Electrical Muscle Stimulation

Aetna considers transcutaneous electrical nerve stimulators (TENS) and other electrical muscle stimulation medically necessary durable medical equipment (DME) when used as an adjunct or as an alternative to the use of drugs either in the treatment of acute post-operative pain in the first 30 days after surgery, or for certain types of chronic, intractable pain not adequately responsive to other methods of treatment including, as appropriate, physical therapy and pharmacotherapy.

A transcutaneous electrical nerve stimulator (TENS) is a device which utilizes electrical current delivered through electrodes placed on the surface of the skin to decrease the patient’s perception of pain by inhibiting the transmission of afferent pain nerve impulses and/or stimulating the release of endorphins (1). Transcutaneous electrical nerve stimulation is characterized by biphasic current and selectable parameters such as pulse rate and pulse width. In theory, TENS stimulates sensory nerves to block pain signals; it also stimulates endorphin production to help normalize sympathetic function (1).

It has been shown to benefit acute musculoskeletal pain (1,2). At Falls Chiropractic and injury who utilize this therapy in two types of patients. Firstly, we use it to block pain and normalize sympathetic function in the acute injury patient. The very mild electric current passed through the muscle belly also allows for a decrease of inflammation and relaxation of the muscles.

It is excellent for the patient immediately following an acute injury such as a motor vehicle accident. Secondly, stimulation of the muscle belly causes an increase in mechanoreception inhibiting nonciception. This blocks pain during the therapy and is great for the chronic pain patient. It is a very comfortable therapy with the patient either in the seated or prone position and usually takes about 8-15 minutes.

1. http://www.aetna.com/cpb/medical/data/1_99/0011.html#dummyLink4.
2. Long DM. Fifteen years of transcutaneous electrical nerve stimulation for pain control. Stereotact Funct Neurosurg. 1991;56(1):2-19.

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