pain relief

What is transcutaneous electrical nerve stimulation aka TENS?

by Dr. Zsolt Zatrok 2023-10-13

Transcutaneous electrical nerve stimulation (TENS) is a method of electrostimulation that reduces or eliminates pain by activating your body’s natural pain relief mechanisms. The main targets of TENS are your nerve pathways that transmit pain stimuli and the system that produces your own pain-relieving substances. TENS treatment is symptomatic, i.e. it does not cure the underlying disease itself, despite eliminating the pain. Its main advantage is that it replaces medication (or at least the amount needed is less) and you can reduce unwanted side effects.

Efficacy of transcutaneous electrical nerve stimulation

The effectiveness of transcutaneous electrical stimulation may vary depending on the location and type of pain and the TENS program used.

All relevant research concludes that TENS provides significantly greater pain relief than placebo interventions. The results of the studies vary, which is also due to the fact that different stimulation pulses (different frequencies, amplitude, treatment duration) are used. All studies are consistent in considering transcutaneous electrical stimulation (TENS) as a suitable method for pain relief.

TENS refers to any electrical stimulation delivered through electrodes placed on the skin surface to stimulate sensory nerve endings and pain reduction mechanisms.

Mechanism of action of TENS

The tiny electrical impulse emitted by a TENS machine stimulates the sensory nerve endings in your skin, activating your natural pain relief mechanisms. It acts at two main points, the pain-transmitting nerve pathways and the endogenous opioid system. The parameters of the electrical stimulation determine which pain relief system is activated by the pulse.

Pain gate mechanism

The pain gating mechanism is associated with the “Aβ” (A beta) sensory nerve fibres. 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 the pain signal is not transmitted, the pain sensation does not develop.

Empirical evidence indicates that the most effective stimulation for “Aβ” fibres is in the 90-120 Hz range, which is relatively high.

However, it’s important to note that there isn’t a single universal frequency that works for everyone. While frequencies within the mentioned range are often effective, the ideal frequency should be determined individually for each person.

For optimal pain relief, it’s advisable to acquire a device that permits treatment frequency adjustment to find the best frequency for you. While you can achieve pain relief with the default settings on TENS devices, these may not be the most effective treatment for your specific needs.

Endogenous opioid system

When used at slow frequencies of 2-5 Hz, these stimulate the “Aδ” (A-delta) fibres. Their activity stimulates opioid mechanisms and increases endogenous opiate (encephalin) production in the spinal cord. Encephalin has a strong analgesic effect and also reduces the activity of pain transduction 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.

TENS devices and their programmes

Simpler TENS units offer traditional TENS programs like high (conventional TENS) or low frequency (endorphin TENS), typically effective for short-term pain. However, these programs lead to habituation, with results diminishing after a few days. In contrast, quality devices provide programs like Burst, Modulated TENS, or Microcurrent (MENS) to avoid habituation, offering long-lasting effects as the brain can’t filter them out.

What can you do to avoid habituation?

For short-term pain like toothaches, muscle strains, and sprains, you can use a cheap TENS unit. Since it’s most painful in the first few days natural healing reduces pain. But if you have chronic conditions like arthritis or herniated discs, opt for a TENS unit with modulated TENS or microcurrent therapy to prevent habituation and maintain effectiveness during long-term use. These modern devices may be more expensive, but they provide lasting relief for chronic pain.

Before choosing a TENS unit, think about how often you need to relieve your pain. If it’s usually 4-5 days, then cheap TENS may be good, but if it’s more than a week for a flare-up, then you need a device that provides modulated TENS or microcurrent (MENS) treatment.

Here you can read about how to use a quality TENS unit for ailments that you may have with success.

Side effects of TENS

Transcutaneous electrical stimulation clearly has fewer side effects than what one would expect with the long-term use of pain medications.

The most common complaint is reddening of the skin at the treatment site. However, this is usually only due to the local capillary dilating effect of the electrical pulses. It disappears 15-20 minutes after the treatment. If it does not disappear and the site swells, you may be allergic to the adhesive or gel of the self-adhesive electrode. Replace the electrode with a different type from another manufacturer and this usually helps.

I wrote about what conditions TENS should not be used for in this article.

Accurate information to know before TENS treatment

Never treat new pain with a transcutaneous electrical nerve stimulation (TENS) device if it occurs suddenly, consult a doctor first. In general, it is true that you should only treat pain for which you know the cause. If your doctor has recommended pain medication, you can choose TENS treatment instead of pain medication. Only a mentally competent patient should use a TENS unit independently.

If you have a pacemaker, transcutaneous electrical nerve stimulation treatment is generally not recommended. It is not ruled out but should be carefully and carefully assessed. You should not apply it near the pacemaker on the chest, back, shoulders or neck.

Placing electrodes in the chest, abdomen, and pelvic area during pregnancy is contraindicated. A recent study suggests that, although TENS is not the ideal (first-choice) treatment option during pregnancy.

TENS pain relief during work (for example, sitting in your office chair) is safe and effective. However, never use it while driving, operating heavy machinery or working at height!

If you are allergic to the electrode gel or adhesive, do not use it with a self-adhesive electrode. In this case, use a rubber (silicone) electrode. Avoid applying electrodes to areas with skin issues, the neck’s front, or near the eyes.

Typically, doctors do not advise using stimulation when treating patients with epilepsy, so consult your doctor.

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Achilles tendinitis: Symptoms, Causes, Treatment

by Dr. Zsolt Zatrok 2023-10-12

You get out of bed, feeling tired and stiff in the calf. Every day, you’re increasingly haunted by the feeling that something is wrong. You wonder if you should start today’s distance or if it’s time to suspend your runs until the discomfort subsides. You need to move, you think, and so you start. The Achilles pain gets worse as you run and you finally change to walking. But it’s still no better, your hamstrings are stiff and aching. I wonder what it is?

Did you know Achilles tendon injuries account for 5-12% of all running injuries? And that they are more common in men?

How does Achilles tendinitis develop and what can be done about it?

Let’s start at the beginning. It connects your calf muscles to your heel bone. You use it every step of the way, all the time: when you walk, run, climb stairs, jump, or even stand on tiptoe.

Despite the fact that it can withstand very high loads, it can sometimes become overstretched. Its irritation can lead to degeneration and inflammation. The Achilles is like a bungee-jumping cord made up of thin rubber strands, except that it is made up of elastic protein fibres. When the Achilles tendon is injured, these so-called collagen fibres are damaged. Healthy tendons run alongside each other in a nice, even, smooth bundle. However, if any abnormalities are observed, these fibres become tangled and untidy.

Another problem, in addition to heavy use and strain, is that the blood supply to the Achilles tendon is “inherently” poor, making it particularly vulnerable to injury, and when injured, it is slow to heal.

Achilles tendinitis – What causes pain in the Achilles?

Achilles tendinitis is not usually due to a specific injury but to micro-injuries from repetitive bad movement or overuse. It can also be triggered by sudden increases in load intensity, poor equipment, overly tight muscles or even an aggressive exercise programme.

Symptoms are most common in people who are actively involved in sports. It’s most common in runners, triathletes, footballers, handball, basketball and volleyball players. In the mornings, pain and stiffness in the Achilles tendon or heel area can be felt, which may improve with little movement. The tendon may thicken, potentially swelling, with the possibility of worsening as the day progresses or at the end of a training session. Achilles pain can be categorized into two types: either the middle of the tendon is painful (66.6%), or the point where it attaches to the heel bone (33.3%). In the latter case, bone growth may develop under the tendon attachment point (in case of persistent inflammation), which can rub the tendon and cause a lot of pain. So-called bursa inflammation (bursitis) can also occur, which can aggravate the symptoms. The bursa is a fluid plug whose normal role is to reduce friction between the tendon and bone. In both cases, the cells are observed to calcify, i.e. deposit calcium and therefore harden.

What can you do if you notice these symptoms?

First and foremost, get it seen by a doctor. Since Achilles pain can lead to a more serious injury – even a rupture – you should let a professional diagnose and guide your treatment.

Treatment options for Achilles pain

Achilles pain can be treated using a variety of methods, either individually or in combination:

Nonsteroidal anti-inflammatory drugs
Non-steroidal anti-inflammatory drugs
Physical therapy treatments

The main aim of these treatments is to relieve pain, reduce swelling and help and support the anti-inflammatory (healing) process.

The choice of rehabilitation protocol depends on the severity of the condition and whether the athlete is a professional athlete. Total weight relief is now considered an outdated method, but all interventions should be done carefully! Rest should not be taken to mean lying on the couch. Reduce the intensity, and try to relieve the load on the injured limb (for example with kinesio tape). Switch from running to exercises that help increase blood circulation but do not overstretch the calf and Achilles tendon: cycling or using an elliptical trainer (these are less demanding on the Achilles).

Replace your bad running shoes! If you notice that the heel is worn out, or the back of the shoe is very hard, or the insole is too soft, you should replace it. In many cases, a simple heel lift can solve the problem.

Loosening the calf

The simplest, but big issue is the condition of your calf muscles. The tension of the calf muscles exerts a constant pull on the Achilles and contributes to overuse and inflammation.

So, if your muscles are stiff and tight, stretching and relaxing them alone can solve your complaints. For example, the Fit Stretch device is specifically designed to relax leg muscles and improve ankle movement. Just a few days of exercise can reduce the strain.

Another tool for relaxing the calf muscles is the foam roller.

Foam-Roller

The FoamRoller foam roller can help relieve muscle soreness, alleviate muscle stiffness and knots, facilitate stretching, warm up the muscles, and enhance muscle recovery.

The greatest benefit of the foam roller is that it provides many of the benefits of physiotherapy and massage. Meanwhile, a foam roller is cheaper than a single gymnastics or massage but can be used for years. Of course, it is not a substitute for either exercise or massage. But for someone who can afford a few treatments, it is well worth choosing and using a foam roller.

When you roll, your muscles stretch and relax. The foam roller squeezes the blood out of the muscles, while fresh blood flows into place, bringing vital nutrients such as oxygen and glycogen to the muscles, fasciae and tendons. You can control the “pressure” of the foam roller, and the intensity of the massage. The more you put your body weight on it, the less pressure you apply.

Muscles with a better blood supply and looser muscles are less sore when moving. Increased blood circulation flushes out accumulated waste products. Muscles get the nutrients they need more quickly, resulting in better recovery.

[message title=”I recommend getting a foam roller” title_color=”#ffffff” title_bg=”#1e73be” title_icon=”” content_color=”#000000″ content_bg=”#ededed” id=””]

To loosen the calf, I recommend the 3-in-1, Hollow, Spiky foam roller.
The foam roller in the 3 in 1 kit is the softest and gentlest.

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Physical therapy treatments for Achilles tendinitis

Thankfully, if we are looking at how to heal Achilles tendinitis, we get a variety of answers. I listed the below treatments that are either pain relief or a helping hand during the healing process and beyond.

TENS treatment:

Mainly a pain relief method. The device transmits impulses through the skin to the nerve endings in the body part undergoing treatment. In most cases, this stimulation significantly reduces or eliminates pain. It also slightly stimulates blood circulation, which may contribute to the healing process, but TENS alone is a temporary pain relief.

EMS treatment, i.e. muscle stimulation:

It relaxes stiff muscles, aids in strengthening the calf at a stage when exercise is not possible, and accelerates blood circulation, thereby removing waste products and delivering essential nutrients.

[message title=”Globus Triathlon Pro – With Muscle, TENS and microcurrent therapy” title_color=”#ffffff” title_bg=”#1e73be” title_icon=”” content_color=”#000000″ content_bg=”#ededed” id=””]

23 microcurrent programs
Pain reduction, anti-inflammatory treatment and healing stimulant
Extensive fitness and sports programs
Recovery, warm-up, endurance and strength muscle stimulation programs

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NEMS, or microcurrent treatment:

The latest and one of the most effective electrotherapy methods. It powerfully reduces pain, restores the membrane potential of damaged cells and thus triggers ATP and protein production and healing processes. The advantage of the aforementioned devices, capable of performing these treatments, is that they can address Achilles pain and provide support for strength exercises after healing. Additionally, conditions like tennis elbow, lumbago, and sciatica can be similarly treated. So these devices are quite versatile and good to have around.

Therapeutic ultrasound:

The tissues absorb ultrasound directed into the body, which accelerates blood circulation to the treated area, stimulating the healing process.

Soft laser treatment:

Performing it is very easy, as you simply direct the laser beam to the painful area and hold it there for a few seconds or minutes, depending on the device’s laser class. The laser beam penetrates the tissue and stimulates cell regeneration, thus accelerating the healing process.

[message title=”Personal Laser L400 Soft Laser” title_color=”#ffffff” title_bg=”#1e73be” title_icon=”” content_color=”#000000″ content_bg=”#ededed” id=””]

Laser Power Class 3
808 nanometer laser beam
400mW power
12.5 seconds / 5 Joule

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Manual therapies:

It is worth visiting a manual therapist who can use a variety of techniques to promote faster recovery.

Movement therapy:

A movement therapist can help your ankle joint to work with a greater range of motion- at home, use appropriate exercises to relieve tendon overuse.

You can reduce your risk of Achilles tendinitis by following these steps:

Increase intensity gradually, whether it’s speed or pace.
Choose your shoes carefully. Be comfortable and cushion properly. Get rid of worn, worn-out shoes. If you wear heels often, do stretching and mobilisation exercises regularly.
Do ankle mobilisation exercises to avoid straining your Achilles tendon and calf.
If you have an ankle impingement or flat feet, deal with it. Do proper physiotherapy.
Strengthen your calves with eccentric exercises.

If you delay in dealing with the problem, it can have more serious consequences: the Achilles tendon can rupture, requiring surgery and taking you out of training for a long time. So as soon as you notice the symptoms, take the advice and take action for your recovery.

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Tendinitis or Tennis elbow: Symptoms, Causes and Treatment

by Dr. Zsolt Zatrok 2023-10-12

Tendinitis or tennis elbow is formed by overuse. It’s not only athletes who struggle with it. It can also affect people who have never held a tennis racket. Unfortunately, the discomfort is not easy to get rid of.

The main cause of tendinitis

When you do repetitive, strenuous physical work with your arm, you overload the points where the tendons of the forearm muscles attach to the bone. A variety of problems can occur. Small tears can develop in the tendon. Parts of the tendon may tear out of the bone or damage the periosteum. Inflammation may develop in these areas. This is the development of tennis elbow – named after its common occurrence among tennis players, but it is not just a condition that affects athletes.

It can happen to anyone who makes frequent repetitive movements with their arm. Most often, for example, among carpenters, joiners, carpenters, carpenters, and butchers. It can also be triggered by things that seem “innocent”, such as prolonged mouse use.

It is often caused by the sudden strain (digging, raking, pruning) of spring gardening after a long winter’s “rest”.

I have met patients who have acquired it while caring for a relative who is permanently bedridden. Pulling a heavy body into a sitting position, turning it over when washing, etc. puts a lot of strain on the forearm muscles and through them the points of attachment to the bone.

Symptoms of tendinitis

The pain develops in the arm you use, the one you put the most pressure on

Even grasping, lifting or holding a small, light object, or even gripping your hand, can cause very severe pain
the pain on the outside of the elbow increases with strain
tension of the back of the hand and fingers increases the pain
pain may also be excruciating at rest

Home treatment options for tendinitis

One of the most important steps in treating it is to relieve the strain. If possible, you should stop the activity (be it sport or even work) that is causing the discomfort

A wide range of painkillers, steroid and non-steroidal medicines, creams and patches are available. You should be aware that painkillers (usually) have no curative effect, they only suppress symptoms, so it’s worth looking for a solution that also acts on and heals the inflammation.

For recent onset pain, start with cooling. Cooling machine straps that take the shape of the joint are best. If using ordinary ice, also place a towel between the ice and skin. Placing ice directly on the skin and leaving it there for half an hour can lead to frostbite! The analgesic effect of cooling is strongest if the skin temperature is reduced by at least 15°C within 10-15 minutes.

If the cooling doesn’t stop your tennis elbow pain, you can choose to have further physiotherapy treatments. The effects of these are slow to develop – you can expect the pain to ease after 7-10 days of treatment. However, tennis elbow is a very stubborn ‘thing’ and you can expect it to go away completely after 23 months of persistent treatment. In fact… sometimes more than that. In other words, 10-15 days of treatment does not make it go away, it does not mean that the treatment is ineffective, but that the inflammation is extremely persistent.

TENS treatment

TENS devices use electrical pulses to relieve pain. Stick 1-1 electrode 3 to 5 cm above and below the pain and treat in this way. If your device has a modular TENS program, use it, if not, you can choose between the traditional or endorphin programs. TENS is a symptomatic treatment, i.e. although it relieves pain, it has no effect on recovery.

Microcurrent therapy

Microcurrent treatment is similar to TENS, with the difference that microcurrent regenerates the membrane of diseased, inflamed cells and heals effectively, in addition to relieving pain. Thankfully, there are a few devices available that provide microcurrent therapy.

[message title=”Globus Triathlon Pro – With both Microcurrent and TENS therapy” title_color=”#ffffff” title_bg=”#1e73be” title_icon=”” content_color=”#000000″ content_bg=”#ededed” id=””]

- 23 microcurrent programs
- Pain reduction, anti-inflammatory treatment and healing stimulant
- Extensive fitness and sports programs
- Recovery, warm-up, endurance and strength programs

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Ultrasound treatment

Ultrasound rays raise the temperature of the treated tissue, accelerating blood circulation and thus the healing process. Always use contact gel for ultrasound treatment. Move the treatment head in a slow, circular motion over the painful area.

Soft laser treatment

Point the laser beam at the most painful point on the tennis elbow and hold it there until 5 Joules of energy are applied to the painful area. Different laser power levels require different treatment times – read the device’s guide! The energy of the laser beam penetrates deep into the tissue, stimulating the healing process. Effectively reduces pain and inflammation.

Examples of soft lasers for tennis elbow and tendinitis treatment at home:

[message title=”Personal Laser L400 Soft Laser” title_color=”#ffffff” title_bg=”#1e73be” title_icon=”” content_color=”#000000″ content_bg=”#ededed” id=””]

- Laser Power Class 3
- 808 nanometer laser beam
- 400mW power
- 12.5 seconds / 5 Joule

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[message title=”B-Cure Classic Soft Laser” title_color=”#ffffff” title_bg=”#1e73be” title_icon=”” content_color=”#000000″ content_bg=”#ededed” id=””]

- Laser Power Class1
- 808 nanometer laser beam
- PW (pulsed) laser
- 250mW power
- 6 minutes / 5 Joule

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Magnetic therapy

Pulsating magnetic field therapy using electric current is effective for any joint or tendon condition, including tennis elbow.
Warning: so-called static magnets – not produced by electricity – such as bracelets, necklaces, straps, belts, etc. have no medically proven effect.

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Treatments

MENS therapy: microcurrent pain relief

by Dr. Zsolt Zatrok 2023-10-07

Electrostimulation has been proven many times over in a number of areas – rehabilitation, sports, beauty, and pain relief. The aim of this article is to describe MENS therapy, i.e. nerve stimulation with microcurrent. This technique will soon take its rightful place among effective treatments without side effects.

How does MENS therapy work?

While traditional nerve stimulation (TENS) measures the electrical current used in a treatment in milliamperes (mA). In MENS therapy (microcurrent neuromuscular stimulation), only microamperes (μA) of current are used. This rate is so low that the patient cannot even feel it.

Although several different theories have been put forward about the exact mechanism of MENS treatment, there is one thing they all agree on: the common denominator is the phenomenon of ‘injury current’. It is a known fact that there is an electric current in the cell membrane. While the outer surface of the cell carries a positive charge, the inner surface carries a negative charge. When a cell sustains damage, the damaged surface becomes negatively charged, causing electric current to flow from the healthy area to the damaged one. This damaged current, known as microcurrent, aids in healing damaged cells and tissues. Supplementing it with artificially induced microcurrent further boosts the natural functions of the damaged membrane, expediting the healing process.

MENS, or microcurrent, offers an added advantage by enabling pain-relieving electrotherapy treatments for individuals who experience discomfort with traditional TENS treatments. This freedom from discomfort is undoubtedly a major advantage of MENS over TENS.

History of microcurrent stimulation

Researchers developed microcurrent neuromuscular electrostimulation therapy approximately 20 years ago. Lynn Wallace has studied the positive effects of MENS therapy on pain in over 600 patients.

Wallace found that treatments as short as 15 to 20 minutes can relieve pain in as many as 95% of patients.

Lerner and Kirsch later investigated the effects of MENS. Patients with chronic low back pain were divided into groups treated with MENS therapy and those treated with a placebo, i.e. an ineffective device. While in the first group, 75% of participants reported a reduction in pain, in the second group this rate was only 6%.

Gault and Gatens’ research showed that ischaemic patients treated with microcurrent healed twice as fast as the untreated control group. In addition, several researchers claim in their studies that low-level electric current also has a positive effect on the healing of bone fractures.

We can conclude that MENS therapy treats both acute and chronic pain. Moreover, it also aids in healing damaged tissues, wounds, and fractures. Physiotherapy and clinical applications commonly use this type of current.

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Symptoms Treatments

Osteoarthritis: Symptoms, Causes and Treatment

by Dr. Zsolt Zatrok 2023-10-07

Osteoarthritis (also known as arthritis) is one of the most common diseases of the knee joint. Symptoms develop slowly and can last for years or decades. Because it is a degenerative disease, there is not much they can do for you in hospital. However, your doctor may recommend home physiotherapy. You can use TENS treatment, microcurrent, therapeutic ultrasound, magnetic therapy and soft laser treatment may help you in different ways.

Your knee joint is made up of your thigh and shin bones, held together by ligaments and joint capsules. The ends of the bones are covered with articular cartilage, and the joint space is filled with a material that helps the joint to slide. But it is your leg muscles, especially your thigh muscles, that are responsible for the stability of the joint. As long as the muscles are strong, the bones of the joint are well-spaced so that the bone surfaces slide frictionlessly over each other during movement.

Cause of osteoarthritis

When the strength of the leg muscles is reduced (due to lack of movement, excess weight, surgery or illness, etc.), the bones are pressed together and the cartilage slowly deteriorates – first thinning, then the surface becomes cracked and crumbles, and finally is absorbed.

This is osteoarthritis.

When this happens, the two bones in your joint come into direct contact with each other, bone to bone. This hinders movement because they don’t slide easily. Moreover, it damages the bone and causes considerable pain.

The balance between cartilage degradation and build-up is upset and degradation occurs at a higher rate than build-up.

Forms of arthritis

Primary, or primary osteoarthritis is more common in women, usually developing over the age of 45. The cause is unknown.

Secondary, or secondary osteoarthritis, can occur at any age and is caused by another disease, condition or predisposing factor. Examples include:

diabetes, rheumatoid arthritis or gout
overuse of joints (joint-stressing work, sports, overweight)
remaining conditions after accidents (loss of muscle strength) or certain occupational hazards (vibration)
congenital malformations such as hip dysplasia or joint laxity
persistent physical inactivity (absolute loss of muscle strength) or obesity (relative loss of muscle strength). Even a few extra kilograms of weight increases the risk!

I – Minimal abnormalities, cartilage volume reduced by 10%
II – Joint space narrowed. The cartilage surface covering the joint begins to fragment. Some bone growths are also present.
III – Joint space is moderately narrowed. The cartilage surface is fragmented and bone is visible in places. Bone growths proliferate.
IV – The joint space has almost disappeared, and the cartilage volume has decreased by more than 60%. Large bone growths at the edge of the joint.

Symptoms of arthritis

Osteoarthritis (arthritis of the knee) usually develops slowly and gradually over the years. However, there are signs to look out for. The most important symptoms of osteoarthritis are:

joint pain on movement
feeling stiffness in the joint (so-called “starting pain”, when starting to move after resting causes pain)
change in the shape of the joint, deformation
restriction of joint movement, narrowing of the joint’s range of motion

Prevention

If knee pain is not treated properly after it occurs, cartilage damage can worsen rapidly and even progress to the point of being unable to walk. The pain allows less and less movement, further weakening the thigh muscles and reducing joint stability. You can also move less with more pain.

You are usually given medication to treat the condition, but these have no meaningful effect on the process, as they are not treating the cause, but aiming to eliminate the symptoms. Not to mention the fact that most of the arthritis drugs cause side effects if taken long-term.

Sometimes little things like changing a poorly supporting shoe or correcting a foot deformity with an insole can “work wonders”. If you stomp on your shoes, it’s a sign that your weight is being put in the wrong place. This tiny static error can cause huge damage over the years, so don’t underestimate it.

Peeling regularly is extremely important for your joints. Maintaining the absolute and relative strength of your legs and especially your hamstrings is essential to protect your knees. If you are overweight and your knee hurts, it is an obvious sign that your knee cannot cope with the load you are carrying. Reduce your weight before it’s too late.

If the pain is already preventing you from moving more, use muscle stimulators. In just a few weeks, you can strengthen your hamstrings enough to get rid of the pain and move more.

Treating osteoarthritis

If osteoarthritis already developed then you have to be treating your symptoms, because there is no way to replace the damaged cartilage today. Joint replacement (prosthesis) is usually recommended in advanced stages – but until then you will have to struggle with pain for a long time.

Home physiotherapy treatments are designed to stop you having to run to the doctor or the surgery. However, it’s up to your doctor to guide your treatment and decide when and how much to treat you.

TENS Treatment

TENS treatment uses electrical impulses to electrically switch off the transmission of pain signals to the brain, so you can be free of pain for hours after treatment. The treatment has no curative effect, so it gives you relief, not an improvement.

Arthritis can plague you for a long time, so buy a TENS unit that has a MODULAR TENS program. Unlike older TENS devices, you won’t need to get used to this. The Dolito or Myolito devices are suitable for this.

[message title=”Myolito TENS unit – For pain relief” title_color=”#ffffff” title_bg=”#1e73be” title_icon=”” content_color=”#000000″ content_bg=”#ededed” id=””]

2-channel TENS unit
12 programs
Possibility to create own treatment program
Records time and average intensity – so you know which settings were effective for you

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[message title=”Dolito TENS unit – For pain relief” title_color=”#ffffff” title_bg=”#1e73be” title_icon=”” content_color=”#000000″ content_bg=”#ededed” id=””]

2-channel TENS unit
6 programs
Possibility to create own treatment program
Records time and average intensity – so you know which settings were effective for you

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Microcurrent Treatment

Microcurrent treatment is more powerful in relieving pain, but it can “do more”. Especially in the early stages of arthrosis. It has a regenerative effect, so if started early it can help regeneration and inhibit cartilage destruction. Microcurrent devices are significantly more expensive than simple TENS devices.

Soft Laser Therapy

Soft laser has similar effects, as there is growing evidence and experience of high-dose joint treatment. Electromagnetic energy of 20-50 Joules per sub-unit delivered into the joint space stimulates cartilage regeneration. Such treatments include Personal-Laser L400 and Energy-Laser L500 Pro.

[message title=”Personal Laser L400 soft laser device” title_color=”#ffffff” title_bg=”#1e73be” title_icon=”” content_color=”#000000″ content_bg=”#ededed” id=””]

Commonly used for arthritis treatment
The red laser provides visual help during treatment
Laser Power Class 3
10 seconds / 4 Joule
808 nanometer laser beam
400mW power

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Additional treatment methods

Muscle stimulation is also a good option in this case. Strengthening the leg muscles reduces symptoms because strong muscles keep the bones apart and less pressed against each other, which relieves pain during movement.

Ultrasound therapy and PEMF pulsed magnetic field therapy are both excellent for treating osteoarthritis. They improve blood circulation, and oxygenation and stimulate regeneration processes in the area around the joint.

My suggestion

Take your knee pain very seriously! Begin treatment at the first warning signs, as it can improve and even eliminate the condition at that time. If you let the cartilage surfaces wear away, there is little or no way back from there.

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Symptoms

Sciatica aka Sciatic Nerve Inflammation: Causes and Treatments

by Dr. Zsolt Zatrok 2023-09-29

Ischiasis, or sciatica, is a severe lower back pain that radiates into the muscles of the buttocks or legs. It is often “deceptive” because the complaint is not pain in the lower back at all, but pain radiating down the buttocks and into the legs. But the root of the problem is in the lumbar spine. The pain itself and the underlying cause is very similar to lumbar pain. It can also be mistaken for it. My article is about what you can do about its recurrence.

The cause of sciatica

The sciatic nerve starts in the lumbar and sacral vertebrae IV-V and runs under the gluteal muscles, down the deep thighs, and down to the shin and toes.

In case of sciatica, the disc between these vertebrae weakens and presses on the nerve running through the intervertebral space (See diagram below). When the nerve is pressed, pain occurs.

Ischiasis, lumbago and herniated disc are essentially the same condition. They are now “widespread diseases”, i.e. they affect a very large number of people. The main causes are too much sitting and a sedentary lifestyle. The muscles supporting the spine weaken and do not hold the spine properly, putting more pressure on the discs. Add to that excess weight or lifting heavy objects and you have a problem. Sciatica, lumbar hernia and herniated discs usually develop suddenly, with a single movement – only to torment the “victim” for a long time.

I’ve already mentioned the most common cause, but spinal stenosis, wear and calcification of the joints between the vertebrae, or even spasmodic muscle contraction due to stress (e.g. piriformis syndrome) can also trigger sciatica.

Isiasis can also be caused by psychological factors! Psychology sees it as an overwhelming feeling of being overwhelmed – it can be triggered by past or present problems, or by fear of the future. The pain of sciatica may prompt a patient, who often feels inferior, to find a solution to their problems, to eliminate their real or imagined overload.

Symptoms of sciatica

The pain may primarily affect the lower back, but it typically radiates downward to encompass the bottom of the buttocks, the inside back of the thighs, and the back and outside edges of the shins. In mild cases, there is only pain, but there is also sensory disturbance and even paralysis.

The location of the pain can fool you and even the inexperienced doctor! Because you feel the pain in your leg, you may not even think that your back or spine is the real cause. Although your leg hurts a lot, the cause is higher up in the lumbar spine!

In this case, the lumbar spine requires treatment as the primary concern, not the leg. The aim of the treatment is to “free” the sciatic nerve from “pinching”, from pressing down on the disc.

Tips for prevention

Regular exercise and back muscle strengthening exercises can help prevent sciatica.
Choose sports that strengthen your spinal muscles to relieve the load on your discs. Ideal exercise is swimming, (indoor) cycling, yoga, any back muscle strengthening exercise.
Sitting in the wrong position at work often triggers these complaints. The chair should support your lower back! Raise your monitor to eye level. Don’t sit all day, stand up often and do some waist-relaxing exercises.
Exercise regularly, even 15-20 minutes a day can do wonders.
If you need to lift a heavy object, do it with a straight spine, starting from a squat.
Load both sides of your body evenly. If you always carry your bag on the same side, the asymmetrical load will also unbalance your muscles, which will affect your spine.
Use a proper recliner in your bed. It should be neither too hard nor too “lumpy”

Home treatment for sciatica

If you haven’t had sciatica before, see your GP as soon as possible. You should be referred to a neurologist (neurology) or a spine centre. You need to find out the extent of the disc herniation. If the disc is intact, they will recommend conservative treatment. However, if the cartilage is torn, your neurological symptoms may be severe, e.g. pain, sensory disturbance, muscle weakness, mobility problems, urinary and bowel problems. A hernia that has been torn out can only be repaired with surgery.

Ischiasis is characterised by recurring from time to time, caused by not strengthening your back muscles, changing your work or lifestyle despite the symptoms. Such recurring complaints do not always require a further examination (only if neurological symptoms occur).

You can help yourself by treating it at home for a few days. For one thing, you can take some medication prescribed by your doctor for just such occasions. Muscle relaxants, painkillers, NSAIDs are available in tablet, capsule, patch or even suppository form. If these drugs are taken for long periods (several weeks), undesirable side effects (e.g. stomach pain, ulcers, black stools, etc.) can be expected. If you experience any of these, consult a doctor.

Physical therapy devices are side-effect free, simple to use and effective. They are not miracle cures, of course, which means that you won’t find a single method that will make the pain go away in one treatment. You can gradually improve your condition over a few days.

Multimodality treatment

Sciatica requires multi-modality treatment. This means that you should use several different treatments in parallel, if possible, rather than trying just one.

To understand my usual example of tinkering. If you want to make a birdhouse but you only have a hammer, it will never be finished. You need a saw to cut the planks to size. A drill to make the hole for the hole. Hammer and nails to assemble the wooden boards. A hook to hang it on a branch.If you have all the tools, but you use them incorrectly (the hammer to cut, the saw to hammer), the result will be poor. If you use them in the right way and in the right order, you will have a hole.

There are also several different “tools” for sciatica, none of which alone guarantees an improvement. It’s best – and in a physiotherapy practice this is why you can get several treatments at once- if you have several different types of equipment at home. If you don’t have one, go for the simplest (and cheaper) one and if that is ineffective, move on to the more complex (and more expensive) one.

In the next section, I’ll look at what methods can be used to treat sciatica and which ones work.

What you can expect from each method

TENS treatment

Tens Treatment is a pain-relieving method that you can use instead of medication. If you use it with them, you can enhance the effect of the medication, meaning you need to take less poison. The disadvantage of TENS is that it is only temporary, i.e. it does not act on the cause of sciatica, nor does it eliminate it.

Dolito TENS device

two-channel TENS unit
modulated, conventional, endorphin and burst TENS programs
It can be used for pain relief in any area of the body, with the exclusion of the skull.

Microcurrent (MENS) treatment

Microcurrent Treatment is also an electrotherapy method, but it has a stronger analgesic effect than TENS. It also has the advantage of reducing the swelling (oedema) of the pinched nerve fibre and stimulates and accelerates the regeneration of the damaged nerve fibre.

Therapeutic ultrasound

Ultrasound treatment, when applied during the acute period (first three days after the pinch), reduces swelling (oedema) of the nerve fibre and relieves pain. It relaxes the muscles of the spinal cord and thus reduces pain. Ultrasound does not strengthen the muscles and does not affect possible recurrence.

M-Sonic 950 Therapeutic Ultrasound

Ultrasonic frequency: 1.0MHz
Transducer area: 4.0cm²
Power: 1.6W/cm²
Max. power: 6.4 W (continuous mode)
Cycle time: L (5%), M (50%), H (100%)
Waveform: Pulsating, Continuous

Soft Laser treatment

Soft Laser treatments help to relieve acute pain, their main role is to reduce the edema and swelling around the pinched nerve and to regenerate it. None of them strengthen the muscles, so they do not affect possible recurrence.

Personal Laser L400 soft laser

Laser power class 3
808 nanometer laser beam
CW (continuous wave) laser
400 mW power
12.5 sec / 5 Joule

Muscle Stimulation (EMS)

If you have sciatica, you can expect to get the most out of muscle stimulation (EMS). Its effects are twofold. It relaxes tight muscles in the spinal muscles that have become stiff from pain. The main benefit of muscle stimulation is that, with daily use for 10-12 weeks, you can strengthen your spinal muscles to the point where sciatica symptoms are permanently relieved. This is essential because without strengthening your spinal muscles, it only takes one sudden movement to trigger a recurrence of your symptoms.

Premium 400

Dedicated Sciatica treatment program
Multifunctional electrotherapy device
TENS | EMS, NMES, FES | MENS, MCR | Iontophoresis
max. 4 channels (8 electrodes)

In the case of sciatica, muscle relaxant-pain reliever stimulation should be performed on the lumbar spine (because that is where the problem itself originates) and over the complaints radiating to the leg.

Treatment strategies for sciatica at home

Keep the following in mind:

ease the pain

TENS treatment
microcurrent treatment
ultrasound treatment (to reduce oedema around the nerve roots)
soft laser treatment (to reduce oedema around the nerve roots and regenerate damaged cells)
muscle stimulation, muscle relaxation programmes
pulsating magnetic field treatment (with anti-pulsation programme)

reduce muscle stiffness

muscle stimulation, with muscle relaxation programmes
ultrasound treatment (therapeutic ultrasound relaxes muscles, reduces oedema)

prevent recurrence by strengthening spinal muscles

this is the most important step in getting rid of sciatica!
By strengthening your spinal muscles, you can prevent the vertebrae from stacking up and putting pressure on the nerve.
a good tool for this is the muscle stimulator.

Home physiotherapy devices are designed specifically to treat such conditions.. All you have to do is follow the instructions.

You can reduce your pain for some time with a single treatment, but achieving lasting results requires persistent treatment. You can typically achieve symptom relief within 10-15 days. To prevent a recurrence, you need to strengthen the muscles that support the spine and take about 60-90 days to recover.

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Diseases

Disc hernia – how can you fix it?

by Dr. Zsolt Zatrok 2022-06-02

Your spinal column is made up of separate “bricks” called vertebrae. The space between them is filled by a flexible material called the intervertebral disc. This prevents the vertebrae from coming into direct contact with each other. The stability of the spine is provided by ligaments and a number of muscles. If your spinal muscles are strong, they hold the vertebrae in place and only enough load is placed on the disc to prevent damage. If it becomes deformed, it causes complaints of varying severity. Herniated discs affect many people. But most do not require surgery. However, pain in this condition is often recurrent. Surgery is a looming shadow. In most cases, you can reverse this condition yourself! Here’s how

Causes of disc herniation and how to prevent it

Your body weight is put on your spinal column with every movement you make. Your vertebrae, the disc between them, ligaments and muscles act like a cushion to absorb this shock. As long as your spinal muscles are strong enough to hold you up, you’re free of complaints. If they don’t hold well – you’ll have complaints. The force-absorbing system can be weakened and upset for a number of reasons.

Most spinal hernias are caused by something you or your lifestyle is responsible for.

Most spinal injuries are caused by accidents, such as falls and collisions.
Genetic predisposition – If you have a family history of herniated discs, you need to be consciously prepared to avoid them. This means that regular spinal exercises, yoga, etc. are “mandatory” for you.
If you are overweight, your muscles will be under more strain than “designed”. It’s like you’re always carrying a bag on your shoulders.
If you do heavy physical work, your muscles can handle your own body weight, but not the weight of the objects you regularly carry. The only way to avoid this is to build up your back muscles to the point where they can sustain not only your own weight but also the extra weight.
The driver or jackhammer operator is exposed to constant vibration. These jobs put more stress than normal on the spine.
However, the most common cause today is sedentary work and lack of exercise. You sit in the office, on the bus, on the subway, in the car, in front of the TV, at the movies.

My advice

If you miss the opportunity to prevent and get injured, it will take a long time to recover. Prevention is cheap. To “undo” a hernia? Well… that can be very expensive.

You’ll need a variety of tools and professionals. Physiotherapist, physiotherapist, massage therapist, muscle stimulator, soft laser, therapeutic ultrasound…. you would have to pay for their expertise, you would have to buy the equipment. These costs will be particularly painful because your pain will prevent you from working and earning an income.

My advice: Don’t let discus hernia develop! Regular back exercises can “cheaply” prevent it

How does a disc hernia develop?

The disc between the vertebrae is made up of an outer fibrous ring and an inner, gelatinous substance. Imagine a doughnut filled with jam. The dough is on the outside (like the fibrous ring on the cartilage) and the jam is on the inside (like the jelly inside the cartilage). The jam is invisible, it stays inside, it only appears when you press it, the dough breaks away and gives way to the jam. Now sit on the doughnut…it will crumble apart. Do you understand?! The heavier the load on your cartilage, the more jelly will flow out.

The space at the spine is very tight. In other words, there’s no place for the “jelly” to drain! However, there are plenty of sensitive things: the nerve bundles that exit between the spinal cord and the vertebrae are located here.

If you’re lucky, your disc will rupture in a direction that the jelly doesn’t press on the nerve – in which case you won’t have any complaints despite the hernia.

But the hernia is usually revealed when you can’t move because of the pain. This is not caused by the hernia itself, but by pressure on the spinal cord or nerve root. The location and intensity of your symptoms will depend on the vertebrae at which the hernia is located.

As the greatest stress is concentrated around your lumbar spine, it is in this area that a hernia most often develops. But it can also occur in the neck and back.

Symptoms of disc hernia

Mostly sharp, splitting, stabbing pain that stiffens into a compulsion to simply not move. With increased abdominal compression (sneezing, coughing, abdominal squeezing), the pain usually intensifies. It decreases when lying with knees up and hips bent.

Pain radiates to the area of the affected nerve supply (dermatome), where there may be sensory disturbances (burning, numbness, numbness). Reflexes may be weakened or lost.

If the nerve remains under pressure for a long time, the motor nerve may be “damaged”, resulting in muscle weakness or even peripheral paralysis.

Treatment of disc hernia

It is up to the doctor to decide what to do. Surgery is usually performed if the hernia has neurological symptoms and paralysis. If immediate surgery is not needed, conservative treatment is started. If there is no significant change after 6 weeks, then surgery may be decided for an “indirect” reason.

In the majority of cases, surgery is not needed and treatment reduces but does not eliminate the symptoms. In case of back pain avoid physical exertion. Sleep on a hard mattress, lie on your side with your knees up and your waist “curled”. This relieves pressure on the lumbar discs.

The medication for lumbar sprains is aimed at relieving pain and relaxing the muscles. However, oral medication not only reaches the painful area, but also spreads throughout your body. It can lead to undesirable side effects.

Physical therapy is likely to be prescribed alongside the drugs. You will get a combination of ultrasound, electrotherapy, soft laser and magnetic therapy. The effects of these will develop slowly and once you start to feel the benefits, the prescribed course of treatment will expire. I’m sorry to say that you’re on your own from here. This is where you need to seek help from private providers, physiotherapists, physiotherapists.

Methods of providing symptomatic therapy

You can use a range of home physiotherapy equipment to help reduce your back pain. These devices are designed to be simple, effective and safe for you to use. They’re not too complicated, but they’re not completely risk-free – you could harm yourself if you ignore the rules and suggestions.

You need to understand that different medical devices work in different ways, they are made for different things. They all aim to restore your health, but in different ways. It’s like a spoon, knife and fork. They are all for eating, but for different things.

First, we look at the devices that contribute to reducing or even eliminating your pain, but these methods do not add anything to your treatment in the long term, they do not restore you to your original condition. So although you may not be in pain, it can recur at any time.

TENS treatment

You can choose not to ask for the side effects of painkillers and use TENS treatment for pain relief. This easy-to-administer treatment works in two locations, resulting in pain relief for several hours after treatment.
Since herniated discs cause persistent pain – lasting up to weeks – choose a device with a so-called modulated TENS programme. Devices that do not have a modulated TENS program will only provide pain relief for a few days because the brain gets used to the stimulation (unfortunately, the most common Omron, Beurer stimulators do not have this, so they are only temporarily good for spinal hernia pain)!
IMPORTANT: TENS is a symptomatic treatment. It relieves your pain, but it has no therapeutic effect, i.e. it does not have any curative effect on the hernia.

[message title=”Dolito TENS Unit” title_color=”#ffffff” title_bg=”#1e73be” title_icon=”” content_color=”#000000″ content_bg=”#ededed” id=””]

dual-channel TENS unit
provides pain relief programs only, no other functions
modulated, conventional, endorphin and burst TENS programs
possibility to create your own program (requires expertise)
applicable to any area of the body (skull excluded)
recommended for home use

[/message]

Microcurrent treatment

It provides more effective pain relief than TENS, but only the more modern and currently more expensive devices provide this treatment. In this case, the treatment is not only symptomatic. It reduces the oedema of the nerve roots pressed by the hernia and relieves pain. It stimulates the regeneration of damaged tissue. This method does not eliminate the hernia itself.

[message title=”Premium 400 TENS/EMS/MCR /4channels” title_color=”#ffffff” title_bg=”#1e73be” title_icon=”” content_color=”#000000″ content_bg=”#ededed” id=””]

high skill level, 4-channel electrotherapy device
multifunctional, i.e. in addition to muscle stimulation, it also provides other forms of current (TENS, MENS, FES), i.e. versatile
precise programmes for muscle pain, muscle stiffness relief, prevention of muscle atrophy and muscle recovery
Joint and tendonitis treatment with microcurrent (MENS)
can be used to treat 1 channel only (i.e. small muscles) or the largest muscles (thighs, back, abdomen) simultaneously

[/message]

Ultrasound treatment

Ultrasound warms the tissues, speeding up blood circulation, relaxing stiff muscles and reducing edema around nerve roots. The effect is slower than with soft laser and more treatments may be needed. Ultrasound machines are cheaper than soft lasers, for example. With ultrasound, you need to be careful about the correct dosage and you can’t use it directly over the spine, only on the muscles on either side of the spinal column. Ultrasound reduces pain but does not eliminate the hernia or the underlying cause.

[message title=”M-Sonic 950 Therapeutic Ultrasound” title_color=”#ffffff” title_bg=”#1e73be” title_icon=”” content_color=”#000000″ content_bg=”#ededed” id=””]

1Mhz frequency ultrasound-emitting therapeutic device
Relaxes stiff muscles, relieves tension pain
Symptomatic treatment of lumbago
Recommended for home use

[/message]

Soft laser treatment

The effect is similar to microcurrent. It reduces the edema around the nerve root, leading to pain relief. A 2017 study by the American College of Physicians (ACP) recommends soft laser as the first procedure to use for spinal hernia (non-surgical). In 2/3 of cases, surgery was also avoided. The soft laser device is more expensive than microcurrent or TENS, and unfortunately, it is not a permanent solution to the hernia, because it does not eliminate the hernia or the cause itself.

[message title=”B-Cure Classic Soft Laser” title_color=”#ffffff” title_bg=”#1e73be” title_icon=”” content_color=”#000000″ content_bg=”#ededed” id=””]

Laser Power Class 1
808 nanometer laser beam
PW (pulsed) laser
250mW power
6 minutes / 5 Joule

[/message]

[message title=”Personal Laser L400 soft laser” title_color=”#ffffff” title_bg=”#1e73be” title_icon=”” content_color=”#000000″ content_bg=”#ededed” id=””]

Laser power class 3
808 nanometer laser beam
CW (continuous wave) laser
400 mW power
12.5 sec / 5 Joule

[/message]

Muscle stimulation and disc hernia – effective help

If you’ve got this far in your reading, you already know: a spinal hernia is caused by your muscles not having enough strength to maintain the distance between your vertebrae for some reason. This puts enough pressure on the disc between them to “squeeze the juice out” – hence the herniated disc.

While it’s obvious that regular spinal strengthening exercises can reduce the likelihood of developing a herniated disc, once a herniated disc has developed, gymnastics is very risky and should be avoided! In fact, if you start strengthening your back muscles with the very weak muscles that led to the hernia, you will make matters worse.

This is where muscle stimulation (EMS) comes in. This is a way to strengthen your back muscles without putting extra weight or stress on your spine and causing more trouble.

I recommend these muscle stimulators

[message title=”MyoBravo multifunction electrotherapy device” title_color=”#ffffff” title_bg=”#1e73be” title_icon=”” content_color=”#000000″ content_bg=”#ededed” id=””]

mid-level, 4-channel electrotherapy machine, large area treatment at once
multifunctional, i.e. provides TENS, EMS and FES currents, versatile use
modulated TENS program for pain relief
precise programmes to release muscle stiffness and strengthen spinal muscles
can be used to treat only 1 channel (i.e. small muscles) or to treat the largest muscles (thighs, back, abdomen) simultaneously

[/message]

[message title=”Premium 400 TENS/EMS/MCR /4channels” title_color=”#ffffff” title_bg=”#1e73be” title_icon=”” content_color=”#000000″ content_bg=”#ededed” id=””]

high skill level, 4-channel electrotherapy device
multifunctional, i.e. in addition to muscle stimulation, it also provides other forms of current (TENS, MENS, FES), i.e. versatile
precise programmes for muscle pain, muscle stiffness relief, prevention of muscle atrophy and muscle recovery
sport applications
Joint and tendonitis treatment with microcurrent (MENS)

[/message]

The goal of muscle stimulation is to strengthen your spine supporting and back muscles to the point where it’s safe for you to do back exercises, yoga or even gym workouts.

Muscle stimulation is no different from traditional exercise in terms of muscle. If you strengthen a muscle for exercise, it will also strengthen for stimulation. The only difference is efficiency and time. Muscle stimulation is more effective than exercise and therefore can be used to develop a specific muscle group in a shorter period of time.

Naturally, stimulation is not a substitute for exercise. It complements it. However, in the case of injury, it is the only possible and effective method. You should treat it at least once a day. After 2-3 weeks, you will feel the improvement. In 2-3 months, you can strengthen your muscles to the point where you can safely move on to exercise.

And here’s my next piece of news: you can’t quit exercising from now on. Because if you do nothing, your painstakingly strengthened muscles will be back to square one in about 2-3 weeks, and you’ll be back to torturing your injury again…

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pain relief without drugs and side effects

Treatments

Pain relief without pills: TENS treatment

by Dr. Zsolt Zatrok 2022-01-05

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

muscle pain, myalgia,
strain,
sprain,
arthritis,
joint haemorrhage,
tendonitis,
periarteritis,
lumbago
neuralgias: sciatica, brachialgia, intercostal nerve pain, trigeminal neuralgia, post-herpetic neuralgia, scar pain,
pain caused by phantom pain, etc.

pain caused by chronic (weeks, months) musculoskeletal disease

spinal hernia,
tendon and muscular stiffness (contracture),
osteoarthritis, arthrosis.
rheumatism,
epicondylitis (tennis elbow and golf elbow),
cervical, lumbar and back pain,
wrist, elbow and finger-joint pain
pain of hip, knee, ankle, foot joints, etc.

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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