Placement of Electrodes for TENS Placement Chart.pdf
The placement of electrodes can be one of the most important
parameters in achieving success with TENS therapy.Of utmost
importance is the willingness of the clinician to try the
various styles of electrode placement to find which method
best fits the needs of the individual patient.
Every patient responds to electrical stimulation differently
and their needs may vary from the conventional settings suggested
here.If the initial results are not positive, feel free to
experiment.Once an acceptable placement has been achieved,
mark down the electrodes sites and the settings, so the patient
can easily continue treatment at home.
This is the most common placement
technique.It involves placing the electrodes alongside the
area of localized pain site, in such a way as to direct the
flow of current through or around the area of pain.
In a single
channel application, this would involve placing each pad on
either side of the pain site if the pain is localized on a
limb and deep within the tissue.Pad placement on the posterior
and anterior aspects of the affected limb will allow the current
to flow completely through the limb and thus through the endogenous
With a two channels application, the clinician may either
direct the current flow to cross through the pain site or,
in what is called the "bracket" method allowing the current
flow on either side of the painful area, generally through
the nerve branches that feed into the pain site.
DERMATOMES, MYOTOMES AND SCLEROTOMES
These are the regions of the body enervated by one spinal
nerve.Electrode placement involves both stimulating across
the similarly enervated area and/or placing one electrode (or
set of electrodes) at the pain site and another electrode (set)
at the point where the nerve root joins the spinal cord.
MOTOR, TRIGGER AND ACUPUNCTURE POINTS
While these points of high tissue
conductivity can differ in location and in theory of use, their
use as an electrode site is identical.The easiest technique
involves placing one pad directly over the point and completing
the circuit by placing the second pad on some area on the affected
side.This second electrode site can be within a nerve zone,
or a master point located between the thumb and the forefinger
on the dorsal web area between the two metacarpal bones.
Because the TENS has two independently operated channels,
the clinician may take advantage of concurrent pad placement
or example, it is possible to
use two different electrode placement strategies at the same
time.One channel can be used to directly stimulate the pain
site in a contiguous manner; the other channel can be placed
along the involved dermatome or utilized for point therapy.