Pain really gets in the way. It can cause one to stop moving quite so much, to avoid going out and participating in normal activities of daily living; it can trigger emotional reactions and contribute to feelings of depression and hopelessness; and it can make one angry and irritable. In other words, pain can significantly reduce one’s quality of life.
People with Spina Bifida often experience pain. Caregivers of people with Spina Bifida may also complain of back pain as a result of having to assist in transfers. According to various studies, well over 50 percent of adults and children with Spina Bifida experience pain once per week or more often. They may experience pain in the muscles of their back or other muscle groups of the arms or the legs.
Some of the pain is neuropathic in nature, which means that the pain is coming from the nervous system. There are also many musculoskeletal causes for pain, such as problems in the joints because of wear and tear, tension in the muscles, and many more. Read here for a good educational paper on pain experienced by people with Spina Bifida.
As if it wasn’t enough that pain has such a negative impact on one’s quality of life, it is also often underappreciated by the people around us. People may sometimes think and act as if the person in pain is exaggerating a bit, complaining in order to get attention.
The bottom line: people with Spina Bifida are often in pain, the pain is very real and it can put a serious crimp in their life style.
There are many ways to manage pain. For some people with Spina Bifida it is especially important to find a way to deal with pain that is non-invasive and doesn’t come with all kinds of complications and side effects. People with Spina Bifida need an effective method that is easy to use, can be used every day if needed, is not expensive and comes with little or no side effects. Transcutaneous Electrical Nerve Stimulation or TENS is one potential method for pain management.
Transcutaneous Electrical Nerve Stimulation
TENS is a simple application. A battery operated device delivers a small current to electrodes that are attached the skin, usually around the area of pain over a muscle. When the current is strong enough, the person may feel a tingling, buzzing or sometimes a throbbing sensation. The sensation can be pleasant to some people. Most importantly, it can have an immediate effect on the pain and may feel less obvious.
History of TENS development
Electrical stimulation to manage pain is not a new idea. As long as 2,000 years ago the Romans are reported to have relieved their pain by standing on electrical eels at the seashore. The modern use of TENS devices started in the 70’s when surgeons wanting to implant stimulators in the spinal cord to manage pain would first test their efficacy on patients by delivering stimulation to the skin. This worked so well that many patients opted to stick with the non-invasive option rather than to have to go through surgery.
The method is still as effective as it always was and many different types of devices are now available either by prescription or directly over the counter.
How does TENS work?
Electrodes connected to a stimulator are first attached to the skin and the stimulator is turned on. The intensity is increased until the person wearing the device can feel a comfortable tingling or buzzing sensation. At this point the sensory nerves of the skin under the electrodes are being stimulated and are sending the information to the spinal cord. The pain signals arriving in that same spinal cord segment are now being ‘crowded out’ by the sensory signals. As a result, the person wearing the TENS unit will become less aware of the pain. This is called the Gate Control effect – the stimulation closes the gate in the spinal cord and the pain signals can’t get through.
An even more powerful effect occurs when the intensity is turned up higher to the point where it feels very strong, almost painful. The brain reacts to these strong stimuli by releasing morphine-like chemicals – also referred to as Endorphins – into the bloodstream. Once they have accumulated at a high enough concentration, the pain becomes much less severe. You have essentially just self-medicated without taking a single pill!
Also see this blog post for more information on this topic.
Are there side effects to using TENS?
Some people may complain of some skin irritation as a result of applying the self-adhesive electrodes but that is very infrequent. People with Spina Bifida should make sure that they choose non-latex adhesive pads if they are allergic to latex. Others may not be able to use TENS because of some specific conditions, such as the presence of a pacemaker or other implanted electrical device, or the presence of a tumor in the area. Unless directed by a doctor or physical therapist, TENS should not be used in areas where there is no sensation since any problems with the skin may not be felt. Some people also may have areas on their body where TENS may feel uncomfortable.
What are the benefits of using TENS?
Compared to other methods of managing pain, TENS may have some advantages:
- It can work predictably well
- It is cheap
- It is very easy to use
- It can be used multiple hours per day
- There are minimal side effects
- It can decrease the need to take pain medication
Modern TENS devices
There are many TENS devices on the market today. Most are battery powered, they are fairly small, they have a couple of controls on the box to adjust settings, and they clip on the belt or are worn in the pocket. Lead wires connect the device to surface electrodes, which are stuck on the skin.
There are also more modern devices that are truly wireless, that are integrated with the electrodes, and that even collect information about how often it is used and how high it is turned up.
Which TENS device should you try?
People with Spina Bifida or those caring for someone with Spina Bifida who have a need to manage pain should consult their doctor or physical therapist to see if it is worth giving TENS a try. Some require a prescription, but some TENS devices can readily be obtained over the counter for under $50.
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Disclaimer: This blog is for educational purposes only. Any products or services mentioned in this article are not endorsed by the Spina Bifida Association (SBA). For product questions or concerns, please contact Hollywog directly.