A Transcutaneous Electrical Nerve Stimulation (TENS) machine offers a non-invasive approach to managing incontinence by delivering low-voltage electrical currents to stimulate nerves or muscles. This article provides practical guidance on using a TENS machine for incontinence.
Understanding TENS and Incontinence
TENS therapy involves a small, battery-powered device that sends gentle electrical impulses through electrodes placed on the skin. While originally used for pain relief, TENS machines are increasingly recognized for addressing urinary incontinence by targeting nerve pathways that influence bladder function.
For incontinence, TENS stimulates either the pelvic floor muscles or nerves that control the bladder, such as the sacral or posterior tibial nerves. These electrical impulses can help calm an overactive bladder, reducing urgency and frequency. TENS can also strengthen weakened pelvic floor muscles, similar to Kegel exercises. This therapy is often considered for urge, stress, and mixed incontinence.
Step-by-Step Application Guide
Begin by ensuring your skin is clean, dry, and free from oils, lotions, or cosmetics where electrodes will be placed. This maintains optimal adhesion and conductivity. Inspect the TENS machine and its leads for damage; ensure the device is charged or has fresh batteries.
Electrode placement varies based on the type of incontinence and targeted nerves. For sacral nerves, electrodes are typically placed on either side of the spine in the lower back, at the sacrum level. Ensure pads are at least two inches apart to prevent signal overlap.
For urge incontinence, another common placement involves the posterior tibial nerve on the inside of the ankle: one electrode near the medial malleolus (ankle bone) and the other approximately 10 cm above it. Some methods also suggest placing one electrode between the genitals and rectum, and the second at the base of the spine near the sacrum.
Once electrodes are securely placed, connect them to the device and turn it on. Common settings for pelvic floor stimulation involve a frequency between 10 to 50 Hz and a pulse width of around 200 µs. Lower frequencies (e.g., 10 Hz) can relax overactive bladder muscles, while higher frequencies (e.g., 50 Hz) aid in muscle contraction for strengthening. Start with a low intensity and gradually increase it until you feel a strong but comfortable tingling or lifting sensation in the targeted area. The sensation should not be painful.
Typical session durations range from 20 to 30 minutes. For optimal results, TENS therapy may be used daily or several times a week, often for 2 to 12 weeks depending on incontinence type. After each session, turn off the device, carefully remove the electrodes, and clean the skin with mild soap and water if needed.
Important Considerations for Use
Certain conditions are contraindications for TENS therapy, including pregnancy, having a cardiac pacemaker or implantable defibrillator, or epilepsy. Individuals with skin conditions, open wounds, or impaired sensation in the application area should also avoid TENS on those sites. Always consult a healthcare professional before beginning TENS therapy to ensure it is appropriate for your specific health situation.
If the sensation is uncomfortable or the device does not seem to be working, check that the electrodes are firmly adhered to the skin and that all connections are secure. Low or dead batteries are a frequent cause of insufficient output, so replacing them is a simple first step. If electrode pads lose their stickiness, cleaning them with a damp cloth or replacing them can improve conductivity. Should skin irritation occur, ensure proper skin preparation, consider rotating electrode placement, and consult a professional if it persists.
Results can vary and may take time. Improvements in symptoms for overactive bladder may be noticed within a few weeks, but a full course of treatment, often 12 weeks, is typically recommended. TENS is frequently used as part of a broader treatment plan that might include pelvic floor exercises and bladder training. For device maintenance, clean the TENS unit casing with a damp cloth and store it in a cool, dry place away from direct sunlight. Regularly check battery compartments for corrosion and replace electrodes as they lose adhesion, typically after 20 to 30 applications.
When to Consult a Healthcare Professional
Using a TENS machine for incontinence should be part of a comprehensive treatment plan supervised by a healthcare professional. Consult a doctor or physical therapist before starting TENS therapy to ensure it is suitable for your specific condition and to receive personalized guidance on settings and electrode placement. They can help determine the underlying cause of your incontinence and rule out other medical conditions that may require different interventions.
Seek professional medical advice if your incontinence symptoms worsen or do not show improvement after a consistent period of TENS use. A healthcare provider can assess your progress, adjust the treatment parameters, or suggest alternative or additional therapies. They can also provide support for any discomfort or skin irritation experienced during TENS application.