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March 1, 2010

Today's Special: TENS

Today reminded me of my massage therapy practice. It was one of those days where everybody who walked in needed the same thing, like having a daily schedule full of knees, necks, shoulders or low backs. Today, everybody who was a walk-in (patients who can get equipment without an appointment) needed a TENS units.

TENS units are portable electric stimulation devices that people use manage pain without the use of drugs. Our job when a physician recommends this for a patient is to educate them on the use and care of the device. The TENS unit we issue to the patient come with two rechargeable batteries, a recharger that plugs into the wall, a package with four electrodes, two sets of cable leads, the console, the directions, and a soft carry case to keep all your stuff in. We also issue them two extra packages of electrodes.

First I show them how to use the recharger. It's no big deal, but there is a little clip at the negative pole of the charger that flips up so that the metal is in contact with the battery. People without good vision may overlook that and believe the device is malfunctioning when it doesn't charge their batteries. So we have to point that out to them.

Next I show them how to operate the console. I show them where to put in the batteries, where the control panel is hiding, where to plug in the leads to the electrodes, and where the dials are to crank up the amps. The unit we issue is very simple to use with 5 modes for stim, a locking mechanism, and a built-in timer. To turn the unit off, they simply hold down the "on" button for three seconds. In case the settings getting messed up, we simply instruct the patient to pop out the batteries out and reset them so the settings default back to normal.

The electrodes have a gel coating on one side of them to help them adhere to the patient's skin and conduct the electrical current. One set of electrodes last about a month if they are taken care of correctly. So I advise patients to make sure their skin is clean and dry, no lotion or oils -- which can be removed with rubbing alcohol. I try to warn people who have dry flaky skin to wipe wipe their skin with a moist towel before applying the electrodes. If the gel matrix gets gummed up with dead skin cells, they won't stick very well. Patients can attempt to clean them with a moist towelette to rejuvenate the electrodes. It's also important to store them on the plastic sleeve that comes with them a make sure that the zipper baggie is well sealed to retain moisture.

Placing the electrodes on the skin is easy. Each lead has a black wire and a red wire that "speak" to each other. The electrodes should form an X over the area of the most pain. Electrodes should be place over soft fleshy area, not over bone. And finally, electrical stimulation should be strong but comfortable, but not create muscle twitching. Repeated muscle contractions, such as what a chiropractor might use, is designed to eliminate muscle spasms by fatiguing the muscle. This is not what pain management through use of a TENS machine is designed to do.

I issued five of these units today! Even central supply was commenting on how many of these units I came to get today. I'm guessing that our pending whether may be responsible for so many people's pain. My theory is that it must be similar to why I get cold hands and feet on cloudy days: low barometric pressure may reduce blood flow. In sensitive individuals, build up cellular metabolic by-products may serve as irritants to the nerves, heightening their perception of pain.

Posted by linda at March 1, 2010 4:32 PM

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