TENS

What is TENS?

TENS stands for transcutaneous electrical nerve stimulation: a unit that sends weak pulses of current through pads on the skin to dampen pain. It is not a brand but a class of device from pain relief. In the playroom the same unit is used to stimulate rather than to dampen.

What a TENS unit does according to the research

Dampen pain, measured in an unusual amount of research. Mark Johnson and colleagues brought together 381 randomized studies with 24,532 participants in BMJ Open and found moderate-certainty evidence that pain during or just after TENS is lower than with a sham treatment.

For this site their second finding is the most interesting. Adverse events with TENS were mild and rare, skin irritation, sensitivity, discomfort from the stimulation, and there was not a single serious event directly attributable to TENS. In the eighteen studies that reported numbers on it, the chance of an adverse event was no greater than with the comparison treatment. The authors note honestly that these events were poorly reported.

Where a TENS unit is not allowed

Not “above the belt”, but on a list of places that is written out.

The clinical description in StatPearls is precise about it. Electrodes do not belong on the front of the neck or the carotid artery, not straight across the chest, not over the eyes, not through the skull, and not internally unless the device is specially made for it. With an implanted electronic device, pacemaker, ICD, neurostimulator, TENS must be avoided, and that source explicitly names the chest, the trunk, an arm, and the vicinity of the device’s leads.

That last point puts the scene rule of thumb in its place. An arm is on that list not because it sits high, but because current from one arm to the other runs straight across the chest. “Never above the belt” is a crude summary of one real rule: no current may run through your heart.

Where this fits on this site

Current is part of what I do, and the unit I use comes from the same corner as the device above. Where the pads go and where they do not is one of the things we go over beforehand. Together with what you tell me about medical matters. How such an evening is prepared is on the page about the BDSM date.

Sources

• Efficacy and safety of transcutaneous electrical nerve stimulation (TENS) for acute and chronic pain in adults: a systematic review and meta-analysis of 381 studies (the meta-TENS study). Mark I. Johnson, Carole A. Paley, Gareth Jones, Matthew R. Mulvey & Priscilla G. Wittkopf, BMJ Open 12(2), e051073, 10 February 2022 (DOI 10.1136/bmjopen-2021-051073; PMID 35144946; open access under CC BY-NC, full text read). Systematic review and meta-analysis of 381 randomized studies with 24,532 participants. Provides moderate-certainty evidence that pain intensity during or just after TENS is lower than with placebo and “without serious adverse events”; that adverse events with TENS were mild and rare and consisted of skin irritation, sensitivity, and discomfort; that not a single serious adverse event was directly attributable to TENS; and that in eighteen studies with 1,587 participants there was no significant difference in risk between TENS and the comparison treatment. The authors themselves report that adverse events are poorly reported in this literature.
• Transcutaneous Electrical Nerve Stimulation (TENS). StatPearls, NCBI Bookshelf. From this source only the contraindication part is taken here, because /en/term/e-stim already draws the dosing and the internal use from it. Provides that electrodes do not belong on the front of the neck or the carotid artery, not straight across the chest, not over the eyes, not transcranially, not internally unless the device is designed for it, and not near patches that release medication; that stimulation over the carotid artery can change heart rate or blood pressure; and that TENS should generally be avoided with a pacemaker, ICD, neurostimulator, or other implanted electronic device, in particular when the stimulation would reach the chest, the trunk, an arm, or close to that device’s leads.

Related terms

A TENS unit is one of the devices under e-stim, the page where all three units stand side by side.

• E-stim. The umbrella term for the gear, with what exists in pads, plugs, and rings.
• Elektroplay. The practice itself under its Dutch name, with the contraindications from the Dutch pain clinic.
• Electro play. The same practice under its English name, with the research literature behind it.
• Neon wand. The other unit, which works with high voltage and barely any current instead of the other way around.
• Edgeplay. The frame this falls into: a risk you reduce and do not remove.