TENS and HVPC


Define TENS


transcutaneous electrical nerve stimulation


Contraindications for TENS


Undiagnosed pain - unless recommended by medical practitionerHeart Disease - clear with cardiologistEpilepsyPregnancy - first trimester and over the uterusDo not apply over carotid sinus, on broken skin, internally


Common pulse waveforms used in TENS


Monophasic pulsedSymmetrical biphasic pulsedBalanced asymmetrical biphasic pulsedSpike like biphasic pulsed


Conventional TENS


Uses: more acute conditions, gating mechanismOptimal Elcetrode Sites: dermatomes, cutaneous intervation or peripheral nerve to areas of pain


Conventional TENS Settings


High Frequency Low intensityShort Duration20-60min treatmentTemporary relief


Acupuncture like TENS


Uses: more chronic conditions endorphine responseOptimal electrode sites: myotomes, superficial motor points, nerves, acupuncture and trigger points


Acupuncture like TENS settings


strong low frequency to be tolerancelow frequencylong durationpain relief takes 20-30 mins post treatment


Define Train/cycle burst


a modulation which combines high and low frequency modes


Burst TENS settings


intensity comfortable Rate highburst lowduration variableTreatment time 20-60minslong lasting pain relief


Define HVPC


HVPC is the application of monophasic direct current to the body with a known polarity under each set of electoresuses a twin peaked waveform or a train of two single pulses with a very short phase durationaverage current is low and low pulse charge results


HVPC for gait


intensity - sensoryfrequency - highlow pulse durationcontinuous modeelectrodes over painful site


HVPC for opiate


motor intensitylow frequencylong durationcontinuous modeelectrode placement over painful site