Electrical Stimulation
Electricity-based therapies have been used to treat disease and injury for more than 2,000 years. The first reported use of electric therapies was found in Eygpt where electric catfish were used to treat many ailments, including epilepsy, arthritis, and acute pain. However, electrical stimulation therapy did not gain popularity until the 18th century when German physician Altus Kratzstein began publishing papers on the subject. Pharmaceutical interventions have taken priority for the past century or two, but a desire to avoid dependence and addiction to medications has renewed interest in drug-free treatments. As an increasingly prevalent method of pain management, electricity-based therapy provides an alternative, modern, and fast-acting treatment strategy for most patients.
TENS Units
Transcutaneous electrical nerve stimulation (TENS) therapy is a rapidly growing form of non-pharmaceutical pain management for both acute and chronic pain. It is the most popular and well-known form of electrical stimulation therapy. TENS involves using an electrode to send electrical signals through the skin to the muscle’s nerve fibers. The applied electricity will block nerves from sending pain signals to the brain. Further, TENS therapy promotes the release of endogenous opioids that naturally block pain. Once a prescription-required pain management therapy, many over-the-counter (OTC) TENS units exist today for alleviating various areas and types of pain. Combinations of TENS therapy and pain medication have also shown to be effective in reducing a patient’s need for pain medication. TENS is a non-invasive and increasingly thrifty pain management technique that any RLS patient could add to their routine.
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High-Frequency TENS
High-frequency TENS (HF-TENS; a.k.a. conventional TENS and/or sensory TENS) uses low intensity, small pulse width, and high-frequency alternating current to relieve pain. HF-TENS is the most common form of TENS therapy, recommended for acute (intermittent) pain. HF-TENS works to block large-diameter nociceptors (pain neurons) in the leg from transmitting pain signals to the brain while simultaneously promoting the release of natural opioids fro the body. Patients using HF-TENS should feel comfortable paraesthesia (tingling sensations) with 1) no pain/discomfort or 2) muscle contractions.
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Low-Frequency TENS
Low-frequency TENS (LF-TENS; a.k.a. acupuncture-like TENS and/or motor TENS) uses higher intensity, longer pulse width, and low-frequency alternating current to more deeply relieve pain. LF-TENS works through the same mechanisms as HF-TENS plus the additional recruitment of mu-opioid receptors. It is characterized by the perception of strong muscle contractions that the patient perceives as muscle twitching. Though more aggressive than conventional HF-TENS, LF-TENS provides longer-lasting pain relief to patients and is recommended for treating subacute and chronic pain. LF-TENS represents a great pain-relief opportunity for RLS patients to add to their daily or nightly regimen if they are willing to stand the slight discomfort accompanying LF-TENS treatment.
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Electrical Stimulation Options for
AT-HOME TREATMENT
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TENS UNITS
TENS units have exploded in popularity since the first patented TENS unit appeared in 1974. More importantly, their cost has decreased significantly to the point that most TENS units can be purchased without insurance. Below, we have highlighted some of our favorite OTC TENS units for at-home use.
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High Cost: PowerDot Muscle Stimulator
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The PowerDot is likely the most modern and sleek TENS unit currently available on the market. The PowerDot is an FDA-cleared Smart Muscle Stimulator that connects to your phone via Bluetooth. Alongside programs for muscle recovery, performance training, and injury rehab, the PowerDot is made to handle all TENS applications for alleviating pain (both HF- and LF-TENS). Users create a specialized program within the app for treating their pain. Simply select the area in pain, confirm the type of pain (chronic, acute, injury-related, etc), and set your pain score or tolerance. The company's algorithm will then create a pain program just for you. You are then able to track your individual pain score per body part over time to see if progress is being made through treatment. If you are able to pay the higher cost for this product, it is well worth it.
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PowerDot Uno $199
PowerDot Duo $349
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Uno
Duo
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Mid Cost: Omron Heat Pain Pro TENS unit
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Omron Heat Pain Pro TENS unit contains three massage modes that ensure an appropriate remedy for pain, while the six pain modes let you attend to a specific body part. The device is very portable with good battery life. The device has 20 adjustable levels of power intensity to help relieve pain; however, some users have wished the device's TENS power was stronger. The pads/electrodes can heat up to 110°F and can be used up to 30 times before replacing them. The main advantage of this product is the combination of both heat and TENS. This is uncommon for most TENS units on the market and makes the device more effective and unique than most. Moreover, the Omron brand has many trusted variations of TENS units for patients who may be looking for a different look or features in their Omron TENS unit.
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Omron Heat Pain Pro TENS Unit $89.99
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