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Professionally endorsed

TENS for CRPS: Understanding the Effectiveness of Electrotherapy

A large and long wing iTENS electrode with refill gel pads

Complex Regional Pain Syndrome (CRPS) is a chronic condition characterised by severe and persistent pain in the lower and upper limbs. It affects adults and children alike. It decreases their range of motion and causes disability in adults and children with CRPS. One treatment method is Transcutaneous Electrical Nerve Stimulation (TENS). Using TENS for CRPS is an effective method that causes a reduction of pain. TENS delivers electrical stimulation to trigger the pain gate mechanism and endorphin production for relief.

Many use conventional treatment modalities to help with CRPS, such as medicines and exercise therapy. They may also use TENS with these different therapy methods to increase functional improvement for CRPS patients. Furthermore, TENS also helps with other conditions, such as diabetic neuropathy and other neuropathic pain conditions. This article will present information about understanding electrical nerve stimulation for CPS, how to apply it, and safety precautions.

Understanding TENS for CRPS

CRPS is a chronic condition that affects the limbs. Although its cause is not well understood, it often appears after injuries to the hands, arms, legs, and feet. These injuries may vary from fractures, wounds, or surgery. The painful condition can have various symptoms. Moreover, conventional treatment modalities for it include taking pain medications, occupational therapy, and undergoing physical therapy programs. Another option is using TENS for CRPS.

TENS is a form of electrotherapy that uses low-voltage electrical currents to alleviate aches from various acute and chronic pain conditions. It has adjustable settings that allow individuals to customise their treatment for optimal pain relief. The electrical stimulation from high-frequency TENS can trigger the spinal nerve cells to block pain signals from reaching the brain. This is also known as the pain gate mechanism.

In addition, TENS can induce endorphin production with motor nerve stimulation. These hormones build up and block opioid receptors, causing a reduction of pain felt. Electrical nerve stimulation therapy can also increase blood flow to the target area. This can reduce muscle tension and speed up the healing of the affected limbs.

Symptoms of CRPS

These are some symptoms people with CRPS may experience:

  • Continuously burning aches felt in the lower or upper limbs, including hands, arms, legs, and feet
  • Spontaneous pain intensity changes
  • Swelling of the skin, muscles, and joints of the area
  • Muscle spasms, tremors, and atrophy of the affected limb
  • Motor dysfunction and stiffness, resulting in a decreased range of motion
  • Visible changes to the outward appearance of the affected limb, including skin colour and texture
  • Noticeably different temperatures between the affected and unaffected appendages
  • Increased sensitivity to hot and cold
  • Changes to the nail and hair growth
  • Sensory impairment (allodynia hyperesthesia)

A woman wearing a long wing electrode on her wrist

How to Apply TENS for CRPS

Using TENS for CRPS for pain relief and functional improvement is straightforward. One of the advantages of TENS is that it is easy to self-administer. Nevertheless, it may help to study the instruction manual to ensure safety while using electrical nerve stimulation treatment. In addition, conducting preparations, such as cleaning the skin and checking the unit before using it, is ideal.

To start, the user must apply the electrode pads near or on the muscles of the affected area. After placing the pads, they must link them to the control unit using either wires or Bluetooth. Afterwards, they may turn the unit on and start adjusting the settings. It is best to start on low settings to avoid sudden shocks or discomfort. Then, they may gradually increase the settings to address their severe pain.

Generally, TENS therapy sessions last between 20 to 30 minutes. The duration of treatment may vary depending on various factors. This includes the settings used and the pain intensity. Once the time elapses, the user may turn the unit off and remove the electrodes.

Electrode Placement

Proper electrode placement is crucial for effective stimulation in patients with CRPS. Generally, people apply the TENS pads on muscles near or on the pain origin. However, those with CRPS must be careful during application. They must avoid placing them in areas with irritated or broken skin. Furthermore, they should avoid attaching them to joints and bones.

They may use multiple pads during their therapy session. However, these should be applied at least an inch away from each other to avoid interference. Lastly, avoid applying them closely to sensitive areas, such as the spinal cord, chest, throat, and head.

A person holding their pained hand

Safety Guidelines When Using a TENS for CRPS

It is crucial to follow safety guidelines when using a TENS for CRPS. Firstly, consulting a healthcare professional is ideal before using any electrotherapy device. They may conduct a physical examination and ensure that TENS suits the overall health condition. This is vital because some ailments may react negatively to transcutaneous nerve stimulation. Examples of these conditions are heart disease, epilepsy, seizures, and cancer.

Moreover, users must stay alert during the session. This will allow them to react quickly if they feel any adverse reactions during the duration of treatment. Hence, they should avoid sleeping or doing safety-sensitive activities like driving or operating heavy machinery. This is also because the electrical current stimulation may cause a distraction and lead to an accident.

Furthermore, individuals must avoid overusing the unit. Although using TENS multiple times daily is safe, people must take breaks between sessions. This allows the skin to rest and prevents skin irritation or mild burns from forming underneath the pads.

When to See a Doctor?

With CRPS, early intervention is ideal since rehabilitation treatments are most effective at the early stages. Hence, individuals should consult a doctor if they are experiencing persistent pain that affects their lower or upper limbs. This is especially true if simply touching or moving the appendage causes significant pain.

Moreover, while undergoing TENS therapy, users must remember that it should not cause an increase in pain intensity during or after the session. If they experience this, they should consult a health professional since they might have an underlying condition reacting negatively to the electric nerve stimulation.


Using TENS for CRPS is an effective method of alleviating pain from the condition. It is a non-invasive method complementary to conventional approaches to treating CRPS, such as taking medicines, occupational therapy, and exercise therapy. It uses electrical stimulation on motor and sensory nerves to trigger the pain gate mechanism and endorphin production. Moreover, it helps increase blood flow to the area to reduce muscle tension and improve healing. People may use personal TENS units to help with their condition.

TENS machines are easy to use even without medical supervision. The user must apply the electrodes on muscles near the pain source and adjust the settings accordingly. Nevertheless, ensuring safety is crucial with any treatment. Hence, consulting a medical professional is ideal so they can diagnose the ailment and ascertain that TENS suits the overall health condition. Those looking for a wireless TENS unit may consider the iTENS from ITENS Australia.

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