TENS, or Transcutaneous Electrical Nerve Stimulation, is a popular method of pain relief that uses electrical impulses to stimulate the nerves in the target area. It is widely used in healthcare due to its affordability, safety, and ability to be self-administered. However, there are certain contraindications for TENS, such as pregnancy, epilepsy, and pacemakers. Though there have been no clinical trials to prove that TENS does not have an adverse effect on epilepsy, physicians should be cautious when administering it to patients with this condition.
It is not recommended to apply electrodes to the neck or head. Additionally, TENS-induced seizures have been reported in a patient who has suffered a stroke, so it should be used with care in these cases. Pacemakers and seizures involve electrical impulses, one from the machine and the other from the brain. TENS units can interfere with these electrical impulses and cause problems.
Furthermore, TENS can cause uterine contractions and premature birth in women in the early stages of pregnancy. Two good-quality randomized trials revealed that women preferred active TENS compared to simulated TENS under double-blind conditions. Initially, TENS was used to predict the success of dorsal spine stimulation implants until it was discovered that it could be used as a successful modality on its own. Evidence from animal studies shows that TENS reduces continuous nociceptive cell activity and sensitization in the central nervous system when applied to somatic receptive fields.
Scherder et al. (IQQ) reported an increase in the frequency of seizures when TENS was used to improve memory and behavior in a child with severe psychomotor disorder and epilepsy. In the United Kingdom, “standard” TENS devices can be purchased without a prescription for approximately 30 pounds sterling. It is recommended not to apply TENS directly to areas of active malignancy, except in palliative care and under the supervision of a specialist.
Negative findings in randomized controlled trials (RCTs) were attributed to inadequate sample sizes, inadequate TENS technique, underdosing of TENS, measurement of results after discontinuing TENS, and the use of pain as a result when participants in the simulated and active TENS groups had access to additional painkillers. The researchers say that the lack of randomized trials on TENS compared to conventional therapy makes it difficult to evaluate its effectiveness and that more studies are needed. First, conventional TENS is administered because it is commonly used by patients with long-term TENS. It's always best to consult your doctor before using TENS, even if you think you are in perfect physical health.
TENS should not be applied to skin with reduced sensitivity as nerve damage is likely to decrease its effectiveness and the patient may not know that high-intensity currents are causing skin irritation. Pain relief is maximum when experiencing strong and painless TENS paresthesias below the electrodes, so patients may need to administer it throughout the day. Your doctor should be able to tell you about the relative risks of using TENS or other medications to relieve pain in your particular circumstances. Ultimately, it is important for people with epilepsy to consult their doctor before using this method of pain relief.