TENS: How does that work?

A TENS unit from Analgesic Healthcare and electrodes are pictured to the left.



TENS is an acronym for Transcutaneous Electrical Neuromuscular Stimulation. It is often referred to as “muscle stim” or “E-stim,” for short. TENS uses electrical current going though body tissues to help with pain control and swelling. Now, this is just a small amount of current - less than if you were to lick a 9 volt battery. (It’s OK to laugh, we’ve all done it at some point.) An electrical current is nothing that the body isn’t used to. After all, nerves and muscles already use electrical current to function. 


TENS helps with pain by working with nerve function. Pain signals travel along nerves and different speeds, is modified along the way, and is interpreted in the brain. When the TENS current is picked up by a nerve, it is quickly transmitted. If the stimulus is strong enough, the spinal cord will pay more attention to it than the pain stimulus. Finally, the brain interprets the pain signal as lower priority compared to the TENS signal and you can feel better.

TENS helps with swelling, too. As the current goes through muscle, it turns the muscle on and off. Contract and relax, contract and relax. This creates a pumping action that pushes out the swelling. We often use ice along with TENS to help this process.

We use TENS in out office and have units available for rental or purchase. Ask us if it would be right for you.

How should I use ice?

Ice is generally safe and effective but there are a few things to keep in mind to to make it most beneficial. First, put a layer between you and the ice - a paper towel or t-shirt work well. Ice should be used for 10-15 minutes at a time as frequently as hourly. The goal is to get the pain and swelling control benefits without giving yourself frostbite. If you have a vascular problem, such as Raynaud’s Phenomenon, or prior frostbite in the are you want to use ice, be extra careful or consider trying something else such as chiropractic, acupuncture, massage, or medication.

Should I use ice or ibuprofen?

You have pain and swelling. Which one should you use? Or both?

You have probably taken Advil or Aleve, two anti-inflammatory medications. A problem with oral medications like this is that is has to be digested, go throughout your body in the blood stream, and finally some gets to the injured part where you want pain relief. Sometimes it may even take a couple days to build up in your system to take effect. You also may have heard about problems with these medicines causing bleeding of the stomach or intestine in some people. The good news is that they are inexpensive, generally safe (especially in the short term), and can work for up to several hours once in your system.

Ice can be used as an anti-inflammatory, too. Generally placed right over the painful area, it can cool the local tissue and help swelling quickly. Cooled nerves function slower and don’t transmit pain as well. Ice is generally safe to use as long as you don’t leave it on too long and get frostbite or if you have some vascular problems.

So which should you use? The safe bet is to start with ice. If this works well enough, stick with it. If your pain becomes intolerable between hourly icing sessions or at night, it makes sense to add an over-the-counter medication of your choice to your pain control and swelling therapy program.

Should I use ice or heat?

You’ve probably heard a few answers. You may be confused. I hope I can clarify things for you here.

ICE
Ice is a main stay of first aid for musculoskeletal injuries. You may have heard of an acronym for first aid such as PRICES (Protection, Rest, Ice, Compression, Elevation, Support). The main goal of using ice is to control swelling and inflammation. This is your body’s first response to injury and is actually part of the healing process. But you can have too much of a good thing; the swelling itself can cause further tissue damage and prolong paina. Ice will help control swelling and pain as well as speed initial heeling.

HEAT
Heat is best used to help with dull, achy pain and stiffness. In short, warm stuff bends easier. Let’s say you injure your shoulder. It hurts, of course, especially when you move it. So what do you do? Not move it for a while. But your shoulder gets tight and stiff during this time and even when your pain is improved you can’t reach as high as before. Another, more extreme example is the joint stiffness after taking a cast off. This is where heat comes in. Heating your shoulder first will make it easier to do stretching. Bikram yoga, performed in a hot room, is an example of of this idea.

Take home: Use ice first after an injury, usually until pain and swelling are improved. Use heat later to loosen up sore and stiff areas.

What does DABCO mean?

DABCO is an acronym for Diplomate, American Board of Chiropractic Orthopedists. That’s a bit of a mouthful so we usually just say “dab-coe.” After graduating for the usual 5 academic year Doctor of Chiropractic program, Dr. Kozak continued training to earn this designation in a couple more steps.

First, Dr. Kozak was accepted to a residency program in Clinical Sciences at the Southern California University of Health Sciences (AKA Los Angeles Chiropractic College). Only one chiropractor is accepted to such a program each year, sometimes even less often. This is a full-time, three year program that involved patient care, research, writing for publication as well as teaching students, interns, and doctors at the post-graduate level, research. Completing this residency program made Dr. Kozak eligible for the next step.

Dr. Kozak then passed a rigorous examination. This exam was designed to test all aspects of orthopedic patient care in real-life way. Asking the right questions to patients, requesting the appropriate diagnostics (such as x-rays or blood work), reading diagnostic imaging (x-rays, CAT scans, MRIs, and bone scans), and finally choosing the therapy that will get a patient healthy. The cases tested included neck and low back pain, wrist fracture, and ankle sprain. All that should sound familiar to your experiences at the doctor.

Dr. Kozak is the only chiropractor in Grand County with this level of training and expertise and one of only a handful in the state of Colorado.

Want to learn even more about the ABCO, check out: http://www.abconet.org

Dr. Kozak is always continuing his education. His next goal is earning a second diplomate in chiropractic orthopedics. More to come on that as it evolves.