Book on Tens Electrode Placement

Dear Mr.Bob Johnson,

I am a pain nurse from the Netherlands and i saw your video’s from MedFaxxinc. And the only thing I can say is that they are very helpful for me. This because I just started with TENS-treatment after I followed a course.
I show the patient the movies on the internet if they want to see or hear more about TENS, and the only thing I can say is that the patients are very glad to see your video’s on your webpage.

But I have also another question: do you have a book were you put all the treatments in and also the positions of the electrodes? If so, can you give me the title and the place where I can buy it?

With regards,

T. S.
The Netherlands

 

Hi T,

 

Thanks for the very nice comments.   So kind of you.

 

The answer to your question is “No don’t have a book”, but let me expand on that.

 

There really is no such thing as a “correct” electrode placement guide.  There is such a thing as an incorrect electrode placement guide such as:

 

1.  Do not put electrodes on bony prominences ( logic- bone is not conductor of electricity, but resistor, so little gained if bone close to surface and little moist tissue between electrode and bone)

 

2.  Do not use small electrodes for large pain areas ( current concentration hurts before relief gained)

 

3.  Do not put tens machines electrodes on head ( refer to 1 above)

 

Here is what is logical though and this varies from Rx to Rx and patient to patient and time of day to time  of day which is why can’t generalize:

 

1.  For tens basically want flow of current through area pain being felt ( logic:  pain moves and after treatment then another area may now hurt enough to warrant electrode change so change to target area ( use rifle scope analogy of zeroing in on pain with criss cross ( that’s your electrodes and the flow of current)

 

2.  What type machine using?  Tens, Hi volt, Russian, Interferential etc. as the current density of those machines changes electrode placement.  ( For Russian/Katz at 2,500 pps you need electrodes placed longitudally (sp) to go with muscle endplates, not transversally)

 

3.  Unlike acupuncture where one interferes with electrical flow using small pins in specific areas with an electode you are proactive and dispersing electricity  over a general area, not a specific area so need for specificity not as great.   Also acupuncture points, even though specific are specific to each person’s body vis a bis “cun” which is a standard measurement but standard only to the patient’s body, not anyone else.

 

Giving you some of a “non answer” but there are lots of charts, books etc. but they actually prevent you or your patients from learning what is really going on rather than asking for a “cook book” of pictures on electrode placement.

 

Hope this makes some sense and if not please let me know.

 

Thanks.

 

Bobj

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Reader Comments

Dear Mr.Bob Johnson,
I am a post graduate student of oral medicine from India.I saw your videos’ from MedFaxxinc.They helped me understand many things. I am conducting a study “TENS therapy in chronic orofacial pain”.

My question is, where should we place the electrodes in temporomandibular joint pain, trigeminal neuralgia, post herpetic neuralgia, and migraine. I also want to know, which modes and types of TENS are recommended in each.

With Regards,
Dr. Monali Prajapati

#1 
Written By Dr Monali Prajapati on April 25th, 2015 @ 6:20 pm

Hi Dr. Prajapati,

Generally the placement is where the patient is experiencing pain to go to outer regions of the pain sensation and turn the machine on “constant” with the “width” minimum setting. Turn power to patient feels “topical sensation” and once that sensitivity is felt then adjust the width from the lowest setting up. The patient will then feel the sensation “going deeper and farther” spreading into the areas where pain is felt. That is the goal, to stop the pain, however not necessarily to “feel the tens”. If you are performing say a tooth extraction then let patient hold tens, and adjust amplitude as procedure is ongoing and patients adjusts based on pain experienced during procedure. Hope this helps some.

bobj

#2 
Written By painguru on April 25th, 2015 @ 7:04 pm
This post was written by painguru on February 2, 2012
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