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Instructions For Proper Tens Electrode Care, Proper Maintenance For Tens Cables and How To Prevent Skin Irritation
Be certain to follow the instructions for use and care, removal and storage of the electrodes before using them. Improper care may damage or destroy the electrodes.
Choose the Correct Electrode
Use the proper electrode style for the treatment site and type of stimulation. MedFaxx offers a variety of electrodes to meet the needs of each individual patient. If you have any questions about choosing the correct electrode, call our customer service department at
Prepare the Skin
Clean skin is the best preventive against skin irritation so always wash skin at the application site with soap and water and pat dry with a towel. Never use alcohol, lotions, oils, or creams on the skin prior to placing the electrodes. Trimming (not shaving) body hair from the area is often helpful. Additionally, pre- and post-treatment skin care products protect the skin and help to keep the treatment area healthy. Should any irritation occur, discontinue treatment until the skin heals.
Use & Care of Reusable Infrex & Tens Electrodes
Remove the electrodes from their liners by bending the liner slight at a corner. Loosen the gel from the liner by rubbing your thumb across the edge of the electrode in an upward motion. Once the gel has loosened from the liner, grasp the edge of the electrode and peel from the liner.
For those electrodes with pre-attached wires (or pigtails), PLEASE DO NOT PULL ON THE WIRE.Doing so will cause damage or destroy the electrode. The proper method of removal is to grasp the edge of the electrode and lift it from the liner or the skin.
Rotating Electrodes - Alternate Sets Every 6- 8 hours When Possible
To extend the life the electrodes, alternate their use. They should be swapped out every 4 to 6 hours if being used in a hot or humid environment with another set of fresh electrodes.
Over-saturation can occur if electrodes are worn too long without rotating. Over-saturation occurs when the solid gel electrode absorbs and retains moisture from perspiration, hot/humid environments, or excessive addition of water to re-hydrate the gel surface. Over-saturation results in an eventual lessening of the physical and adhesive properties of the gel. The electrodes should be removed from the skin and allowed to air dry in a cool and dry environment such as a refrigerator, with the gel exposed to the air for at least 24 hours.
Storing & Re-hydrating
Always check to electrode gel for tac prior to use. If the gel does not readily adhere to a gentle touch of your fingertip, rub a drop of water on the gel surface and repeat until the surface has been completely re-hydrated.
Return the electrodes to the release side of their liner and return to the storage bag. Store in a cool, dry place, avoiding exposure of the gel to heat and humidity.
To prolong battery life of rechargeable batteries, discharge the battery completely before re-charging to full capacity. Place the battery in the charger and charge for 12 to 14 hours. After charging, remove the battery. DO
NOTstore the recharged battery in the charger.
Lead Wire Care
The lead wires can become discolored and brittle from the effects of skin oils, perspiration, etc. To help keep lead wires clean and to help retain flexibility, cleaning daily with mild soap and water is suggested.
When using pin connectors, place the connectors horizontally to prevent detachment or excessive strain with movement. Be sure that no bare metal is exposed. Twisting the pins in and out of the electrode aids in full insertion and easier removal.
The Importance of Water
To achieve the best results, it is important to stress that the patient be hydrated. The absence of proper fluid levels in body tissue may cause conductivity to be partially or totally blocked. Water is the recommended liquid, as beverages such as coffee, tea, and cola act as diuretics and actually rob the tissues of fluid.
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Tens units are the most used modality outside a pain clinic for pain relief, interferential the most used inside the clinic, however both modalities operate on similar pain relief principles. That overriding principle is the use of positive or negative charges for pain relief.
Here is an option for anyone with a tens unit or the Infrex Plus combination tens/interferential unit to gain more pain relief by reversing the polarity, fancy way to say, changing the charge from negative to positive or vice versa. Our body responds differently to negative and positive charges. As an example say one has a bulging disc between two vertebras and the compression is on the nerve. The pressure on the nerve root is the causative agent that makes the patient experience pain. The inflammation/swelling of the disc needs to subside before there is appreciable pain relief. Negative charges are used to reduce swelling and inflammation as well as the sensory nerves of the body are stimulated differently between a negative and positive charge. In this situation we want the negative charge to be applied to the nerve root, or the area at the disc and spinal cord.
All tens and interferential devices emit postive and negative charges but one charge is predominant over the other. As an example if the charge is negative then more intensity is applied for that phase of the pulse and after the higher intensity is allowed then for a time period a much smaller postive charge is balancing the negative charge, but not in a manner where it is felt. The balancing of the charges is done so there is no skin damage and the effect is the negative and positive charges are balanced. This is what allows either device to be worn 24/7 if necessary.
When the patient puts the electrodes on, they usually place one electrode at the spine and the other electrode at the end of the painful area, for example let's say along leg for sciatica pain, and often the patient does not know which charge is where. Is the negative charge at the spine, or at the leg? The basic rule is to place the electrode that is felt the most at the area having the most pain. That is a general rule but that also is an effect of the charge, electrode size and overall sensitivity. Here is the tip that will help any tens or interferntial patient or clinician gain an advantage over pain, especially when it concerns "carryover pain relief".
Once the electrodes are placed in the most efficacious position the turn the unit off. Now remove the cable from both electrodes and reverse the cables into the opposite electrode. This is called "polarity revesal" and really is changing the charges from positive to negative or vice versa. What most patients will find is:
1. The sensation changes from one area to another area.
2. If swelling, edema are causative of the pain, the negative charge may help reduce the swelling and thus remove some of the structural aspects that is causing the pain to occur.
For any patient using tens or interferential as a home modality we recommend this procedure be tried in order to facilitate greater continual pain relief.
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Meet The Modern Snake Oil Salesman
In 1977, mushing through the snow at Greensboro Hospital to do an educational training session, was the point of revelation, me, the Peddler, had become the modern day snake oil salesman. Underneath my arms were 6 each TENS units, which were used to control pain but rather than drinking oil, we sent electrons through the body. That was the beginning of 34+ years of watching electrotherapy eventually heal bones for people who were facing amputation, fill in and totally form new tissues for the patients with bed sores, watch stroke patients who had lost the ability to pick up a cup of coffee relearn the process using functional stimulation and ....
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The term shingles is derived from the Latin and French words for belt or girdle, reflecting the distribution of the rash in usually a single broad band. This band of pain and infection is only on one side of the body in the large majority of people and represents a dermatome -- the area that a single sensory nerve supplies in the skin. The painful area may occupy part or all of the dermatome and the total distribution is not linear but may blossom at the nerve endings of the dermatone and be a patch of infected nerve endings resulting in blisters. It is rare for shingles to affect more than one dermatone on one side of the body.
Shingles is caused by the varicella-zoster virus , the same virus that causes chickenpox. Anyone who's had chickenpox may develop shingles. After you recover from chickenpox, the virus can enter your nervous
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Interferential treatment previously only available by visiting the clinic, is now available in a portable home unit – The Infrex Plus
The Infrex unit is the first portable unit to combine the most used forms of electrotherapy in and outside of the clinic. Developed for home use, the Infrex Plus is worn like a tens unit, and comes with an AC adaptor for home or office use. Similar electrodes you have always worn for tens will cross over seamlessly for use with this new technology.
Portable, drug-free relief for sufferers of:
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Fibromyalgia is really a never-ending, health condition that's best explained by defining its symptoms. Such as, but definitely are not limited by:
•all-over body pain within the muscles, ligaments and tendons;
•numerous sore-to-the-touch areas on the body, or tender points, where the slightest strain causes immense pain and recurrent tiredness despite lengthy sleep.
The indications of Fibromyalgia can differ according to the time, weather, stress and/or physical activity. There are no medical tests for Fibromyalgia. Doctors must first rule out all the conditions that might be causing these symptoms before diagnosing the patient with Fibromyalgia.
• Experts theorize that people with Fibromyalgia never truly achieve the profound restorative phases of REM sleep, and that is where the exhaustion emanates from. Some fibromyalgia patients can sleep for extensive periods of time yet still wake feeling tired. One major insomnia issues connected with Fibromyalgia is:
• Restless-Leg Syndrome ( RLS pain)
Experts have a theory of why patients that have Fibromyalgia feel pain. They feel individuals with fibromyalgia possess a lower limit to pain because of heightened feelings within the brain to pain stimuli. In addition they believe that some people have repetitive nerve stimulus that creates the mental changes seen in some personalities exposed to chronic pain.
The intense, chronic pain and sensitivity in muscles and ligaments experienced by Fibromyalgia sufferers can be debilitating and persistent. Although more common in females, Fibromyalgia can happen to anyone and occur at any time. The largest obstacle with Fibromyalgia is that there is no known cure, which means a lifetime of pain relieving drugs, such as NSAIDS (Non-Steroidal Anti-Inflammatory Drugs) or other specialized medications. Such prescriptions can be expensive and have unpleasant side effects such as drowsiness, irritability, and for many lessened mental alertness.
Other treatment plans for Fibromyalgia include, hot and cold packs, stretching, physical exercise and ultrasound therapy. Therapeutic ultrasound for treating fibromyalgia provides deep tissue stimulation and pain relief. Ultrasound physiotherapy can be a very effective way to manage this of Fibromyalgia.
Ultrasonic waves penetrate your skin to cause vibrations in tendons and soft tissues, providing gentle deep tissue heating that decreases pain and inflammation to hurry healing. Ultrasound therapy increases the flow of blood and oxygen to tendons as well as relaxes muscles and decreases swelling. Ultrasound works extremely well as a pain therapy system to manage Fibromyalgia pain flare-ups and can now be utilized in enhanced comfort of the home without having to go to a clinic or doctor's office for infrequent treatments.
Home ultrasound machines are now available for Fibromyalgia treatments and rehabilitation. Visits to a chiropractor or physical therapist office for ultrasound physical therapy can be expensive and inconvenient, but it is now possible to rehab fibromyalgia, and many other chronic injuries, in the comfort of your own home.
Because fibromyalgia involves soft tissue inflammation, several specific sorts of home ultrasound machines may be used. Generally all ultrasound units come with pulsed and continuous modes. Pulsed for physiological changes and continuous for internal heating with the associated thermal benefits. The devices have to be FDA approved and no less than a 1 year warranty.
Clinical professional units may have several different size treatment heads, multiple frequencies and larger effective ultrasonic stimulation areas. The clinical ultrasound units can be rented if the supplier is an approved A.C.H.C. accredited company.
Our video explains how ultrasound works for better understanding:
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The way to decide when to use heat versus cold is dependent upon what has happened, when. It would be simpler if the issue were clear, but that is not the case when deciding what to use. Physical therapists, athletic trainers, doctors all have to take the patient as they are, when they show, and deal with the situation at hand. This article is an attempt to help educate the patient on what to use if there is injury or chronic pain.
First is this warning for all patients and health care practicioners:
Hot or Cold Therapy should not be used by individuals who are sensitive to temperature extremes, such as those with circulatory problems, diabetes, nerve damage, paralysis or sensitive skin.
Now having stated the warnings let's figure out what to use, when. First let's talk about the use of cold therapy.
Cold therapy often revolves around the acronym RICE (rest, ice, compression, elevation) and reminds us how to treat injuries, such as sprains, strains, bumps and bruises.
Cold therapy, Ice Therapy, Cold Pack or "Cryotherapy" should be applied within 72 hours following any type of acute injuries such as a knee sprain or an ankle sprain.
Cold therapy can also help treat some overuse injuries and chronic pain.
Cold therapy will help stop bleeding in the muscle, reduce pain and inflammation.
Cold also causes contraction of the involuntary muscles of the skin.
Cold therapy is generally used to relieve pain after exercise or other strenuous activity.
Cold or ice should never to applied directly to the skin. As you see a general rule is to use cold therapy within 72 hours of the injury as an aid to decrease the inflammatory process ( our body's way to prevent further injury and accelerate healing).
Today you may be familiar with those situations where there is spinal cord or brain injury and one of the first steps is to stop the swelling. Additional swelling actually may cause permanent paralysis in spinal cord injuries. We have found this can be the causative problem of permanent neural cell destruction so the advanced method of treatment is to stop the unnecessary swelling. This is done by advanced chilling methods to decrease the temperature in the injured tissue areas.
A very important point to remember is the use of cold therapy involves settling or calming the inflammatory processes. When one exercises, as one should to increase the elasticity of the injured structures, that this is simply the re-injury of the area. The use of cold is due to the process of re-injury when rehabbing, so the old injury is now not old, but a new injury of much less severity.
Stretching and increasing range of motion is in reality a process of allowing some healing to occur, but then reinjuring to restart healing but with greater range of motion going forward. decide when to use heat versus cold is dependent upon what has happened, when.
Now let's look at warm, moist heat therapy.
Warm, moist therapy: Apply heat to help reduce pain and promote healing once swelling has subsided.
Please note this type of heat is referred to as "warm, moist" heat and not "heat therapy" or "hot therapy". There are so many situations where dry heat is not indicated. In many clinical settings heat thearapy is administered by use of infrared lamps. Infrared lamps are the same heat source we use to keep french fries warm!! This often is not the heat therapy of choice.
Unfortunately even in classic wound care manuals the heat treatments are referenced as the use of "infrared" but this form of dry heat is actually contraindicated and retards healing, rather than assisting in wounds.
The big advantage of warm moist heat is to stop pain. By stopping pain, especially during rehab. exercise programs, one is able to increase range of motion due to lack of pain.
Warm, moist heat should be used during the exercise programs and prior to. The reason for using warm moist heat prior to stretching exercises is the heat increases blood flow which also increases the elasticity of the area where the blood flows to. Increased elasticity is caused by the additional blood flow in the area and the veins are expanded as are the tissues and cells due to the increased capacity due to the increased blood flow.
The heating pad is put over the area to be stretched and there is less pain, greater range of motion and increased tissue elasticity. The restoration of function to an injured area is accelerated when warm moist heat is used in conjunction with and during exercising.
As a general rule once the exercises are finished then it's often good practice to cool down the area with cold therapy to subside the inflammatory effects that occurred during the stretching.
For chronic pain patients, those suffering some form of pain etiology for greater than 3 months, the use of cold or warm moist heat is dependent upon what form of thermal therapy provides the most relief. It is common for chronic pain patients to use combinations of cold and warm moist heat to relieve pain.
If an electrotherapy device is used such as a tens unit or interferential unit then in most situations you want to use warm moist heat actually during the use of the tens or interferential unit. The reason for using warm moist heat during interferential stimulation is the moisture of the pads actually puts water, a conductor of electricity, onto the skin surface and this makes for less resistance and greater penetration.
The 2nd reason is the warm heat increases blood flow to the area and blood is also conductive to electrical stimulation and that adds to better conduction so the pleasant stimulus of the interferential is delivered to the targeted sensory nerves. The combination of warm moist heat and interferential therapy provides much greater carryover pain relief. Pain often returns once the thermal effects wear off but with interferential the carryover can be extended considerably longer, often measured in weeks for the chronic pain patient.
Cold for immediate post injury and
Cold for immediate use after stretching and/or exercising
Warm, moist heat for pain whether acute or chronic
Warm, moist heat in conjunction with electrotherapy to extend carryover pain relief and increase conductance in the injured area or area pain being experienced.
Warm and Cold for pain whether acute or chronic condition.
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