TENS A Practitioner s Guide Supplement - Electrode Placements By Dr Gordon Gadsby and Michael Flowerdew
TENS A Practitioner s Guide J Gordon Gadsby BA RGN RMN DipN MISBM DHP DHS PhD Michael Flowerdew BSc MSc MIBiol PhD 2000, updated 2012. 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)20 8532 9595 email sales@bodyclock.co.uk www.bodyclock.co.uk www.bodyclock.net a Mikjos Production, 42 Milton Crescent Leicester LE4 0PA UK. telephone +44 (0)116 2352204
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
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
S.2 Musculoskeletal problems S.2.1 Spine S.2.2 Arm S.2.3 Leg S.2.4 Temporomandibular joint
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.
lumbar 5 cervical 7 IIlustrations of electrode placement for back pain and treatment within individual dermatomes. NO referred pain
lumbar 5 cervical 7 IIlustrations of electrode placement for back pain and treatment within individual dermatomes. WITH referred pain
Cervical pain / whiplash injury Bilateral treatment using one or more pairs of electrodes
Electrode placement Golfer s elbow electrodes placed medially and laterally over epicondyle
Electrode placement tennis elbow electrodes placed medially and laterally over epicondyle or over pain and within dermatome
Electrode placement wrist pain electrodes placed medially and laterally or one over pain and other in same dermatome
Electrode placement hand pain electrodes placed medially and laterally or one over pain and other in same dermatome
Electrode placement shoulder pain pairs of electrodes arranged as appropriate to drive the stimulation through the muscle bulk where the pain lies
Electrode placement Achilles tendon Electrode placement over most painful areas on both medial and lateral aspects
Electrode placement rear ankle pain
Electrode placement ankle pain electrodes placed medially / laterally or dorsally / ventrally
Electrode placement lateral / medial ankle placement may be medial / lateral or dorsal / ventral
Electrode placements hip pain
Electrode placements knee pain electrodes used in pairs, one over site of pain, the other in diametrically opposite position
either or Electrode placements for temporomandibular joint and myofacial pains
S.3 Problems specific to women S.3.1 Dysmenorrhea S.3.2 Premenstrual tension S.3.3 Labour pain
either or Electrode placements for primary dysmenorrhea
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;
Electrode placement labour and delivery - back points
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.
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
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
either or Electrode placements for trigeminal neuralgia and myofacial pains
Electrode placement for postoperative neuralgia over site of pain and diametrically opposite not to be used on the thorax
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
Electrode placement phantom limb pain two pairs of electrodes one of each pair arranged medially and the other laterally to drive current through stump
S.5 Dental uses S.5.1 Pain control S.5.2 Temporomandibular joint
TENS Electrode placement to anæsthetise a tooth using a modified rubber dam clip hand held electrode with ackowledgments to equinox international
TENS Electrode placement to anæsthetise teeth using 2 modified rubber dam clips H with ackowledgments to equinox international
either or Electrode placements for temporomandibular joint and myofacial pains
S.6 Miscellany S.6.1 Post operative pain S.6.2 Emesis S.6.3 Skin ulcers S.6.4 Irritable bowel syndrome
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
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
Electrode placement recalcitrant skin ulcers and wounds apply electrodes diagonally to healthy skin in criss cross pattern
Electrode placement irritable bowel syndrome select one or both pairs of electrodes on either the front or back