Electrical Nerve Stimulation/TENS

Rating

Category: Allied Health Options

Injury Type: Acute

What is it?

An alternating electrical current (AC) or modulated direct current (DC) underpins all stimulating forms of electrotherapy. The electrical current, rectified to a safe, low-voltage level is applied to the body via electrodes placed on the skin. Transcutaneous electrical nerve stimulation (TENS) is one form of electrical nerve stimulation. TENS machines come in various sizes but most are small enough to clip onto your belt and wear whilst walking around.

How does it work?

The current may inhibit pain in the tissues surrounding the electrodes by inhibiting pain impulses (the so-called 'pain gate theory'). It works by distracting your nerves and brain from the pain sensations.

Is it effective?

A systematic review has been conducted on the use of electrotherapy (including electrical nerve stimulation) for people with neck pain, however only one of the included studies looked at people with whiplash of less than 2 months duration. This study included various other treatments so it was not possible to determine the effect of TENS on these patients. Another recent systematic review found there was insufficient evidence to support or refute the use of TENS.

Are there any disadvantages?

There has been no research on the disadvantages associated with electrical nerve stimulation. TENS machines are available to purchase however they may be costly, and may not be suitable for everyone.

Where do you get it?

TENS units are available to purchase from various sources (i.e. internet, medical suppliers, pharmacies/chemists) or through your treating therapist.

Recommendations

The use of TENS for whiplash is not recommended due to limited current research evidence. More research is required.

Key References

  • Guzman, J, Haldeman, S, Carroll, LJ, Carragee, EJ, Hurwitz, EL, Peloso, P, Nordin, M, Cassidy, JD, Holm, LW, Côté, P, Velde, G & Hogg-Johnson, S 2009, 'Task force on neck pain and its associated disorders', Journal of Manipulative and Physiological Therapeutics, vol. 32, pp. 227-243.
  • Kroeling, P, Gross, A, Goldsmith, CH, Cervical Overview Group, 'Electrotherapy for neck disorders', Cochrane Database of Systematic Reviews 2005, Issue 2. Art. No.: CD004251. DOI: 10.1002/14651858.CD004251.pub3.
  • Leaver, AM, Refshauge, KM, Maher, CG & McAuley, JH 2010, 'Conservative interventions provide short-term relief for non-specific neck pain: a systematic review', Journal of Physiotherapy, vol. 56, pp. 73–85.
  • Mercer, C, Jackson, A & Moore, A 2007, 'Developing clinical guidelines for the physiotherapy management of whiplash associated disorder (WAD)', International Journal of Osteopathic Medicine, vol. 10, no. 2-3, pp. 50-54.
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