Transcutaneous Electro Neural Stimulation
Transcutaneous electrical nerve stimulation (TENS) is a specific therapy for the treatment and resolution of pain related to neurological and myofacial conditions. It does this by delivering a mild electronic impulse through the nerves that control the masticatory and facial muscles. The rhythmic pulsing relaxes the muscles and therefore allows us to determine the correct relation of the mandible to the cranium. It also relieves pain and trismus of the muscles of the face caused by spasms and tension. In addition, it propels the mandible through space to a position which is most compatible with a relaxed musculature.
This procedure involves the placement of electrodes bilaterally in the preauricular area anterior to the right and left ears, just lateral to the coronoid notch. The current emanating from the electrodes stimulate the motor divisions of the fifth and seventh cranial nerves. The TENS pulse rate is once every 1.5 seconds (low frequency). It mimics the natural pulsing action of the body somewhat like a massage. The effectiveness of the TENS therapy is documented by EMG recordings.
Although the use of TENS is a mode of treatment it can be used most effectively when used in conjunction with CMS and EMG recordings simultaneously in objectively documenting and diagnostically gathering information before, during and after treatment.
The efficacy of low frequency TENS in the diagnosis and treatment of TMJ/MSD has been clearly confirmed in the published literature. It is clear and unequivocal that low frequency TENS (.05 Hz – 10 Hz) is both safe and efficacious for muscle relaxation and pain control. It is clear that low frequency TENS has a high degree of specificity when utilized for craniofacial pain. (Over 44 internationally published studies support and confirm this fact).