TENS

[Griff522]

I was prescribed a TENs unit back In June. My PT at the time showed me where to put the electrodes and I have been using it sporadically for the last 5 months. My electrodes were wearing out so I called the company today to order some more. So the representative asks me where I'm putting the electrodes and I tell her my lower spine. She informed me that you are not supposed to put them on your spine because there are too many nerves there. So just like every other medical experience I've had regarding this condition, I have been given wrong information -- AGAIN!

Is there anyone that has a TENS unit that would like to share with me where they put their electrodes? My appt with Dr Conway isn't until January so I feel kind of weird calling him and I really don't want to call the PT that told me to put the electrodes on the spine. I guess I could ask my pain dr at my appt tomorrow but I don't know that he would even know!

[calluna]

I use my TENS unit regularly. I got it from the Pain Clinic that I attend, and the nurse consultant there showed me how to use it and where to place the electrodes.

I do not put the electrodes on the spine. I put them either side of the spine with about three or four inches clear between them, towards the top of the sacral plate. The idea is to put the electrodes either side of where they join the spine - which with the pudendal nerve is S1 and S2.

By the way, I get my replacement electrodes from Amazon, for me it is much much cheaper than getting them from the company.

[nyt]

I have had a TENS unit for about 1.5 years and use it 5-6 times a day for 20-30 minutes. Mine was ordered by my chiropractor and I was taught not to place it on the spine but adjust to it. Because I use mine so much I have to change my electrodes every 2 days. I can tell when the electrodes are nearing the end of their life as the sensation is more of an electrical shock than a tingling sensation that is quite pleasant. The electrodes usually have silver chloride in them and they will wear out with use. Thank goodness my insurance covers my electrodes mine are quite expensive. I use mine for my piriformis syndrome and it has been a God sent for that.

[missyrg]

I have a unit for about 2 months and I cannot get it to recharge. What could be wrong with it? Missyrg

[calluna]

TENS machines vary a lot and there are a lot of things which could cause this. First try it on another power outlet. Then check the fuse in the plug, if it is not a sealed unit. Then check the troubleshooting section of the instruction leaflet, if there is one, and if that doesn't help then you need to contact the manufacturer, I'd suggest.

[HerMajesty]

I just got one of these last week and opened the box for the 1st time today. So I am wondering if those who use TENS can clarify: Is everyone using the electrodes on either side of the S1 - S2 area as calluna does, or does placement vary in those who have used is successfully?
Griff, has your response to the TENS improved since you started it in the areas suggested? My Pain Clinic PA was at least not dishonest enough to pretend he knew where to put them: he said he had no idea for pudendal so just play around. The package says to kind of surround the painful area, and my most objectionable symptoms are anal. I also know my piriformis is locked up and that is a big issue...so right now on my 1st session of playing around, the 4 electrodes are placed like this: One on the insertion point of the piriformis (mid-butt) on both sides, and one on each side down as close to the gluteal crease as I can get without getting nasty.
Is this just stupidity on my part? Should I just stick them up on either side of the sacrum and be done with it?
Also, do those of you that use TENS only get relief while using it, or do you for example use it in the a.m. for a period of time and then have some relief throughout the day?
As you can tell I have NO idea what I am doing; I was basically just handed the machine and told to trial it for a month and by that time I would know if my insurance would pay for it or not. If not, I could return it or pay for it based on how well it works. So far sitting here with this thing on, all I can sat is, there is something to be said for being distracted by strange sensations. Please anyone who uses this, give me the "TENS For Dummies" overview

[nyt]

I use my TENS unit for my piriformis syndrome, I have not found any placement of the electrodes that help my pudendal. I do vary my placement some just so I don't get rashes because I use my TENS unit alot. My machine is a dual channel meaning it has one wire that divides for 2 pads. My machine has 2 wires for a total of 4 pads.

1. I place one electrode on the great trochanter of the femur and the matching electrode next to the sacrum.

2. I place one electrode next to the sacrum and the matching electrode about 1-2 inches above on the lower back.

3. One electrode very low on the back (high on the butt) and the matching electrode on the opposite side a couple of inches above on the lower back. This will form a "X" when all electrodes are placed.

My rate is 125 pps (pulse per second), cycle is 1 sec, and span is 60%. I use my TENS unit at lest 4 times a day for 20 minutes at each session. This is really bare minimum as I use mine alot. If I drive, need to try and sit for anything, am on my feet like cooking, having a bad night where my butt just aches, or when the husband is sleeping and isn't rubbing my butt , I turn on the TENS unit. I put on the electrodes after I shower in the morning and just leave them on otherwise they loose their stickiness if I keep taking them on and off. My electrodes are disposable and I get about 2 days use out of them before I need new ones. I have not asked the company what type of wire they use in the electrode but I would imagine it is silver chloride and with use electrons are given off so with time the wire would need to be recoated for continued use. Thankfully my insurance pays for my electrodes as they are about $26.00 for 4 pads. It has been a life safer for my piriformis syndrome and if at some point my insurance no longer pays for them I will need to figure out where the money will come from because I can't live without my TENS unit.

You may need to play around with the settings to find what works best for you. My machine has preprogrammed settings that I can adjust if I need to. One disadvantage is the wires get in the way when you have to go to the bathroom. I have peed on a wire . I clip the machine to my sweat pants but sometimes it falls off my pants when I pull my pants down. I have gone through 3 machines in the last 1.5 years because the connections where the wires plug into the machine get loose.

The manufacturer of my machine is Empi and they are currently beta testing a wireless machine. I told my rep I want one of those when they are available. I get called once a month from my rep at Empi to see what I need for supplies and once a year they send a request to the dr. to justify continued use. My machine keeps track of my use and the settings so if the dr. ever needed to download my usage to justify me having the machine they could verify usage and determine that my husband is slacking on the butt rubbing .

Hope this helps. You can PM me if you want more details.

[HerMajesty]

Thanks nyt,

I'll stay public instead of PM if that is OK in case it helps somebody else. I have an Empi with the 4 pads / 2 channels too, but I think either ours are different or else I just don't understand the thing too well. You mentioned

125 pps (pulse per second), cycle is 1 sec, and span is 60%

But mine has a display for each channel that starts at zero and goes up when you press the "up" arrow, in increments of .5...so for example you could keep pressing til your number was 20.5 or whatever. No units are given so I don't know 20.5 of what (??) The way it cycles is you either choose a pre-set (choices are knee, shoulder, low back / hip, hand/wrist, or back); or can put it in a mode of "continuous", "burst", "modulation", or "SMP", whatever that is.

So far I have found that I like it on "continuous" as far as comfort of wearing, and was comfortable wearing it up to number "50" whatever that signifies...but then after I placed it on either side of the sacrum and used it on "50" for awhile, I started to get heart palpitations which I am still having now even though I turned it off. Palpitations (PVC's, for you medical people) don't really worry me, because I used to get them regularly when I first developed mild mitral regurgitation in 2007, but then they gradually stopped as my body adapted to the change in the heart. I have not had them for at least a year til now. So maybe I should not be turning the thing up to the maximum tolerable level?

On the level you use it, is the sensation very mild?

Is there any way you can correlate the numbers you gave me, with what I am describing on my display, or is your Empi just too drastically different from mine?

So far I don't know if it works because I am always a delayed reaction type of girl. I know something works if I have a good day the next day, or that it was a bad thing if I flare the next day. But if you have any further advice for me based on what I described I would much appreciate it. I would love to figure this thing out and get enough benefit from it to cut my meds.
Thanks!!!!

[nyt]

I believe they are the same machine.

I use the low back/hip presetting. After you hit that button you will see in the middle bottom portion of the display the matching symbol for the low back/hip. Then hit the "set" button once. The display will now show 125 pps, you can decrease or increase the number of pulses/second that it delivers within a certain range. Hit the "set" button a second time and you will see 1 sec, as above you can change this number with the up or down arrow keys. Hit the "set" button a third time and you get 60% you can increase or decrease the duration of intensity you feel in the 1 sec rate. Hit the "set" button a fourth time and you can put in the time, in minutes that you want the machine to run for, use the channel 2 to increase or decrease the time and it will automatically turn off. Now hit the mode button and you will see zero's. Using the arrow buttons you now can turn up or down the intensity of the impulse you feel in 0.5 increments. After about 1 minute the intensity is locked in and you will see on the display under channel 2 a symbol of a lock. That means unless you hit the down arrow key on the channel 2 you can't change the intensity of the impulse you feel.

The mode key takes you to the other predetermined settings like continuous that you use.

The manual is very helpful and if you have a chance you might want to read it.

The sensation should be a mild tingling sensation. You will get more of an electrical shock sensation when the pads are wearing out. If the sensation is not a pleasant tingling sensation move the pads until you fnd a location that it feels good. There should be no muscle contractions if there are, turn down the intensity setting using the arrow keys in 0.5 increment.

I use anywhere from a 3.5 - 12.0 setting. The intensity setting increases the further apart the electrodes are. If you look closely at the display there is a decimal point. I think you're 50 is actually 5.0. I don't think the machine goes up to a 50.

[calluna]

A bit more information about my TENS experience, in case it is of help to anyone.

I should perhaps have said that the nurse consultant told me about the sacral plate placement and said this would probably be the best siting for the electrodes - she actually put the pads on for me,when I collected the machine - but she said that I could also play around with it, placing the electrodes near the pain site. I did try placing them in various different sites 'underneath', but nothing seemed to be very satisfactory at all, if it helped one specific area then it was leaving out another area. My machine does have two channels, so I could use four pads if I wanted to. I tried all sorts, but with such a large area of pain it definitely ended up that (for me) the best result was from placing two pads around where the nerve entered the spine, as the nurse had said it would probably be.

My machine is from Nidd Valley Medical, and it is called Pro Tens II, you can see more info about it here on the manufacturer's website. The electrodes that I use are on that page as well - lower right) - they last me about four weeks with daily use.

My usual setting: width 200 milliseconds; frequency 100 Hz. I use one channel.

The different modes :
Burst - I limit my use of the 'Burst' setting, no more than 30 minutes at a time, and no more than two or three sessions a day at the most - this is to avoid tolerance building up, which can happen if you use it too much. As this setting is very good for pain relief, I want to keep that so I am careful not to overuse it.
Continuous - This mode can be left on all day.
Modulated. This mode is useful for muscle spasms, I do use this occasionally.

Intensity - I set the intensity to what feels right at the time, it is like a 'volume control' really. It should feel like a comfortable tingling, it should not be uncomfortable in any way at all.

If the tingling starts to become a little sharp and uncomfortable, like small electric shocks, this is because the gel on the electrode surface has lost some of its conductivity because it has got a bit dry. Best way to deal with it - turn the TENS off first! - take the electrodes off the skin and very gently rub a couple of drops of water over the gel surface, not too much, you only need literally a couple of drops of water - this will rehydrate the gel and will make it feel comfortable again. Then reapply, and off you go again. Another thing that some people do to lengthen electrode life is to use a little bit of conducting gel rubbed over the electrode gel surface, I've not tried that.


HerMajesty - With regard to heart palpitations, there is usually something in the small print of the instructions that says if you have ANY heart rhythm anomalies then you should NOT use a TENS machine. So if you've got something amiss with your heart rhythm then I'd really recommend that you discuss with your doctor whether using TENS is sensible or not.