TENS for Headache

EFFECTIVENESS: 3/5

Studies of TENS have shown conflicting results, but some reviews of the studies have demonstrated effectiveness for some patients. There have been problems with how the studies have been done, which contributes to the confusion. Many guidelines indicate a trial of TENS is appropriate.

From a scientific standpoint, researchers cannot make any definite recommendations about the effectiveness of electrical stimulation because the quality of the studies done to date is generally poor and the number of studies is small.  However, these treatments are widely used and may be helpful. TENS is listed as an alternative treatment in national treatment guidelines.

Sources:

The effect of TENS on selected symptoms in the management of patients with chronic tension type headache: a preliminary study. Tella BA¹, Unubum EV, Danesi MA. Nig Q J Hosp Med. 2008 Jan-Mar;18(1):25-9.

Moshkani Farahani D, Tavallaie SA, Ahmadi K, Fathi Ashtiani A. Comparison of Neurofeedback and Transcutaneous Electrical Nerve Stimulation Efficacy on Treatment of Primary Headaches: A Randomized Controlled Clinical Trial. Iranian Red Crescent Medical Journal. 2014;16(8):e17799. doi:10.5812/ircmj.17799.

Physical therapy for headaches. César Fernández-de-las-Peñas and María L Cuadrado. Cephalalgia .Vol 36, Issue 12, pp. 1134 – 1142. First Published December 9, 2015.https://doi.org/10.1177/0333102415596445

SELF CARE: 5/5

While electrical stimulation is frequently provided by medical providers, all of these therapies are available for home use, and can be purchased by the general public.

COST: 5/5

TENS units are available online for as little as $30, and interferential and muscle stimulation units are available for between $125 and $600.Durable medical equipment companies will often charge insurance carries several thousand dollars. In general, these units would be considered very affordable.

USEFULNESS (overall rating): 5/5

TENS, Interferential and muscle stimulation units don’t work for everyone, but can be very useful for those who do benefit. They are a reasonable alternative for those who cannot or choose not to use anti-inflammatory drugs, including patients with stomach issues, kidney or liver disease or heart disease. They are also an option for recovering substance abusers who cannot take pain medication. This article will focus on TENS, since electrical muscle stimulation has recently been shown in national guidelines to not be recommended for neck pain.

Sources:

Bussières AE, Stewart G, Al-Zoubi F, et al. The Treatment of Neck Pain-Associated Disorders and Whiplash-Associated Disorders: A Clinical Practice Guideline. J Manipulative Physiol Ther. 2016 Oct;39(8):523-564.e27. doi: 10.1016/j.jmpt.2016.08.007.

Electrical stimulation has been used therapeutically for more than 100 years. There are a number of different types of electrical stimulation, broadly they break down into 2 categories: stimulation of muscles (i.e., contraction of muscle) and stimulation of nerve pathways to reduce acute and chronic pain.

Electrical stimulation to reduce pain uses sticky electrodes or larger plastic pads placed over specific areas.

TENS (Transcutaneous Electrical Nerve Stimulation): usually a battery operated portable device about the size of a cell phone. Typically prescribed for home use for acute and chronic pain.

http://www.electrotherapy.org/modality/transcutaneous-electrical-nerve-stimulation-tens