A Transcutaneous Electrical Nerve Stimulation (TENS) unit is a non-invasive device that uses a low-voltage electrical current to provide temporary pain relief. This device delivers electrical impulses through electrode pads placed on the skin, which are thought to interrupt pain signals traveling to the brain and stimulate the release of natural pain-relieving chemicals called endorphins. For wrist pain, TENS therapy can manage discomfort caused by conditions like tendinitis, general sprains, or nerve compression. Effective use relies heavily on the correct placement of the electrode pads to target the electrical energy precisely where it is needed.
Prerequisites for Safe TENS Use
Proper skin preparation is necessary before applying electrodes to ensure safety and effective treatment. The skin area must be clean and dry, as oils or lotions reduce electrical conductivity and prevent pads from adhering correctly. Any hair should be trimmed, but not shaved, to allow for secure adhesion and prevent irritation upon removal. Check the electrode pads themselves to confirm the gel is not dried out and the pads are sticking firmly.
Be aware of certain contraindications, especially when treating the hand and wrist. TENS pads should never be placed over broken or irritated skin, open wounds, or areas of severe numbness. Placement over these areas can worsen skin conditions or prevent the user from accurately sensing the current intensity. Individuals with implanted electronic devices, such as pacemakers or defibrillators, should avoid TENS, as the electrical impulses can interfere with the device’s function. Consult a healthcare provider before beginning TENS therapy to ensure it is appropriate for your specific condition.
General Placement for Broad Wrist Discomfort
For pain that is generalized, such as from a mild strain, sprain, or diffuse soreness across the joint, the goal is to encompass the entire painful region with the electrical field. A common method is the “sandwich” technique, which uses two pads to bracket the area of discomfort. One electrode pad should be placed on the forearm, slightly above the wrist joint, on the side corresponding to the pain. The second pad is then placed on the back of the hand or directly over the joint crease, ensuring the electrical current passes through the main site of the pain.
This broad placement strategy aims to flood the entire painful area with the electrical current. If the pain is primarily on the top (dorsal) side of the wrist, both pads should be placed dorsally, one on the forearm and one on the back of the hand. Conversely, if the discomfort is concentrated on the palm (volar) side, the pads should be positioned on the inner forearm and the base of the palm, avoiding the wrist crease to prevent pad detachment. The pads should be spaced at least one inch apart to ensure the current stimulates the tissue between them effectively.
Targeted Placement for Nerve-Related Pain
When wrist pain is localized and radiating, suggesting a nerve entrapment condition like Carpal Tunnel Syndrome, placement must be precise to target the affected nerve pathway. Carpal Tunnel Syndrome involves compression of the median nerve as it passes through the wrist, causing pain, numbness, and tingling in the thumb, index, middle, and half of the ring finger. To treat the median nerve, one pad is placed on the volar (palm) side of the forearm, two to three inches above the wrist joint, over the muscle belly.
The second electrode is positioned at the base of the palm, near the wrist crease, ensuring the current travels along the median nerve path. For ulnar nerve pain, which affects the little finger and half of the ring finger, the pads should run parallel along the nerve’s course on the pinky-finger side of the forearm and wrist. For radial nerve pain, involving the back of the hand and thumb side, the pads are placed along the path on the thumb-side of the forearm and wrist. This linear placement stimulates the nerve fibers directly, helping disrupt pain signals originating from the compressed nerve.
Session Duration and When to Stop
TENS therapy sessions for wrist pain typically last between 30 and 60 minutes and can be repeated up to four times daily, as needed. Users should start the intensity at the lowest setting and gradually increase it until they feel a strong, comfortable tingling or buzzing sensation. The sensation should never be painful or cause visible muscle contraction; the intensity may need to be slightly increased during the session as nerves adapt to the current.
Discontinue TENS use and consult a physician if the pain worsens or if there is no noticeable improvement after several sessions. Users should also stop the session immediately if they experience skin irritation, excessive redness, or a rash underneath the electrode pads. While TENS provides temporary pain management, it is not curative; if the device fails to provide relief or if symptoms change, consult a medical professional to re-evaluate the underlying cause of the wrist pain.