What’s the big deal you ask? Back in the late 70’s, early 80’s there was a movement in the U.S. to use tens machines post operatively for pain control. The most noticeable effect was on patients who had abdominal surgeries, thoractomies, and any procedure where there was a loss of muscle tone in the abdominal area. The mantra was the use of a tens machine immediately after surgery and, the incision was sewn, would help:
1. reduce pain,
2. decrease need for pain meds,
3. decrease time before rehabilitation exercises like range of motions could resume,
4. reduce pain from bloating, gas.
There were several problems in trying to get a program started in hospitals.
The one big obvious is there was not a billing code to reimburse the facility for time, materials and use of the tens machine. Obstetric use of tens machine for labor and delivery was being used in Europe extensively, but not so in the U.S. other than by physical therapist Moms with access to a tens machine. In the U.S. without a billing code the use of the machine, cost of labor and expertise, and the sterile electrodes cost were being undergone as a “loss leader”. Unfortunately the thinking at the time was tens was indicated only for “chronic pain” and an operation was not classified as “chronic” so there was no coverage. In the U.S. the use of tens therapy post operatively died and was overlooked for almost 30+ years.
What was not known then was the tens therapy could not only be effective for pain as previously thought, but the use of positive and negative charges of electricity ( what tens machine delivers) could accelerate tissue repairs. As a few clinicians and researchers developed the knowledge and did the studies it became obvious that if one wanted to reduce the time of incapacity and loss of function, the use of tens electrotherapy would help. Electrotherapy became main stream in using units to heal non-fractures. The book, “The Body Electric” by Dr. Robert Becker moved the application of tens type machine to heal fractures to main stream orthopedic use. To heal bones faster, and in many situations to heal bones rather than amputate, became the main reason for using tens type “bone healing machines” with bone fractures.
Electrotherapy machines were being used and had been shown to also heal bedsores, decubitus ulcers in the 70’s. The form of electrotherapy was called “high voltage”, later becoming “pulsed galvanic stimulation”. In all the machines whether for pain, for bones, or for soft tissues the commonality of electrotherapy was using the positive and negative charges to accelerate repair for tissue and for sensory input for pain. Today the standard form of electrotherapy that was exclusively reserved for the clinic is interferential therapy. Today a patient can do, as with a tens machine, and take an interferential unit home for personal use whether pain or tissue healing. The most useful form of take home electrotherapy machine is a unit with both tens and interferential functions.
Using tens machines post-operatively languished form the early 80’s to present day.
Today I’m encouraged to see that many post operative orthopedic procedures involve the application of tens machines to patients for pain control. The physician ( or the manufacture’s rep.) is applying the unit while the patient is sedated, well before the pain cycle begins. The patients are being stimulated 24/7 and pain is reduced. That is good.
My personal opinion though is the main benefit being gained is still not being acknowledged. It is the tissues are regenerating faster than they normally would and the patient is healing faster than ever. As read about and shown repeatedly, positive and negative charges are what excites our body to repair itself, whether bone tissue, soft tissue or heaven forbid the discussion, but the mating of sperm and egg cells. The process of rejuvenation is one of basic physics and the charges are the excitator to start or accelerate cellular growth and division. Greater rate of growth means shorter rehab. and faster healing over time.
Finally electrotherapy is gaining the recognition for healing and that is good.
What is bad though is always only if someone is paying for gain, when the best would be for just plain helping patients heal faster with less pain and for the benefit of good health care. The knowledge is there, results are there, but the reimbursement processes are hampering full use of electrotherapy for better human health.