TENS provides a beneficial adjunct for the treatment of cancer pain, especially when utilized as a goal-directed therapy. The use of transcutaneous electrical nerve stimulation (TENS) in a major cancer center for the treatment of severe cancer-related pain and associated disability
How is tens used to treat cancer patients?
TENS provides a beneficial adjunct for the treatment of cancer pain, especially when utilized as a goal-directed therapy. The use of transcutaneous electrical nerve stimulation (TENS) in a major cancer center for the treatment of severe cancer-related pain and associated disability Pain Med.
Should TENS units be used during exercise for breast cancer patients?
Are you aware of any evidence supporting or negating the use of modalities such as a TENS unit to assist with pain during or after exercise for breast cancer particularly with patients with metastases? Let me first say that, in general, we want to minimize the use of modalities in patients who have had a cancer diagnosis.
Does tens work for metastatic pain?
Typically metastatic pain is a bone pain and TENS is not going to affect that. TENS is going to give them more superficial pain control, and it works well with musculature pain. This is not something that you are going to have a lot of opportunity to use, but if you, the patient, and the physician want to trial that, I think it is possible.
How does a TENS machine work for pain relief?
A transcutaneous electrical nerve stimulation, or TENS machine, provides pain relief by sending low-voltage electrical impulses through electrodes placed on the skin to a painful area on the body 1. A TENS unit can lessen pain without the use of medication.
Can a cancer patient use a TENS unit?
While A-alpha (motor stimulation or acupuncture-like TENS) may provide similar inhibition of the nociceptive pathways, it is usually not recommended for active cancer patients, as the more intense stimulation may be poorly tolerated.
Is electrical stimulation contraindicated with cancer?
The authors dismiss myths around the use of electrical stimulation on patients with certain medical conditions, acknowledging that NMES can be used safely and effectively in patients with cancer, chronic obstructive pulmonary disease, and heart disease.
Can TENS help with cancer pain?
TENS stands for transcutaneous electrical nerve stimulation. TENS may temporarily help pain that is in one area of the body. But more studies are needed in people with cancer pain to know this for sure. Your doctor or nurse will stick small pads onto your skin, which release a small electrical charge.
Can you use a TENS machine for bone cancer?
The newly included study suggested TENS might improve cancer bone pain on movement, but as a pilot study it was not designed to determine the impact of TENS on pain. The two studies in the previous review did not show that TENS significantly improved cancer pain.
Who should not use TENS?
Do not use TENS if you have undiagnosed pain and a history of cancer in the last 5 years. Epilepsy. Do not apply electrodes to your head, neck or shoulders. The impulses could cause seizures.
When should you not use a TENS unit?
Do not use TENS on:Open wounds or rashes.Swollen, red, infected, or inflamed skin.Cancerous lesions, or close to them.Skin that does not have normal sensation (feeling)Any part of your head or face.Any part of your throat.Both sides of the chest or trunk at the same time.Directly on your backbone.
When should you not use electrotherapy?
You should avoid electrical stimulation if you have:A change in tissue sensation.Impaired mental status.Presence of an implanted electrical device (the e-stim could interfere with pacemakers or implanted pain stimulators)6.Malignant tissue.Wounds that are too moist.More items...•
What is the best pain relief for bone cancer?
Most pain medications for bone cancer are taken by mouth, in pill or liquid form....Bone Cancer: Moderate to Severe PainCodeine.Vicodin or Anexsia (hydrocodone)Oxycontin or Roxicodone (oxycodone)Palladone or Dilaudid (hydromorphone)Duragesic (fentanyl)Dolophine or Methadose (methadone)
Is hot pack contraindicated for cancer?
If you're getting radiation therapy, you shouldn't put ointments, salves, menthol, or liniments on the treatment area, and you shouldn't use heat or extreme cold on treated areas. If you're getting chemotherapy, some techniques for the skin may worsen skin-related or neuropathy side effects.
Does a TENS unit promote healing?
It is suggested that TENS stimulates skin wound healing and tendon repair, as well as the viability of random skin flaps. Such effects may be due to the release of SP and CGRP, which would increase blood flow and, consequently, hasten the events of tissue repair.
Do TENS machines work on bone pain?
They found that pain decreased for those who used active TENS, and that pain when moving improved more than pain at rest. The research team concluded that TENS could be useful to help with bone pain.
Can a TENS unit affect your heart?
The same TENS stimulation had no effect on coronary blood flow of patients with heart transplants.
Can a person with cancer get a massage?
Absolutely. Light, relaxing massage can safely be given to clients at any stage of their cancer journey. Massage can help with many of the temporary side effect of chemotherapy and radiation, lower anxiety and pain, improve energy, and decrease nausea.
Is therapeutic ultrasound contraindicated with cancer?
Purpose: Ultrasound (US) therapy is an electrothermotherapeutic modality that uses US energy to provoke physical and chemical alterations. US therapy has been widely used in physical therapy. However, in clinical practice, it is contraindicated in cancer patients due to the possibility of exacerbating tumor growth.
What is the best exercise for cancer patients?
Once you feel comfortable, you can work your way up to aerobic exercises, like jogging, cycling (stationary bikes are fine), swimming, or brisk walks. These can help you burn calories, lose weight and build cardiovascular fitness.
Is electrical stimulation contraindicated with DVT?
Other contraindications are over any implantable electrical devices, like phrenic nerve stimulators, urinary bladder stimulators, pain pumps, ITB pumps, etc. If there is an area known peripheral vascular disease, thrombophlebitis, a known DVT or suspected DVT, you want to avoid Estim in that area.
Can cancer patients use TENS machine?
Cancer- distant to local site (Local site- see contraindications) • Application of TENS at sites distant to the site of cancer is a precaution and not contraindicated. TENS may be used for patients in palliative care when benefits of pain reduction outweigh risks.
Can cancer patients use TENS machine?
Cancer- distant to local site (Local site- see contraindications) • Application of TENS at sites distant to the site of cancer is a precaution and not contraindicated. TENS may be used for patients in palliative care when benefits of pain reduction outweigh risks.
At what stage are Macmillan nurses brought in?
Some people think Macmillan nurses only help people at the end of life. But you can be referred to a palliative care nurse at any stage of your cancer experience. Some people may be referred when they are first diagnosed with cancer.
What is a Macmillan Cancer nurse?
Macmillan nurses are specialist cancer nurses with experience and qualifications in cancer care. They can help you to understand your cancer diagnosis and treatment options and support you through your cancer experience. What does a Macmillan nurse do?
How do I contact a Macmillan nurse?
The Macmillan helpline does not have contact details for Macmillan nurses. Macmillan often fund a Macmillan post for 3 years, but then the NHS or other organisation will continue the funding. If you want to talk about your care or give feedback about a Macmillan nurse, you should contact the hospital, hospice or your GP practice.
What is tens in cancer?
The use of transcutaneous electrical nerve stimulation (TENS) in a major cancer center for the treatment of severe cancer-related pain and associated disability. TENS provides a beneficial adjunct for the treatment of cancer pain, especially when utilized as a goal-directed therapy. TENS provides a beneficial adjunct for the treatment ...
What is the treatment for cancer pain?
While medication management remains the mainstay for the treatment of cancer pain, medications are often associated with undesired side effects. Transcutaneous electrical nerve stimulation (TENS) provides a potential adjunctive method for treating cancer pain with minimal side effects.
How can tens be used for cancer patients?
The usefulness of TENS in our cancer pain population seems to depend on adequate patient training during a TENS trial visit. During the visit, a patient's pain is discussed in terms of functional loss (e.g., decreased walking with low back pain). We then assess how TENS can be used to improve their functional disability, with emphasis on improving function rather than pain scores. Finally, the TENS is placed and optimized (in terms of settings and location) before the patient has the device at home. Patients are educated in the use and the settings of the device prior to completing the visit. In patients that felt TENS was not as beneficial as experienced during their trial, improper use of TENS often accounted for decreased efficacy of this modality.
Why are tens used in cancer?
Patients were instructed to use TENS as a means of improving the functional abilities that were limited by their pain. Improvements of quality of life and pain scores were evaluated to see how to best use TENS in future research studies in the cancer population.
How long was a Tens trial?
At each trial, we determined the TENS settings and intensities that provided a noticeable improvement on pain perception and functional abilities. A four-lead trial was performed for 30 minutes, and pad size was based on the area and location of the patient's painful stimuli. Only high-frequency TENS (greater than 80 Hz) was offered to our patients. Location of stimulation was optimized by first stimulating dermatomal patterns in the location of the patient's pain. Neurotomal pattern was utilized if optimal locations were not achieved with dermatomal stimulation (Figures 0001 and 0002 ).
How does Tens work?
TENS primarily alters pain perception through the stimulation of A-beta (sensory stimulation) nerve fibers, which in turn may inhibit the transmission of a nociceptive stimulus mediated by A-delta and C-fibers . While A-alpha (motor stimulation or acupuncture-like TENS) may provide similar inhibition of the nociceptive pathways, it is usually not recommended for active cancer patients, as the more intense stimulation may be poorly tolerated. Application of TENS over intact skin may activate all nerve fiber types depending on the intensity and characteristics of the stimulus. Thus, the practitioner usually titrates various TENS settings to generate a nonnoxious paresthesia (A-beta activity) without frank pain (A-delta or C-fiber activity).
What is the treatment for cancer pain?
While medication management remains the mainstay for the treatment of cancer pain, medications are often associated with undesired side effects. Transcutaneous electrical nerve stimulation (TENS) provides a potential adjunctive method for treating cancer pain with minimal side effects.
How effective are Tens?
Our results show a similar efficacy to previously published data. A review article by Pan et al. showed that TENS provided moderate pain relief in roughly 62–66% of patients described in the reports of case series and that 33% of participants maintaining a sustained benefit from TENS after 3 months within a prospective series . Within our institution, 69% of patients started on TENS therapy showed some benefit in pain symptoms and quality of life, correlating with prior published data. While the location of pain varies among patients, from metastasis, to chemotherapy, surgery, and radiation treatment, patients with metastasis to bone showed good benefit with the use of TENS. This observation mirrors results seen in prior studies on TENS for the treatment of breast and bone cancer pain . Though respective pain reduction scores of 10 mm and 1.0 for the VAS and NRP scoring systems may not appear substantial, the clinical benefit, in conjunction with goal-directed therapy, provided significant relief to patients.
How often should I use a Tens unit?
Patients reporting subjective pain relief during the TENS trial were educated in using the TENS unit for a minimum of four to six times a day for 30 minutes to 1 hour. Patients selected their own settings at home, using a strong but comfortable intensity. The EMPI device has five presets that patients could choose with ease regarding their active settings. Patients were taught how to change between continuous, burst, and various modulation settings and time points; however, the device has an internal setting for pulse width that is not user controlled. Because pain relief from TENS is typically rapid in onset, and the duration of relief can often be short lasting in nature, our patients were advised to apply electrodes in the morning and remove them at night, allowing them to use the device as needed throughout the day .
What devices are not used in tens?
Implantable Devices. According to the American Cancer Society, individuals who have heart problems or those who have an implantable device should not use a TENS machine. Implantable devices include defibrillators and pacemakers. Implantable devices work by delivering small, regular shocks that stimulate the heart to beat in a normal rhythm.
Where to place tens electrodes?
The Multiple Sclerosis Trust advises against placing the electrodes around the anterior cervical spine. Operating the TENS machine with the electrodes placed there can stimulate the carotid sinus. Stimulation of the carotid sinus can cause hypotension, or an unusually low blood pressure in people who have problems with their blood vessels. The American Cancer Society warns against placing the electrodes on the front of the throat and over the eyes or heart. A person who has seizures or convulsions should avoid placing the electrodes on the head or neck area, reports Drugs.com.
What conditions contraindicate tens placement?
Other conditions that contraindicate TENS placement include areas of broken skin, sores or areas of acute eczema and psoriasis.
How do implantable devices work?
Implantable devices work by delivering small, regular shocks that stimulate the heart to beat in a normal rhythm.
Can a Tens machine be implanted?
A mild electrical current travels through the electrodes into the body, near the source of pain. The electrical signals the TENS machine sends may interfere with how the implantable device works. According to the American Cancer Society, individuals who have heart problems or those who have an implantable device should not use a TENS machine.
Can you submerge yourself in water with a Tens machine?
Drugs.com warns people not to submerge themselves in water with the TENS machine turned on. The electrical impulses the machine operates on can send a shock if it’s submerged in water.
Is a tens machine safe?
A TENS machine is generally considered safe. However, certain daily activities or medical conditions can contraindicate, or make inadvisable, the use of a TENS machine.
Does Tens affect metastatic pain?
Typically metastatic pain is a bone pain and TENS is not going to affect that. TENS is going to give them more superficial pain control, and it works well with musculature pain.
Can you use heat on a cancer patient?
Let me first say that, in general, we want to minimize the use of modalities in patients who have had a cancer diagnosis. We are not going to be putting heat on any patient who has had a cancer diagnosis. We are typically not going to be using ultrasound. We are not going to be doing E-stim. However, patients that are having pain and already have known metastases, if they are cleared by their doctor, they could go through a trial of TENS. Typically metastatic pain is a bone pain and TENS is not going to affect that. TENS is going to give them more superficial pain control, and it works well with musculature pain. This is not something that you are going to have a lot of opportunity to use, but if you, the patient, and the physician want to trial that, I think it is possible.
Do Prepare the Skin First
Doing skin preparation before applying an electrode will help ensure proper electrical flow for a more effective treatment. Before you place an electrode, follow these instructions:
Do Focus On Areas of Pain
Before applying electrodes, identify the areas you would like to target, such as a hip or shoulder. Place your electrodes on either side of the pained area, using either two or four electrodes at a time. As with bandages, you can place electrodes horizontally, vertically, or at an angle.
Do Adjust the Current
There isn’t a one-size-fits-all solution as far as the intensity levels go for TENS units. You’ll have to experiment with different levels until you find one that works best for you.
Do Use the Device for as Long as Necessary
There is a specific amount of time you can use most medical treatments before they become dangerous. Because TENS units are non-invasive and don’t utilize any drugs, you can use them as long as you need while doing other daily tasks.
Background
Methods
Statistics
- Statistical analysis was performed on the VAS and NRP scores of each patient prior to the use of TENS and at their follow-up, using a paired t -test analysis. Both the VAS and NRP scores of TENS responsive and TENS unresponsive patients were analyzed using a two-tailed Pvalue less than 0.05 to show statistical significance. Distribution of data was plotted to determine whether the d…
Results
- Cancer patients that had undergone a TENS trial had their charts retrospectively reviewed. As a standard of care at our institution, patients' VAS, NRM, and Short-Form McGill answers were recorded and analyzed. The patients and their resulting data points are shown in Tables 0001 and 0002. Eighty-seven patients were trialed, of which 84 patients reported improvements in pain an…
Patient Training and Education
- The usefulness of TENS in our cancer pain population seems to depend on adequate patient training during a TENS trial visit. During the visit, a patient's pain is discussed in terms of functional loss (e.g., decreased walking with low back pain). We then assess how TENS can be used to improve their functional disability, with emphasis on improving function rather than pain …
Discussion
- Our results show a similar efficacy to previously published data. A review article by Pan et al. showed that TENS provided moderate pain relief in roughly 62–66% of patients described in the reports of case series and that 33% of participants maintaining a sustained benefit from TENS after 3 months within a prospective series . Within our institution, 69% of patients started on TE…
Conclusion
- Though studies remain inconclusive about the efficacy in TENS patients, our initial results find that TENS has positive benefits in cancer patients when administered appropriately. Educating patients with reasonable expectations about decreases in pain intensity and duration of analgesic effects allowed TENS to be a beneficial adjunct for the multi...