TENS and back pain

Written by: Paul Kochoa, PT, DPT, OCS, CKTP, CGFI

The other day a patient with back pain came in to see me.  She had been under my care for about a month now and her symptoms and pain intensity were decreasing.  Previously, she had symptoms of numbness and tingling down one leg to just above her knee.  With physical therapy (see my previous post) we were able to centralize her symptoms and get her back to strengthening exercises at the gym.  On this occasion, she was coming back from holiday traveling and complained of increased symptoms.  We modified her program a little and her symptoms improved.  That’s when she brought out the TENS card…

TENS stands for “transcutaneous electrical nerve stimulation”.  Basically it’s a modality used in medical clinics to control pain.  Other forms of electrical modalities facilitate muscle contraction, reduce edema, or help heal chronic wounds.  Studies have shown that TENS is effective in reducing acute pain, but less so with chronic pain symptoms.  Because of the wide variety of uses and parameters, scientific comparison of the effectiveness of electrical stimulation is difficult.  But across studies, support for TENS is limited.  When the machine is on, the pain is reduced.  When the machine is off, the pain returns, sometimes immediately or after a few hours.  Anecdotally, patients love it.  How does it work?  Basically it decreases the pain signal from reaching your brain, turns down the volume, so to speak.  Think about being at a park or a beach with multiple radios playing at once; you only hear the loudest radio, that’s how TENS can drown out pain signals.

My patient got worried after the exacerbation of her symptoms after her long flights.  She was able to control the worst of it but really wanted something to help.  When she started treatment, she brought in a prescription for PT and TENS, but hadn’t started the TENS until this last visit.

TENS should never be used as a primary or only treatment intervention.  It should be used in conjunction with other physical therapy techniques to reduce pain, restore range of motion, and reduce movement dysfunctions.  TENS can be effective at reducing pain, but it’s not a means to an end.  It can decrease the pain so that a patient can tolerate other physical therapy interventions.  When it comes to chronic back pain, a thorough physical examination can determine if you could benefit from using TENS, but always be aware that active movement and recovery of function is the key to long term relief.

If you would like more information, please call Professional Physical Therapy and Training at 973-270-7417.  Our offices our located within the YMCA locations in Madison and Summit, NJ.  You do not need to be a member of the YMCA to visit with us.