Sciatica is a nerve-related condition that can cause potentially debilitating pain. The sciatic nerve begins in the lower back, where it branches off and goes down each buttock, hip, and thigh. It branches again at the knees and continues to the feet. The sciatic nerve is the longest and largest in the body and, at its thickest, is as large around as a finger.
Sciatica discomfort may begin as numbness or tingling in the buttock or upper thigh, but it often worsens with time.
The discomfort might increase to pain, and the pain can spread from the buttock down the back of the thigh. Eventually, this pain can spread down the lower leg until it’s even felt in the toes. Sciatica pain might also radiate upwards, causing pain in the lower back. No matter where else it might spread, pain from sciatica is always felt in the back of the thigh, and it is almost always felt in just 1 leg.
During a flare-up of sciatica, or a period of acutely increased pain, some rest might be beneficial. As soon as possible, though, a normal, active daily routine should be resumed. In the long-term, rest may actually worsen pain from sciatica. Exercise is highly effective, both at preventing sciatica and as a therapy for existing sciatica. However, if the pain has reached debilitating levels, exercise may not be viable.
Medications are often recommended for sciatica pain. However, the most effective oral medications are usually opioids, which carry a heavy risk of dependency. Injected medications, such as a sciatic nerve block, can provide significant pain relief. While injections are less invasive than corrective surgery, they can still risk infection or bleeding.
Another therapy, called transcutaneous electrical nerve stimulation (TENS), can provide a totally non-invasive alternative.
TENS unit therapy utilizes a small battery-operated remote attached by wires to pads or electrodes. The electrodes are placed strategically on the body, and the TENS unit transmits an electric current. According to WebMD, there are 2 possible reasons why TENS unit therapy relieves pain:
“This may be because the electricity from the electrodes stimulates the nerves in an affected area and sends signals to the brain that block or “scramble” normal pain signals. Another theory is that the electrical stimulation of the nerves may help the body to produce natural painkillers called endorphins, which may block the perception of pain.”
Although literature concerning the effectiveness of TENS unit therapy for sciatica is somewhat inconsistent, most medical professionals agree that the outcome is generally positive. Approximately 70% to 80% of patients experience pain relief during their initial use of TENS unit therapy. The success rate drops to 20% to 30% after a few months. However, if the initial relief of pain allows the introduction of gentle exercises, such as walking or stretching, TENS unit therapy can ultimately lead to very long-lasting relief of pain.
TENS unit therapy is easy to adjust according to symptoms and preference.
There are 3 main components to TENS unit therapy settings: amplitude, pulse width, and pulse rate. Amplitude is the intensity of the electrical current and should be relatively low to avoid the risk of electrical burns. Pulse width is the duration of each electrical pulse. It’s usually measured in microseconds and ranges from 10 to 1,000. The pulse rate is the frequency of the electrical pulses, or how many impulses occur per second.
Most TENS units have three basic settings. The first setting, sometimes referred to as the conventional setting, has a high frequency (pulse rate), low intensity (amplitude), and short duration (width). Pain relief with this setting can be almost immediate, but the relief often abates as soon as the stimulation is stopped. Some individuals wear their electrodes all day and turn on the stimulus at regular intervals, such as every 30 minutes. Sometimes, this can help extend the relief of pain.
Another basic setting on most TENS units is the acupuncture setting. This delivers a low frequency (pulse rate), high intensity (amplitude) therapy. The amplitude is set close to the individual’s tolerance limit, and as a result, this setting is uncomfortable enough that not many people can tolerate it. However, the acupuncture setting is sometimes more effective than the conventional TENS unit therapy.
The final TENS setting is referred to as pulsed or burst setting. It uses low intensity stimuli at a high frequency. Because this method has shown no advantage over conventional TENS, it’s not often used.
The initial settings for TENS unit therapy are usually determined by a professional, such as a physical therapist or physician. Before going home with a TENS unit, the person using it should be sure to learn from his or her physician how to safely adjust the settings. This way, he or she can try different amplitudes, pulse widths, and pulse rates to see what’s most effective.
Electrode placement in TENS unit therapy for sciatica is paramount.
To achieve pain relief from sciatica, the TENS unit must stimulate the correct nerves. Individuals utilizing TENS unit therapy for sciatica can self-adjust placement of the electrodes to see what’s most effective. A simple way to determine electrode placement is to palpate, or feel, the painful area. If 1 particular spot elicits a painful reaction, it’s probably a good place to put an electrode. Generally, these painful spots can be found along the sciatic nerve.
A physician, therapist, or other medical professional can also offer help in electrode placement. The use of TENS unit electrodes on non-painful sites can sometimes provide comparable or improved pain relief. A medical professional will be able to point out trigger points or acupuncture sites that can be effective locations for electrode placement.
Not only is TENS unit therapy low-risk and non-invasive, but it offers people with sciatica a way of adjusting their own therapy as needed. A medical professional is helpful when learning how to properly use a TENS unit, but individuals are then allowed to follow their own bodies’ cues to treat sciatica pain. Because of the as-needed nature of TENS unit therapy, it can be particularly useful to control pain in order to maintain a healthy level of activity.
Could you benefit from TENS unit therapy for your sciatica pain?
Image by srgpicker via Flickr