TENS. A Practitioner s Guide. Supplement - Electrode Placements. By Dr Gordon Gadsby and Michael Flowerdew

Transcription

1 TENS A Practitioner s Guide Supplement - Electrode Placements By Dr Gordon Gadsby and Michael Flowerdew

2 TENS A Practitioner s Guide J Gordon Gadsby BA RGN RMN DipN MISBM DHP DHS PhD Michael Flowerdew BSc MSc MIBiol PhD 2000, updated J Gordon Gadsby and Michael Flowerdew. All rights reserved. This work may not be translated, or subjected to electronic adaptation without prior, written permission of the authors. Brief excerpts may be reproduced for review or analysis. Whilst the advice and information provided are believed to be true and accurate at the time of production, the authors cannot accept any legal responsibility for any errors or omissions that may have been made, nor do they make any warranty, express or implied, with respect to the information contained herein. THIS SUPPLEMENT HAS BEEN PREPARED AS A SEPARATE SECTION SO THAT YOU PRINT OUT THE IMAGES OF ELECTRODE PLACEMENTS Published and distributed by Body Clock Health Care Ltd 208 George Lane South Woodford London E18 1AD UK Telephone +44 (0) sales@bodyclock.co.uk a Mikjos Production, 42 Milton Crescent Leicester LE4 0PA UK. telephone +44 (0)

3 Electrode placements S.1 General Principles S.2 Musculoskeletal problems S.2.1 Dermatomes and the spine S.2.2 Arm S.2.3 Leg S.2.4 Temporomandibular joint S.3 Problems specific to women S.3.1 Dysmenorrhea S.3.2 Premenstrual tension S.3.3 Labour pain S.4 Neuralgias S.4.1 Post herpetic S.4.2 Trigeminal S.4.3 Post operative S.4.4 Peripheral S.4.5 Phantom limb pain S.5 Dental uses S.5.1 Pain control S.5.2 Temporomandibular joint S.6 Miscellany S.6.1 Post operative pain S.6.2 Emesis S.6.3 Skin ulcers S.6.4 Irritable bowel syndrome

4 Electrode placement for localised pain - general principles 1. one electrode over pain and the other diametrically opposite 2. over the painful area and at the nerve root in the same dermatome(s) order of priority for positioning electrodes 3. proximal and distal to painful area 4. criss-cross pattern over painful area 5. both electrodes positioned proximal to the painful area 6. both electrodes positioned distal to the painful area

5 S.2 Musculoskeletal problems S.2.1 Spine S.2.2 Arm S.2.3 Leg S.2.4 Temporomandibular joint

6 Ankylosing spondylitis Unilateral treatment carried out bilaterally, in this case C3 to L5. One pair of electrodes within the dermatome of area of acute pain.

7 lumbar 5 cervical 7 IIlustrations of electrode placement for back pain and treatment within individual dermatomes. NO referred pain

8 lumbar 5 cervical 7 IIlustrations of electrode placement for back pain and treatment within individual dermatomes. WITH referred pain

9 Cervical pain / whiplash injury Bilateral treatment using one or more pairs of electrodes

10 Electrode placement Golfer s elbow electrodes placed medially and laterally over epicondyle

11 Electrode placement tennis elbow electrodes placed medially and laterally over epicondyle or over pain and within dermatome

12 Electrode placement wrist pain electrodes placed medially and laterally or one over pain and other in same dermatome

13 Electrode placement hand pain electrodes placed medially and laterally or one over pain and other in same dermatome

14 Electrode placement shoulder pain pairs of electrodes arranged as appropriate to drive the stimulation through the muscle bulk where the pain lies

15 Electrode placement Achilles tendon Electrode placement over most painful areas on both medial and lateral aspects

16 Electrode placement rear ankle pain

17 Electrode placement ankle pain electrodes placed medially / laterally or dorsally / ventrally

18 Electrode placement lateral / medial ankle placement may be medial / lateral or dorsal / ventral

19 Electrode placements hip pain

20 Electrode placements knee pain electrodes used in pairs, one over site of pain, the other in diametrically opposite position

21 either or Electrode placements for temporomandibular joint and myofacial pains

22 S.3 Problems specific to women S.3.1 Dysmenorrhea S.3.2 Premenstrual tension S.3.3 Labour pain

23 either or Electrode placements for primary dysmenorrhea

24 Electrode placements for premenstrual tenstion either St36 and/or Sp6 based on two acupuncture points: St36 is located between the heads of the tibia and fibia 3 fingers below below the lower border of the patella Sp6 is on the posterior edge of the tibia, three finger breadths proximal to the highest point on the medial malleollus;

25 Electrode placement labour and delivery - back points

26 Electrode placement for labour and delivery - leg points St36 Neima Sp6 St36 is located between the heads of the tibia and fibia 3 fingers below below the lower border of the patella Sp6 is on the posterior edge of the tibia, three finger breadths proximal to the highest point on the medial malleollus; Neima is located one hand width below the medial epicondylar ridge of the tibia.

27 S.4 Neuralgias S.4.1 Post herpetic S.4.2 Trigeminal S.4.3 Post operative S.4.4 Peripheral S.4.5 Phantom limb pain

28 Electrode placement for postherpetic neuralgia on the torso or head either or depending on location and gentle stimulation on the torso pairs of electrodes bridging painful area, criss-cross if necessary

29 either or Electrode placements for trigeminal neuralgia and myofacial pains

30 Electrode placement for postoperative neuralgia over site of pain and diametrically opposite not to be used on the thorax

31 Electrode placement peripheral neuropathy - pair of electrodes at site of pain plus pair on acupuncture point St36 St36 is located between the heads of the tibia and fibia 3 fingers below below the lower border of the patella

32 Electrode placement phantom limb pain two pairs of electrodes one of each pair arranged medially and the other laterally to drive current through stump

33 S.5 Dental uses S.5.1 Pain control S.5.2 Temporomandibular joint

34 TENS Electrode placement to anæsthetise a tooth using a modified rubber dam clip hand held electrode with ackowledgments to equinox international

35 TENS Electrode placement to anæsthetise teeth using 2 modified rubber dam clips H with ackowledgments to equinox international

36 either or Electrode placements for temporomandibular joint and myofacial pains

37 S.6 Miscellany S.6.1 Post operative pain S.6.2 Emesis S.6.3 Skin ulcers S.6.4 Irritable bowel syndrome

38 Various combinations of electrode placement for postoperative pain channel 1 channel 1 channel 1 channel 2 channel 1 channel 2 channel 2 channel 2 channel 2 channel 1 channel 1 channel 2

39 Electrode placement for nausea and vomiting P6 P6 is located 3 finger breadths above the proximal crease of the wrist at the lateral edge of the tendon of the palmaris longus muscle

40 Electrode placement recalcitrant skin ulcers and wounds apply electrodes diagonally to healthy skin in criss cross pattern

41 Electrode placement irritable bowel syndrome select one or both pairs of electrodes on either the front or back