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Electrodes Placement

Placement of Electrodes for TENS                                       Placement Chart 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.

CONTIGUOUS PLACEMENT

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 pain site.

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.

MULTIPLE PLACEMENT STRATEGIES

Because the TENS has two independently operated channels, the clinician may take advantage of concurrent pad placement strategies.
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.

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