Transcutaneous Electrical Nerve Stimulation (TENS) therapy is a non-invasive pain relief method that uses low-voltage electrical currents delivered through electrodes placed on the skin. Plantar fasciitis is a common condition causing pain in the heel and bottom of the foot, due to a disorder of the plantar fascia, a thick band of connective tissue supporting the foot’s arch. This article guides effective TENS pad placement to manage plantar fasciitis discomfort.
How TENS Therapy Works
TENS therapy alleviates pain by activating peripheral nerves with electrical currents. A primary mechanism involves the gate control theory of pain. Electrical impulses from the TENS unit stimulate sensory nerves, effectively “closing the gate” in the spinal cord, blocking or reducing the transmission of pain signals to the brain. This stimulation of large nerve fibers can override pain signals carried by smaller fibers.
TENS also provides pain relief by stimulating the body’s natural pain-relieving chemicals, endorphins. These endorphins interact with opioid receptors in the brain and spinal cord, helping to reduce pain intensity. Additionally, TENS promotes increased blood flow to the treated area, aiding in delivering oxygen and nutrients to tissues and reducing inflammation. These actions offer a non-invasive, drug-free approach to pain management.
Specific Pad Placement for Plantar Fasciitis
Effective TENS pad placement is important for addressing plantar fasciitis pain. One common approach involves placing one pad at the bottom of the heel, where pain is often most pronounced, and the other at the base of the toes. This configuration aims to deliver electrical stimulation across the plantar fascia, the fibrous tissue running along the sole of the foot. Ensure pads are placed on clean, dry skin for proper adhesion and effective conduction.
Another effective placement involves positioning one pad on the bottom of the affected foot and the second on the calf muscle. This targets pain that may extend up the leg or addresses tightness in the calf muscles, which can contribute to plantar fasciitis. Experimenting with different positions, such as surrounding the specific area of pain rather than placing a pad directly on it, can help identify the most comfortable and effective spot for an individual. The goal is to ensure the electrical current flows through or around the painful region.
For broader coverage, some users may find benefit in placing pads on either side of the heel or along the arch of the foot. If using a TENS unit with multiple channels, a “cross pattern” where pads surround the pain from different angles can be tried. Regardless of the chosen placement, the pads should be at least one inch apart to ensure proper current flow and avoid discomfort.
Optimizing TENS Unit Settings
Adjusting TENS unit settings helps tailor the therapy for plantar fasciitis. Common adjustable parameters include frequency (Hz) and pulse width (µs). Intensity, which determines current strength, is also a key setting. Begin with low intensity and gradually increase until a strong but comfortable sensation is felt (e.g., tingling, buzzing, tapping) without discomfort or muscle twitching.
For acute pain, a higher frequency (80-120 Hz) may be effective. For chronic pain, lower frequencies (2-10 Hz) are sometimes used to stimulate endorphin release. Pulse width, the duration of each electrical pulse, can also be adjusted; lower to mid-range pulse widths are generally effective for pain relief. Some units offer different modes, such as normal (constant stimulation), burst (short bursts of stimulation), or modulation (varying frequency/intensity), which can be explored to prevent nerve adaptation.
A typical TENS session for plantar fasciitis lasts 20-30 minutes. Some individuals find relief for several hours following a session. While TENS can be used multiple times daily, be mindful of potential tolerance development with repeated use at the same settings. Adjusting settings or varying the mode can help maintain effectiveness.
Safety and Usage Considerations
While TENS therapy is generally safe, certain precautions and contraindications apply. Individuals with implanted electronic devices (e.g., pacemakers, defibrillators) should not use TENS units, as electrical stimulation can interfere with device functionality. Pregnant individuals should avoid TENS, especially over abdominal and pelvic regions, due to unknown effects on fetal development and potential for uterine contractions.
Never place pads over sensitive areas like the eyes, front of the neck (carotid sinus), or open wounds and irritated skin. Placing electrodes on the neck can cause spasms of throat muscles or affect blood pressure. Skin irritation, redness, or rash can occur at the electrode site, often due to prolonged use or adhesive sensitivity. If irritation develops, remove pads, clean the skin, and consider hypoallergenic pads.
Proper pad care is important for hygiene and effectiveness. Always turn off the TENS unit before applying, moving, or removing pads. It is always advisable to consult a healthcare professional before starting TENS therapy, especially with underlying health conditions or persistent pain. They can offer personalized guidance on pad placement, settings, and pain management strategies.