CPAPtalk.com

Zeecat wrote: ...Therapy with the TENS is much more beneficial once you find the right settings, so if someone has been using it on generic settings, I could see it producing poor results. Ya know, kinda like a CPap...

That is an excellent comparison! Wish I'd thought of it. That could explain some of the study results.

Many "studies" are skewed to get the results paid for by the sponsors of the study.
Like running APAPs wide open and then "concluding" they don't give good therapy.
(Don't even TRY to tell me that one wasn't paid for by $omeone with a $take in the re$ult$!)

chunkyfrog wrote:Many "studies" are skewed to get the results paid for by the sponsors of the study.
Like running APAPs wide open and then "concluding" they don't give good therapy.
(Don't even TRY to tell me that one wasn't paid for by $omeone with a $take in the re$ult$!)

Right. And with the TENS therapy, it directly hits the pockets of every pharmaceutical company that sells pain meds. I could see a company initiating a study comparing pain meds to TENS use and setting it up to fail.

I have the Ultima 5 Digital TENS Unit. It's great - at least for me. Not expensive.

If I could do it myself, I'd be slapping those pads on my lower back right now! With a neuromuscular disease, you tend to overuse the working muscles and I have REALLY pulled/strained a muscle or two in my back. The massage of the TENS unit would really feel good about now.

I'll have to settle for Icy Hot & Advil until hubby is home and has time to help me.

Maddie, I wonder if all T.E.N.S. has to be applied with temporary external pads.
If some kind of contact could be made with comfortable apparel worn for hours at a time,
then the therapy could be activated at any time--and with a timer, if needed.
I guess it's not there yet.

chunkyfrog wrote:Maddie, I wonder if all T.E.N.S. has to be applied with temporary external pads.
If some kind of contact could be made with comfortable apparel worn for hours at a time,
then the therapy could be activated at any time--and with a timer, if needed.
I guess it's not there yet.

The pads are sort of sticky and probably one would get the same problem some people do with their masks - skin irritation or contact dermatitis.

BlackSpinner wrote:

chunkyfrog wrote:Maddie, I wonder if all T.E.N.S. has to be applied with temporary external pads.
If some kind of contact could be made with comfortable apparel worn for hours at a time,
then the therapy could be activated at any time--and with a timer, if needed.
I guess it's not there yet.

The pads are sort of sticky and probably one would get the same problem some people do with their masks - skin irritation or contact dermatitis.

they make units with non-sticky pads that are built into belts and such, meant to just strap onto your back and go... not sure how well they work, though.

palerider wrote:they make units with non-sticky pads that are built into belts and such, meant to just strap onto your back and go... not sure how well they work

Just did a little searching. Those are interesting. Would love to hear if anyone has tried them. I place my electrodes on my lower back, so the belt would have to fit around a pretty wide area.

Avi, this is from the following article: Johnson M (2014) Transcutaneous electrical nerve stimulation: review of effectiveness. Nursing Standard. 28, 40, 44-53.

"Meta-analyses of RCTs using appropriate TENS technique and dosage provide strong evidence that TENS is superior to placebo TENS for chronic musculoskeletal pain and post-operative pain, and moderate evidence that TENS is efficacious for neuropathic pain. In addition, the general consensus from clinical experience is that TENS helps patients to manage their pain."

The following meta-analysis also found substantial support for efficacy with large effect sizes:

Johnson M, Martinson M (2007) Efficacy of electrical nerve stimulation for chronic musculoskeletal pain: a meta-analysis of randomized controlled trials. Pain. 130, 1-2, 157-165.

There have been many studies of this in the last few years - I'm surprised you are citing studies from 1990.

kteague wrote:

palerider wrote:they make units with non-sticky pads that are built into belts and such, meant to just strap onto your back and go... not sure how well they work

Just did a little searching. Those are interesting. Would love to hear if anyone has tried them. I place my electrodes on my lower back, so the belt would have to fit around a pretty wide area.

This made me think and I just checked - Icy Hot has come out with a portable TENS unit. Amazon has the starter kit for around $45 and you buy the refill pads separately. This might be something worth checking out....

Nick Danger wrote:Avi, this is from the following article: Johnson M (2014) Transcutaneous electrical nerve stimulation: review of effectiveness. Nursing Standard. 28, 40, 44-53.

"Meta-analyses of RCTs using appropriate TENS technique and dosage provide strong evidence that TENS is superior to placebo TENS for chronic musculoskeletal pain and post-operative pain, and moderate evidence that TENS is efficacious for neuropathic pain. In addition, the general consensus from clinical experience is that TENS helps patients to manage their pain."

The following meta-analysis also found substantial support for efficacy with large effect sizes:

Johnson M, Martinson M (2007) Efficacy of electrical nerve stimulation for chronic musculoskeletal pain: a meta-analysis of randomized controlled trials. Pain. 130, 1-2, 157-165.

There have been many studies of this in the last few years - I'm surprised you are citing studies from 1990.

Comments,

1) Nick, in your above link

http://www.sciencedirect.com/science/ar ... 0003007806

I see this:
Abstract

This study tested the effectiveness of episodic transcutaneous electrical nerve stimulation (TENS) as a supplement to pharmacologic analgesia on pain with movement and at rest after abdominal surgery and evaluated whether its use during walking and vital capacity maneuvers enhances performance of these activities. TENS, with a modulated frequency, intensity as high as the subject could tolerate, and electrodes placed on either side and parallel to the incision, was compared to placebo TENS and pharmacologic analgesia alone (control) by using a crossover design. Self-report of pain intensity, walking function, and vital capacity were assessed on 33 subjects. TENS resulted in significantly less pain than the control during both walking (P < .5) and vital capacity activities (P < .1) and significantly less pain than placebo TENS during vital capacity (P < .01). TENS also produced significantly better gait speeds than the control (P < .05) and greater gait distances (P < .01) than the control and placebo TENS. Vital capacity and pain intensity at rest were not significantly different among the 3 treatments. These results suggest TENS reduces pain intensity during walking and deep breathing and increases walking function postoperatively when used as a supplement to pharmacologic analgesia. The LACK of affect on pain at rest supports the hypothesis that TENS works through reducing hyperalgesia. " .

2) My comment from the Consumer Reports on Health is from Sep 2014:

3) About the correctness of this post by hyperlexis:

"CR is correct in this respect, although it summarizes something technical down to two sentences. Alas, CR has over the years, also shrunk its magazine and lists of products, as readership has declined (died....) and younger people don't give a damn about product quality, and/or rely more on free online information sources for advice. Where there used to be dozens of items shown in each test, now the print magazine prints only the top five or ten items. The lesser products tested get cut off, only to be seen on the online website, for paying subscribers".

I am sending it to the Neurologist Orly Avitzur, MD, M.B.A. (a niece of my classmate at the technical college, way back) who happened to also be a medical adviser to Consumer Reports. Let's see her response. I'll also ask her about the TENS units and post it here if I get her OK.

Orly {Orlee} is also a beauty:



She also wrote:

Your Neurologist Has Sleep Apnea: When doctors are patients, what do they do?
Avitzur, Orly M.D.


http://journals.lww.com/neurologynow/Fu ... re.18.aspx

Interesting article Avi, http://journals.lww.com/neurologynow/Fu ... re.18.aspx , particularly in that most of the "sleep specialists" referenced seemed to be in denial about their own OSA.

1) Nick, in your above link

http://www.sciencedirect.com/science/ar ... 0003007806

I see this: "These results suggest TENS reduces pain intensity during walking and deep breathing and increases walking function postoperatively when used as a supplement to pharmacologic analgesia. The LACK of affect on pain at rest supports the hypothesis that TENS works through reducing hyperalgesia. " .


Avi, that was not my link. I linked to no 2003 studies by Rakes and Frantz. You are cherry picking articles and statements (and misquoting forum members). When the results of studies disagree, the gold standard is to examine all the studies using a meta-analysis. Johnson and Martinson (among others) did so and found significant effect sizes.

For kteague on RLS:

http://journals.lww.com/neurologynow/Fu ... ome.9.aspx

Look in here for more dated stuff:

http://journals.lww.com/neurologynow/Pa ... mode=cover