ENVIRONMENTS OF USE

• Physiotherapy Clinics
• Acupunture Clinics
• Home and Mobile

As stated earlier, there are three major environments where TENS is commonly used. These environments include physiotherapy and acupuncture clinics and other areas of the medical community, and by the general public for personal use in the home or whilst mobile.

Physiotherapy Clinics
Physiotherapists are mainly attuned to correcting musculo-skeletal, neurological ailments and the electrical management of acute pain (with devices such as large clinical TENS machines and interferentials, etc.).

People do not generally associate a physiotherapist as a specialist to manage or cure their chronic pain, as physiotherapists have not universally adopted the provision of pain management treatment. This is however, well within the realms of their ability.

For the patient to economically afford this treatment it may be necessary for them to rent or purchase mobile TENS equipment, for the treatment to be extended as they go about their business or while resting at home.

For physiotherapists to extend their scope to treat chronic pain, they need to have the necessary multi-channel equipment, and the time and space to apply multiple region stimulation over extended periods of up to 1 hour.

Lumbar and Cervical Nerve Plexus
Stimulation applied to nerve plexus (gathering of nerves) is a frequently used method of application, which I strongly advocate for use in the home and whilst ambulatory. I have named it 'Nerve Plexus Stimulation'.

I consider it more effective to stimulate the nerves coming from the region of pain, where they gather together at their plexus, just before they enter the spinal cord. Nerve plexus stimulation is a very efficient position to apply therapy. Depending upon the pulse rate, pulse mode and the length of time of the application, either a gating effect, an endorphin release, or a combined gating/endorphin effect may be achieved.

These are the applications that I recommend to most of my patients at the "TENS Pain Management Centre" in Victoria, Australia:-

For pain in a limb, place one electrode on the wrist, ankle, or region of pain and the other on the same limb's neural plexus, just before the nerves enter the spinal cord. Alternatively, try placing the electrodes on the neural plexus on both sides of the body, just before the nerves enter the spinal cord. This is the easiest method to apply and is therapeutically effective, as not only is the affected side of the body being stimulated, but a second region (the other side of the body) is also being stimulated.

The Cervical plexus on both sides are best stimulated with electrodes placed on either side of the base of the neck.

The Lumbar-Sacral plexus on both sides are best stimulated with electrodes placed over both sacro-illiac joints. With a BioStim™ Analgesic+2 or a Kinetic+4 System* the plexus from the four limbs may be simultaneously stimulated, to effect multiple regions of stimulation.

*BioStim™ equipment is specifically mentioned as I have personally designed and manufactured the BioStim™ devices in conjunction with my clinical experience. This equipment has optimized outputs to apply the therapy applications presented in this paper.

Electro-zone therapy may be conveniently applied the whole time a patient is receiving other necessary physical therapy. Electro-zone therapy may be also used in conjunction with medical and pharmaceutical treatments.

Electro-Zone Therapy Applications
Electro-zone therapy is best applied using multi-channel TENS systems, with stimulation applied to the palms of the hands, soles of the feet and the facial and throat regions. These applications are achieved with the use of electrodes from wrist-to-wrist, or ankle-to-ankle, and with earlobe electrodes for ear-to-ear stimulation.

Additionally, wrist and ankle bands with electrodes built into them could be used, for an easier method to apply and a more effective result.

For an ailment or pain in the upper body or arms, use one channel to locally stimulate the condition, and another to apply electro-zone therapy using the wrist-to-wrist technique. If long rubber electrodes are used, they may need to be held in position using tennis wrist sweatbands.

For an ailment or pain in the lower back, pelvic region or legs, use one channel to locally stimulate the condition, and another to apply electro-zone therapy using the ankle-to-ankle technique. Again, tennis wrist sweatbands can be used to hold any rubber electrodes in position.

With the use of a stimulator such as the BioStim™ Analgesic+2 or Kinetic+4, both individuals and healthcare professionals can use multiple channel stimulation, and electro-zone therapy. Unlike many other TENS systems, the BioStim™ Analgesic+2 has two channels and four equally active electrodes, whilst the Kinetic+4 has four channels and eight equally active electrodes, for a comfortable and balanced stimulus. Many other TENS systems do not have two active electrodes to each channel, and give an unbalanced stimulus, which is not suitable for electro-zone therapy.

Muscle Twitching TENS
With the use of larger than normal size electrodes it is within the therapists ability to combine muscle twitching acupuncture type stimulation, whilst using electro-zone therapy, regions of pain and multiple region stimulation.

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Pain Management
Home and mobile pain management applications of physiotherapy and acupuncture-type treatments (without the use of needles) can now be self-applied using BioStim™ equipment, because of the high therapeutic efficacy available from small, compact, multiple function equipment.

Relief from chronic pain is achieved by using home and mobile applications of intensive measured daily or sustained doses, applied to painful regions, nerve plexus, or electro-zone therapy positions.

The predominant factor that enables highly effective home and mobile applications of TENS is that intensive doses achieve a much more effective result than that obtained using short duration clinical applications. With a personal use TENS on hand, sustained, repeated or continuous doses can be applied "Upon-Demand" at any time of the day or night.

Upon-demand treatment is a fairly new concept, which can improve the quality of life of many chronic pain sufferers.