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Thoughts on TENS machines

This week's question

What are your thoughts on TENS machines?

My answer - I have a lot of thought on them, but I will try to stick to the facts here. For those of you who don't know, a TENS machine, or "stim" machine is a machine which delivers electric current to your muscle via sticky pads and wires. The setup looks not much different from an EKG machine, but the electric stimulation can be sensed in this case.

In order to fully answer this question, I think it is important to separate the conversation into continuous "stim" and "Russian stim". The latter is a version of this machine that delivers a current which is meant to create a muscle contraction. You may have seen those late night infomercials where someone uses this machine to "get abs while you are sleeping" (its not that simple).

Regular continuous stim, which you may have experienced with your PT or Chiro basically delivers a current that interferes with your body's pain signal. It creates "TV static" in some of your nerves, so that the pain signal is not perceived. It can be effective during treatment, and on average 20 minutes after.

The benefit of having some time without pain is not lost on me, however it is important to remember that this generally has no long term effect on pain, and therefore I do not use it in my clinic as I try to focus on active treatments that have a longer lasting effect. However, if decreasing your pain for a short period allows you to do your PT exercises, or other important tasks for your day, I say go for it, just remember as a treatment on its own it will not do much in the long term.

Russian stim, as stated above sends a signal to the muscle to contract, and creates often a visible contraction, going in on/off intervals which can vary in length. It is used to help "turn on" a muscle. It is important to note, that this can not really help a muscle gain "strength" but rather to improve the neuromuscular (brain <-> muscle connection)

This I do see a bit more of a long term benefit for, however it is also important to look at why the person is not able to "turn on" that muscle on its own. In a case of surgery, it is pretty clear and I think using external stimulation to retrain the brain on how to connect to the muscle can be helpful. However in the absence of trauma, I think looking to the root cause of what is inhibiting that muscle is important for long term gains.

In conclusion, my point of this is not to influence someone to use stim or not use stim, but rather to be aware of why it is being used and what is happening during/after treatment.

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