Originally Posted by Imahotep

The tens helps me to get distracted from the pain but it's a little like sending a bee to kill an elephant. I have been using it a little more recently though.

The biggest problem is that it worsens my tremor that keeps me awake. I can't use it more than about twenty minutes a day because of this.

Originally Posted by Mslday

Can you adjust the modulation on your unit? The TENS that I bought on my physiotherapists recommendation has different programs that I can change it to. On days when I'm really sensitive I switch it to a different program and turn it down.

Originally Posted by ali12

Hi Lorie,

I can't tell you how happy I am to hear that you are finally getting some much-needed pain relief and seeing some improvements - that is GREAT and you SO deserve it after everything you have been through!! I really hope that the improvements continue and that you are in remission very soon!!

I tried a TENS Machine before I was diagnosed with RSD and it didn't work at all for me. If anything, I think it probably made the spasms worse as my muscles just couldn't cope with the stimulation from the electrodes. I also noticed that I was having quite a bit more cramp after the treatment. The TENS didn't work at all for ME although everyone is different and it really is a matter of trial and error - as I am sure you know already, no two people are the same when dealing with this illness!!

Here is an article that my Physical Therapist gave me when I first tried the TENS machine that you might find useful - it tells you what to expect, how the TENS works etc:

Facts about TENS
Technically, it is low voltage and hence safe. It uses a biphasic alternating current so as to avoid tetany and to prevent the increase of ionic concentrations under the electrode surfaces). It can be used as “high” frequency (greater than 50 HZ) or “low” frequency (less than 10 Hz). It is typically battery operated for portability, compact and discreet for the user.

The author’s prescription for TENS:
CRPS pain and changes to that area of your body are like scrambled signals going to your brain. This has resulted in the brain putting that area on the highest alarm status. All signals coming from your area of pain are amplified as a result. Even normal signals are translated by the brain as painful. This has become a vicious cycle. The treatment is aimed at reversing this cycle.

5 Application of TENS to CRPS

Settings
High frequencies (200 Hz) and low intensity (50 to 100 us) have been shown to be the most beneficial for persistent pain conditions [16]. A low pulse width is used usually 75 us. A constant or modulation mode is better tolerated. Few enjoy the “burst” mode. In clinical practice, the constant mode is always used.

Duration
Research into duration of use is scanty. Our current thinking of 20 minutes once during therapy day may not be effective simply because it is not long enough. The longer duration of use is useful. This means using it for up to 8 hours a day.

When can’t TENS be used?
There are several situations where TENS cannot be used:
• TENS cannot be used on the site when the skin sensation is decreased due to sensory nerve damage, or when there is hyperalgesia or allodynia. However it can be used further up from that site to access the nerve or dorsal column.
• Patients who have a high tolerance for opioids and are taking large opioid doses for their pain cannot use TENS, as the opioid receptors in the brain may appear to be the same as the TENS sites.
• If the patient has a pace maker-check safety with the Cardiologist first.
• If someone has severely sensitive thin skin, prone to rashes it cannot be used.


What should the patient feel?
No muscle contraction should be felt. it is not the strength of the sensation that is important. It is simply that there is a pleasant sensation all the time. Remember, we are distracting the brain’s radar from the pain and closing the gate to the nociception. As the skin accommodates the current, the intensity can slowly be increased over the day. What is “started” with is not what will be “finished” with. The first sensation is typically felt around 11 ma and then still comfortable around 30 ma after eight hours.

I'm thinking about you and please keep us updated when you can!