Tennis elbow, also known as lateral epicondylitis, is a condition characterized by pain and tenderness on the outside of the elbow, often extending into the forearm. This discomfort can be caused by overuse or repetitive motions of the arm and wrist, such as those found in racquet sports or certain manual tasks. Transcutaneous Electrical Nerve Stimulation (TENS) offers a non-invasive approach to manage the pain associated with this common ailment.
How TENS Works and General Placement Rules
TENS units alleviate pain by delivering small electrical pulses through electrodes placed on the skin. One primary mechanism involves the “pain gate theory,” where these electrical impulses stimulate sensory nerves, effectively blocking pain messages from reaching the brain. Another way TENS works is by encouraging the body to release natural pain-relieving chemicals called endorphins, which reduce pain intensity.
When applying TENS pads, it is important to place them on either side of the painful area, typically at least one inch apart. The skin should be clean and dry before pad application to ensure proper adhesion and consistent electrical flow. Pads should not be placed directly over joints, bony prominences, or broken or irritated skin to prevent further discomfort or damage.
Targeted Pad Placement for Tennis Elbow
For tennis elbow, effective TENS pad placement focuses on the outer elbow and forearm muscles. One common method involves placing two pads from a single channel directly around the area of pain. One pad is positioned above the lateral epicondyle (the outer elbow bone), and the other pad below it, on the forearm muscles. This “bracketing” technique helps to encompass the discomfort.
Another approach is to align the pads along the extensor muscles of the forearm, which are frequently implicated in tennis elbow. This involves placing one pad closer to the elbow and another further down the forearm, following the muscle belly. When using a two-channel TENS unit, four pads can be employed to create a rectangular or parallel pattern around the area of discomfort, or even an “X” pattern by crossing the channels over the pain.
Individual pain location can vary, so experimenting with minor adjustments to pad placement is often helpful to find the most effective spot for pain relief. Regardless of the specific arrangement, the goal is to surround the area of pain, ensuring the pads are not touching each other but are close enough to allow the electrical current to flow across the affected region. Some units also offer conductive elbow braces that provide comprehensive electrical impulses around the joint, potentially simplifying placement.
Ensuring Safe and Effective TENS Use
Beyond proper pad placement, several considerations contribute to safe and effective TENS use. Begin with a low intensity setting on the device and gradually increase it until a comfortable tingling sensation is felt, avoiding any muscle contraction or discomfort. It is always advisable to consult the device’s manual for specific instructions and recommended settings.
Typical session lengths for TENS therapy range from 15 to 30 minutes, and treatments can be applied multiple times a day as needed. Some studies suggest that daily 45-minute sessions over several weeks can lead to significant pain reduction. To prevent skin irritation, clean the skin before applying pads and periodically rotate their placement.
There are situations where TENS should not be used. These include placement over broken skin, open wounds, infected tissues, or areas with impaired sensation. TENS units should also be avoided near the heart, on the head or neck, if pregnant, or if you have an implanted electronic device such as a pacemaker or defibrillator, as the electrical currents can interfere with these devices. Always consult a healthcare professional before using a TENS unit, especially if you have underlying medical conditions.