Treatment using TENS

So that you get the maximum relief from your TENS; we recommend that you follow this simple treatment procedure which will enable you to find the best electrode placements and stimulation settings for your condition.

Click here to see the General Pain TENS in action on

  1. Using the traditional electrode placement directly over the painful site and a continuous mode output, stimulate for half an hour using the highest amplitude and frequency settings which remain comfortable. Start the frequency control 'R' at 7 and adjust for comfort.

  2. Access the effectiveness of the stimulation. Change the electrode position and/or modify the output of the TENS by using the burst mode. Stimulate for half an hour and assess again.

  3. Repeat the process until the optimum electrode position and stimulation output is achieved

    Continue with your chosen method for 3-4 weeks using the TENS as little or as often as is required, and assess. If you are still getting good relief there is no need to alter the stimulation technique.

  4. If the pain relief is not as good as the initial trial, place the electrodes on the appropriate acupuncture points for the condition and repeat the previous procedure.

  5. For patients who are unable to use the traditional and acupuncture point placement of electrodes, the same procedure should be used to evaluate myotomal and dermatomal positions.
    Both continuous and burst mode stimulation can be used with these electrode placement techniques. Burst mode stimulation with some muscle contraction.
    (Acupuncture-like TENS or AL-TENS) is recommended with the myotomal technique.

Electrode Placement

There are four methods for electrode placement with which we can apply both the continuous and burst mode stimulation outputs:

  1. 1. Traditional Placement

    Traditional placement involves locating the painful or tender points and applying the electrodes on or around these areas. This technique is usually the starting point for all TENS treatment.

  2. 2. Dermatomal Placement

    This technique requires the identification of the nerve roots from the painful site and then knowing what level they enter the spinal cord. The electrodes are placed either side of the spine at the correct height on the back corresponding to the selected nerve.
    Dermatomes are the chosen technique for the relief of labour pain where a pair of electrodes are placed over T10 to L1 and a second pair over S2 to S4.
    A physiotherapist will be able to help you locate the correct position for your condition.

  3. 3. Myotomal Placement

    This involves placing electrodes on the corresponding muscle groups to the painful site but on the opposite side of the body. This is particularly useful if the patient has lost good nervous function and sensation on one side or has has an amputation.
    It is believed that the best results with this technique are achieved if burst mode stimulation is used with slight muscle contraction. This is often described as Acupuncture-like TENS (AL-TENS).


  4. 4. Acupuncture Point Placement

    The use of acupuncture points can be of great benefit. Particularly if it is not possible to use the traditional method. However, it does require knowledge of the appropriate points for the condition. Tender points sometimes correspond to the acupuncture points but check against the chart for the correct placement.
    The position for the electrodes when using orthodox TENS is over the tender areas. When using acupuncture points, one electrode should be on the local tender area and the other on the corresponding distal point.
Operation of your Childbirth TENS

You, or someone present during your labour, should carry out the following steps to apply the TENS as soon as you need it.

If you have an induced labour, it is recommended that the TENS is applied approximately 30 to 45 minutes beforehand. This will allow the effects of TENS time to build up and will therefore provide better relief should contractions be precipitated rapidly after induction.

  1. 1. Inserting battery

    Ensure that the two outer controls 1 and 2 are off. Slide the bottom corner to the right to open the battery compartment. Remove wrapper and insert the battery and replace battery cover.



  2. 2. Connecting lead wires to electrodes

    Gently push the pin connector of each lead wire into the crimp connector of an electrode making sure that they are pushed fully home and that none of the pin is left showing. Leave all the electrodes on the liner.



  3. 3. Adjustment of control R to 7

    Ensure that the two outer controls 1 and 2 are still off and the white boost button on the hand piece is in the unpressed normal position. Turn the central control R to position 7.




  4. 4. Connecting lead wires to TENS

    Push the two output jack plugs into the sockets found either side of the coiled lead on top of the TENS.




  5. 5. Application of the electrodes to your back - Upper back

    Wash the skin with soap and water and thoroughly dry the area where the electrodes are to be positioned.

    Upper set from control 1
    Remove the electrodes from the linear by peeling from the corners opposite the pig tail wire.

    Place the upper pair of electrodes approximately 25mm (1 in) either side of the spine between the T10 and L1 vertebrae. T7 can be found by taking the base of the shoulder blades, with the arms relaxed at the side, and working across the spine.

    Count down three vertebrae to locate T10. An approximate visual guide is just below the bra strap.

    Place the top of the electrodes level with T10. The size of electrode will ensure coverage down to L1.


  6. 6. Application of the electrodes to your back - Lower set

    Upper set from control 1
    Place the lower pair of electrodes approximately 25mm (1 in) either side of the spine between S2 to S4 vertebrae. S2 can be located at the level of the dimples just above the buttocks. By placing the top of the electrodes over the dimples, S2 and S4 will be covered.

    If you have any difficulty in locating these areas, your Midwife or Obstetric Physiotherapist will be able to help you.


  7. 7. Control 1 adjustment

    Turn until a pleasant tingling sensation is felt under the matching set of electrodes.
    The yellow indicator light will flash on and off.




  8. 8. Control 2 adjustment

    Turn until this set of electrodes provides a pleasant tingling sensation. Adjust both controls until the tingling sensation is strong but not uncomfortable.




  9. 9. Control R adjustment

    Rotate around 7 until the most comfortable setting is found.





  10. 10. Use of boost button during your contractions

    When your contraction is felt, press and release the white boost button on the handpiece. the indicator light and sensation will be continuous.
    When your contraction is over press and release the boost button to return to the normal setting.

  11. 11. Further adjustment of controls 1 and 2

    These may require adjustment as the body becomes accustomed to the stimulation and if the pain between and during the contractions increases.

Pain relief after a Caesarian Section

Pain relief after a Caesarian Section

Connect the TENS up as you would steps 1 to 4. At this stage the lower pair of the electrode pads can be moved to the abdomen and placed horizontally or obliquely around the incision so that the electrical current passes through the scar area. The upper pair of the electrodes can be left on the back over the T10 - L1 nerve roots. (As in Step 5 above)

We also recommend leaving TENS set to boost to give a continuous tingling sensation which is generally more comfortable than the intermittent burst output.

Adjust the power (controls 1 and 2) and the speed/rate (control R) of the pulses as with the standard technique to achieve the optimum and most comfortable sensation.

Practicing

  • Before your labour starts you should become familiar with your TENS.
  • Watch the video tape and follow the above guide, but only use 1 pair of electrodes and place these either on your arm or leg and approximately 5cm apart.
  • Familiarise yourself with the power intensity controls 1 and 2, speed/rate control R and the white boost button on the handpiece.
  • Please read the instructions for use on the front of the TENS electrode pack. If you wish to practice more than once, follow these instructions and unsure that the electrodes are always returned to their liner after use.
  • To maintain optimum clinical performance do not over use the electrodes before your labour.