I’m back! Had some muscle spasm trouble over the last few days but I’m finally feeling better after some intensive work on a few misbehaving trigger points. (Don’t worry, that is on my list to post about too.) I will henceforth avoid jinxing myself with overly-ambitious deadlines!
There are many sizes, shapes, and types of electrodes. I usually use the self-stick carbon electrodes. I order them from OTC Wholesale. I’ve tried silver electrodes, which are supposed to be superior, and found that I didn’t like the feel of them quite as much, and they didn’t seem to last as long. I also just got an electrode garment (a sock filled with silver in the fibers) but I haven’t figured out how to use it correctly yet. The self-stick electrodes can be used multiple times, and that sure saves a lot of money. To prolong the life of my electrodes, I wash off any oils or lotions before applying them when possible, and use an electrode prep spray (again, from OTC Wholesale or LG Med Supply). The spray goes on my skin right before the electrodes do. It keeps the gel hydrated and contains silver to improve conductivity. You can also rinse your electrodes gently in water, rubbing them lightly with a finger to remove any oils or fuzz, and then leave them face up for a little bit to absorb a little of the water while the rest evaporates off. I leave them to sit for 30-60 minutes, but it is very humid here. When they are too worn out to use, they tend to make the electricity sting, so it’s pretty obvious when to try to rehabilitate them or toss them out. The vendors say they can last for 30 applications, but I probably get 10 or 15 out of them before they have to go–but I am also not the best and prewashing the area. The last thing I feel like doing when I need some extra pain relief is trying to balance in the shower.
Most often, I apply the electrodes directly to my ankle. Because that’s a rather small space to fit four electrodes, I get the smallest ones I can find, 1.25″ diameter circles. I arrange all four in a crossed pattern over the outside of my ankle bone. This means each pair of electrodes connect along the imaginary diagonal running through the center of the square that the four make on my ankle, instead of connecting along two parallel lines. I find this diffuses the electricity over the whole area very well and is quite effective. I personally use these settings on my original LG Tech: Width 300 microseconds, Rate 50Hz. I turn on the power up to where the tingle is masking my pain but not yet painful or causing any muscle contractions (usually around 4 or 5 on the dial). Then I pick the type of delivery. My favorite setting is N for normal, which is just a constant flow of zapping, but sometimes if that doesn’t seem to help as much as usual, B (for Burst, the electricity is released in many successive zaps with a small pause in between them), or even occasionally a different setting. It really helps to adjust the electrode placement and all the settings until you figure out what your ideal setup is.
Sometimes, if the skin on my ankle is feeling irritated from the gel or just from the CRPS itself, I’ll put the electrodes on my good ankle. I got this idea from reading a study done on mice that had some good results by putting the electrodes on the opposite limb. It’s strange, but it works nearly the same no matter which ankle is being zapped.
If my whole leg is hurting, I’ll often choose my lower back to zap instead. I use bigger electrodes, usually 2″x2″ squares, and surround the area of my back where my lumbar spinal sympathetic nerve block was done. The nerve block didn’t help all that much or last very long, so I never had another, but electricity zapping over my spine does help. When I zap my back, I pair the electrodes in parallel across my spine. It seems to work better this way than in the cross pattern.
TENS is one of those treatments that seem like the more often you use it, the less effective it becomes–like my body adapts to it and starts to learn how to ignore it.
For this reason, I save the TENS for use when it is most effective–when I’m having a sharper ache in my ankle. I don’t necessarily use it instead of medications, because it is so important for people with intractable pain (this means pain that never shuts off) to keep the pain down at a manageable level for a couple of reasons. First, all those stress hormones from being in pain all the time also increase blood pressure and heart rate. Very hard on the old ticker. According to my pain specialist, I am supposed to take my breakthrough medication when I get to 5 or higher out of 10 on the pain scale (I have to work hard at this because I don’t like the breakthrough meds and if I don’t think about it, I’ll wait and take them at 7 or 8.). Second, the worse the pain gets, the more likely I am to have a full-body pain flare. Once I’m up to 7 or 8, there may not be time for the medications to kick in before that initiates a flare that will keep me stuck in bed for anywhere from 8-20 hours or so. The TENS comes out for anything over a 6 on the pain scale, or if the pain is low but sharper than usual. This gives me a sort of last line of defense against a full-body flare. I have tried using it all day at work and while it helped that day, the next it helped less and less until it wasn’t worth using anymore. It’s also not wise to use around water or while driving (can cause muscle twitches), so it’s not necessarily convenient for certain activities. Therefore, it’s best if I don’t use it more than once or twice a week; that way my body isn’t able to tune out the “static” on the line and send that pain through anyway.
Even though I can’t use my TENS constantly, I do use it regularly and it is one of my favorite pain control tools. It has minimal side effects, doesn’t conflict with any medication, and takes effect immediately. When I first started using it I couldn’t understand how anyone could sleep through that feeling, but now that I’m used to it I can turn it on and fall asleep pretty easily, especially when I’m tired from my pain keeping me awake. The one side effect I’ve noticed is that it can make me feel a little bit queasy, but I’m not convinced this is due to the TENS and not the other medications I’m usually taking around the same time.
TENS Therapy is supposed to be prescribed by a doctor in the United States. It is often even covered under medical insurance. While I didn’t need a prescription to purchase my machines, my doctors have approved its use–It’s never a good idea to leave your doctors out of the loop on what you are doing for pain management.
I hope this has piqued some interest in TENS therapy, as it’s a great tool. If I figure out any good uses for the Interferential or Microcurrent therapies on my new unit, or figure out how to make the electrode sock work well, I’ll post an update. If anyone reading knows anything about one of those three things, or any other TENS tricks or tips, I’d love to hear about your experiences, so leave a comment!
One more disclaimer: I am not a doctor and do not give medical advice; I am merely sharing my own personal experiences, which may or may not be similar to your own. Always ask your doctor before trying a new pain management method.