity is used to produce muscle contractions. On the other hand, less than 50 Hz is used with low-intensity stimulation to produce paresthesia or tingling (and relieve pain) without muscle contractions.
Why can't I move my neck without it hurting?
A joint or nerve issue is usually the cause of intense pain. A nerve may be pinched, stretched, or compressed thereby causing pain. Or, the nerve may be irritated by chemicals produced by inflammation. To protect a pinched nerve, the brain signals the body to produce muscle spams, preventing the person from moving the head in case of neck pain or back pain.
Does a TENS unit promote healing?
The TENS causes vasodilation or an increase in blood flow. Other effects of TENS include analgesia or pain relief, sensory response, and possibly even tissue repair.
The three types of TENS:
- Intense TENS (low-intensity and high-frequency)
- Acupuncture-like TENS (high-intensity and low-frequency)
- Conventional TENS (high-intensity and high-frequency)
Conventional TENS can be administered at any time during pain. Acupuncture-like TENS produce muscle contractions to temporarily reduce pain. And intense TENS are used for paresthesia which can mask acute pain and is administered for only a few minutes.
Medications, interventional treatments, and behavioral therapies are just some of the ways of managing pain. For example, medications that relieve pain are acetaminophen and NSAIDs. In particular, NSAIDs reduce the production of prostaglandins, responsible for inflammation and pain.
Oral medications have side effects and adverse effects that may cause systemic problems. Some oral medications like NSAIDs are safe when taken in small doses over a short period of time. They do have some side effects like causing stomach bleeding (ulcers) and kidney problems when overused or used for prolonged periods. The safer painkiller, acetaminophen, has some adverse effects such as headache and can lead to liver toxicity when taken in large amounts.
TENS may provide short-term relief for the pain. Take note that the muscles or tissues causing the pain still have the same structure or injury. TENS is not a cure for chronic pain, per se — the electrical pulses are just releasing natural hormones such as endorphins, resulting in pain relief.
How do TENS work?
A transcutaneous electrical nerve stimulator (TENS) sends pulses of electricity to jumpstart the body's natural pain killers. These electrical pulses can release endorphins, which then relieves pain. TENS can reduce pain sensations.
TENS is used for acute pain to produce a strong enough tingling sensation but is still below the patient’s pain threshold. Also, sensory TENS is recommended in the early stages of tissue healing.
For acute pain and early stages of tissue healing, sensory TENS (50-150 Hz) is indicated. Healing will progress, and TENS should be shifted to lower frequency motor stimulation (1-10 HZ). Motor TENS will stimulate receptors to produce a strong yet tolerable muscle contraction. This activates the release of endogenous opioids from the brain into the blood for pain relief.
What are the benefits of using TENS?
Reviews suggest that TENS is effective for osteoarthritis, postoperative pain, painful diabetic neuropathy, and some acute pain conditions. Below are the situations in which TENS can help:
- Post-operative or acute pain – In a study, patients are evaluated during the first three days after surgery where TENS therapy reduced the need for analgesics.
- Diabetic peripheral neuropathy (DPN) – An improvement of symptoms (hyperalgesia, numbness, pain, and quality of life) is shown from a study where TENS was shown to be better than placebo TENS following four to six weeks of treatment.
- Wound healing – An improvement in sacral and leg ulcers has been reported in a study from TENS use.
- Inflammation – When an area of the body is inflamed, a set of protective responses brings immune cells and molecular mediators towards the affected body part, causing it to swell for tissue repair. However, inflammation is painful, and TENS can reduce the pain sensation by sending electrical impulses to the affected part.
Can TENS build muscle?
No, you can’t use TENS alone for building muscle. However, if you combine TENS with EMS or Electrical Muscle Stimulation, you may build muscles. Using different wavelengths and pulses, this combination of EMS and TENS is useful for athletes recovering from surgery faster.
How is neck pain diagnosed?
The causes of neck pain may be determined through different diagnostic procedures.
- X-ray – this procedure can reveal areas in your neck where bones may pinch your nerves or spinal cord
- CT scan – this procedure combines many X-rays from different directions for detailed cross-sectional views of the neck’s internal structures
- MRI – uses a strong magnetic field to create detailed images of the body — from bones, soft tissues, spinal cord, or nerves
What are the causes of neck pain?
The neck supports the head, and some illnesses or injuries of the neck can restrict motion. Below are some of the common causes of neck pain.
- Muscle strain – may be due to hours hunched over the computer or mobile phone
- Degenerative joints – may wear and tear with age
- Diseases – may be due to meningitis, rheumatoid arthritis, or cancer
- Injuries – whiplash injury from motor vehicle accidents, which occurs when the head is jerked backward and then forward
- Nerve compression – herniated disks or bone spurs in the vertebrae of the neck can produce irritation from narrowing of the small holes through which the nerve roots traverse the spine as they exit the spine to the periphery
A person may feel discomfort or sharp pain in the neck through
- holding the neck in one place for long periods
- muscle tightness and spasms
- decreased ability to move the head
When should you contact a doctor for neck pain?
The brain is engineered to protect the body. One way to protect it is by producing a painful warning, signaling potential or real tissue injury. When the brain recognizes this uncomfortable feeling, it signals the body to become immobile — increasing blood flow, which makes healing faster.
However, some pain is more bothersome than others. It can even be debilitating. For these kinds of pain, contact a doctor if your neck pain
- is severe
- spreads down the arms or legs
- persists for a few days with no relief
- is associated with headache
- is accompanied by weakness, numbness, or tingling
Who should not use a TENS unit?
Do not use TENS if you have undiagnosed pain and a history of cancer in the last five years. Further, do not apply electrodes to your head. These impulses could cause seizures.
If the cause of the pain is undetermined, healthcare providers advise postponing treatment through TENS or risk worsening the pain.
As a standard precaution, manufacturers of TENS units warn individuals with pacemakers, epilepsy, or are pregnant to avoid TENS as using this device can lead to potential complications.
To illustrate, here are conditions when you should seek a healthcare provider first before using TENS unit placement for neck pain:
- Implanted medical devices like defibrillators or pacemakers, cardioverter defibrillators, brain neurostimulators or spinal cord stimulators, indwelling BP monitors, bone growth stimulators
For those with pacemakers, a cardiologist may perform an initial TENS trial with Holter/ECG monitoring.
During the first trimester, the greatest risk can be electrical currents over the abdomen that may lead to unwanted uterine contractions. However, TENS therapy is effective for labor pain.
- Mental impairment
A person who is mentally impaired and is undergoing TENS therapy may have trouble communicating the correct feedback. Thus, the therapist may have trouble in evaluation since the patient may not perceive an intensity that is safe for his or her body.
- Undiagnosed pain
If a person has undiagnosed pain, proper treatment should be postponed to prevent worsening the underlying condition.
Take note not to apply electrodes to the head. These impulses can cause seizures.
Where should you not put a TENS unit?
A TENS unit may be harmful but not dangerous. It may cause a prickling or tingling sensation, which is uncomfortable. In using a TENS unit, give the skin a break from the electrode pads every 20 minutes. Another risk is the skin irritation that comes from leaving the pads for too long in one place.
How to use a TENS unit placement for neck pain
For neck pain, place two electrodes on the lower backside of the neck on the sides (painful area). For some, placing two or more electrodes above or beside the shoulder blades may work better.
Take note not to place electrodes close to the head. Remember that TENS may interfere with how the brain sends electrical impulses to the body.
How do you start TENS treatment?
The skin should be clean and dry. This is to prevent the patches from slipping off. Make sure to switch off the TENS unit and then put in the batteries. Follow the instructions below in using TENS.
- Attach the lead wires on each patch. Take note not to expose the bare metal pins.
- Attach the lead wire plugs into the socket on the top of the TENS unit.
- Take the patches off the plastic liner.
- Place the patches on clean skin. Take note not to let the patches touch metal.
- Turn the unit on. Follow the treatment program.
- Start the treatment and change the intensity as needed. Expect your muscles to contract.
- Stimulation will be less after a few minutes. You can turn up the intensity of the TENS as required.
Can you overuse a TENS unit?
TENS stimulation should last for only 30 minutes at a time. After this, a 20-minute break is advised to give your skin a break for potential skin irritation from using TENS in one area on the skin for too long.
How high should you set a TENS unit?
Different intensities work for different types of pain. For acute pain, the TENS unit should be set between 80 Hz and 120 Hz. For chronic pain, the settings can be lower — around 2 Hz to 10 Hz. This lower setting will stimulate hormones produced naturally by the nervous system to cope with pain.
For weak or tense muscles, a setting between 35 Hz and 50 Hz is for stimulating muscles for relaxation or strengthening.
Can TENS units help pinched nerves?
As a result of too much pressure from its surrounding tissues, a pinched nerve causes pain, tingling, weakness, or numbness. The pressure on the nerve can also disrupt its function. TENS unit neck placement for pain can heal your damaged nerves and improve function.
In addition, electrodes shouldn’t be placed near the genitals. However, healthcare providers can use TENS to assist in sexual function for both men and women. TENS therapy can treat pelvic floor muscles, which can affect obtaining or sustaining an erection.
Also, TENS may work for stomach cramps because of Irritable Bowel Syndrome or IBS. In this situation, using a TENS device may relieve pain.
How long does TENS pain relief last?
The pain-relieving effect of TENS can last from five minutes to more than 24 hours. TENS therapy is so effective that some patients report complete relief of pain after using it.
Can TENS cause a heart attack?
As a general rule, do not apply TENS if a person has heart disease, heart failure, or arrhythmias. There are no studies yet directly linking the TENS unit with a heart attack. Most likely, TENS therapy gives off a minimal current that is unlikely to interfere with heart rhythm.
If you have a bleeding disorder, TENS can cause bleeding at the site because of skin irritation or cause more bleeding in some persons.
If you have a pacemaker, do not use TENS. Other devices that may warrant inadvisability of the use of TENS are bone growth stimulators, cardioverter defibrillators, indwelling BP monitors, or neurostimulators in the brain or spinal cord. Discuss with a cardiologist or neurologist the use of a TENS device.
Can a TENS unit damage the nerves?
Short-term electrical stimulation is not damaging. But chronic electrical stimulation can damage the structure of the nerves. For stimulation longer than 30 minutes, remember to pause for at least 20 minutes to prevent skin irritation.
Is it normal to be sore after using a TENS unit session?
No, using a TENS unit should not be painful or sore. In using a TENS device, make sure that the setting is strong enough to relieve pain but still comfortable enough not to feel any soreness.
If there’s muscle soreness after the treatment or on the day after using TENS, this can be because of prolonged use or the settings are too high. As a solution, abstain from using TENS for a few days. If there’s no more soreness, start at a low setting, then gradually increase intensity.
Can TENS unit placement make the pain worse?
Overstimulation can make pain worse. In using TENS therapy, tiny electrical shocks from the TENS machine can block some pain perceived by the brain. For those who are new to using TENS therapy, take things slowly at first. Don’t reduce pain medications unless advised by your physician.
Remember, TENS is a treatment, not a cure.
Even when getting relief from using TENS, remember that whatever is causing the neck pain is still there. TENS is just a treatment — it provides pain relief by masking pain sensations. It cannot alter whatever is wrong with the bones, tissues, or the structure that is causing it. Also remember, as in all treatments, different people respond in different ways.
In summary, TENS may just be the one treatment that can substantially improve your quality of life. Speak to a pain management professional to learn more about your options.