Dr. Zatrok's blog
Dr. Zatrok's blog

Dr. Zatrok's blog

Pain relief without pills: TENS treatment

by Dr. Zsolt Zatrok

Have you been suffering from persistent pain for months? Doctors usually suggest the same solution: “take painkillers”. Taking a pill may temporarily relieve the pain, but if you take the medicine for a long time, you will eventually experience some unpleasant side effects. Of course, I know most people don’t care what tomorrow brings… no pain now. But there is an alternative… TENS is an effective way to relieve pain without side effects!

What is TENS?

TENS is an acronym for “Transcutaneous Electric Nerve Stimulation”.

TENS is a treatment in which a series of mild electrical impulses are delivered to the area of pain. This contacts the nerve endings in the skin and causes them to

  • stop the transmission of pain impulses to the brain
  • increases the production of endorphins (the body’s own painkillers),
  • and the sensation of pain is eliminated or reduced.

TENS treatment alone is sufficient to achieve pain relief in a significant proportion of cases. When used in conjunction with painkilling medication, the effects add up so you may need less medication. This is most important if you have a chronic illness and need a large amount of medication for a long period of time. It makes a difference how much chemical you put into your body.

A short TENS treatment – 20-30 minutes – can relieve you of unpleasant pain for hours. The main benefit of the treatment is pain relief without drugs and side effects.

Basics of pain relief – how does the nerve stimulation pulse work?

TENS pulses intervene at several points to “manage” the pain.

Gate theory

The pain gating mechanism is associated with the “Aβ” (A beta) sensory nerve fibres. Repetitive stimulation of these fibres reduces or eliminates the transmission of pain signals through the spinal cord to the pain centre in the brain. And if pain signals are not transmitted, pain sensations do not develop.

The “Aβ” fibres are most effectively stimulated at 90-120 Hz, a relatively high frequency.

There is no one frequency that is universally and equally effective for everyone! It can be said that the pulses in the above range will be the most effective, but within this range, you have to “find” the one that suits you best!

In order to ensure the effectiveness of your pain relief, I recommend purchasing a device that allows you to adjust the treatment frequency to find the optimal frequency.

Endorphin theory

Endorphin is an analgesic substance produced in the body, it is one of the most powerful painkillers.
When a pain signal travels to the brain, it “jumps” from nerve cell to nerve cell. Endorphin prevents the pain nerve from passing between cells at “crossing points” called synapses. The low-frequency pulses of TENS devices, called “endorphin TENS”, effectively increase your body’s production of endorphins, reducing or eliminating pain.

When used at low frequencies of 2-10 Hz, they stimulate the “Aδ” (A delta) fibers. Their activity increases endogenous opiate (encephalin) production in the spinal cord. Encephalin has a strong analgesic effect and also reduces the activity of pain-transmitting neural pathways.

As with the way the pain gate works, there is no single, magical frequency that is equally effective for everyone. Everyone needs to find the frequency that works best for them.

How to find the most effective frequency?

It’s best to buy a device that provides a modulated TENS program. In this program, the pulse frequency varies continuously over a range. For example, between 90-120 Hz, so you can be sure to include the frequency that works best for you.

If you don’t have one of these, try the 90, then 95, 100…etc. Hz frequencies. Use the one that gives you the strongest effect.

Importance of frequency

The duration of pain relief depends on which frequency you use.

A short treatment with a high frequency will result in quick but not long-lasting pain relief.

Low frequencies will produce pain relief more slowly (after 20-40 minutes of treatment), but the effect may be long-lasting, up to 24 hours.

Watch out! Some manufacturers advertise TENS as being effective only at 143 Hz. As I mentioned earlier, the nerve fibres (which transmit pain signals) can be stimulated most effectively in the 2-10 and 90-120 Hz ranges. The manufacturer’s advertisements claiming 143Hz exclusivity are misleading!

Prevent the loss of impact!

Traditional and endorphin TENS programs deliver a constant frequency pulse, repeated at the same rate. The brain can “recognise” and filter these signals.

This is why it is common for cheaper TENS devices to reduce and then stop the pain relief, which is still very strong, during the first 3-4 days, i.e. to develop habituation.

If you stop the treatment for 5-10 days, it will regain its effectiveness again.

Modern TENS units provide so-called Modulated TENS programs to eliminate habituation. These change the frequency, duration and amplitude of the pulse continuously, so that it cannot be filtered by the brain and the analgesic effect is permanent.

If you suffer from chronic pain, choose a TENS unit that has a Modulated TENS program, only!

TENS and pain relief – what are the complaints it is effective for?

pain caused by acute musculoskeletal disease

pain caused by chronic (weeks, months) musculoskeletal disease

other pains

  • Regular TENS cannot treat headaches or migraines. Special electrotherapy devices (e.g., Cefaly) are necessary for this purpose.
  • myalgia,
  • post-operative pain
  • gynaecological and menstrual pain
  • in the case of pain caused by tumours, TENS can complement drug therapy. Although it cannot usually completely eliminate cancer pain, it can reduce the need for painkillers.

You can use the tiny, lightweight TENS units in your home at any time. At the time you want, as often as you need.

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