Transcutaneous Electrical Nerve Stimulation for the Management of Frozen Shoulder

Introduction:

The shoulder joint, which connects the hand with the upper part of your body, is one of the most important joints of our body. Shoulder-related discomfort is a major issue for a lot of us. This causes significant hindrances in daily activities. Frozen shoulder is one of the most common shoulder disorders, which affects almost three to five percent of the general population. A significant number of these patients are either elderly or middle-aged persons. Thus, knowing and understanding newer treatment options, such as transcutaneous electrical nerve stimulation (TENS) for frozen shoulder, will be helpful for all of you.

What Is a Frozen Shoulder?

As the name implies, a frozen shoulder is similar to a frozen shoulder joint. It is also referred to as adhesive capsulitis of the shoulder, a condition marked by pain, restricted movement, and stiffness in the shoulder joint. This condition occurs due to increased thickness and tightness of the protective capsule of the shoulder joint. As a result, you will gradually lose movement or persistent immobilization of the shoulder joint. Usually, these symptoms develop gradually over three months or more. As a result, you could quickly identify different stages of this condition;

1. Freezing Stage: This is the initial stage, which lasts for two to nine months. You mostly experience pain in the shoulder region at night. The pain usually worsens at night with gradual difficulty in your hand movement.

2. Frozen Stage: In this condition, you usually experience less pain but with greater difficulty in shoulder movement.

3. Thawing Stage: This phase is the gradual recovery phase with a gradual increase in the symptoms and complications.

You will experience the following frozen shoulder symptoms;

1. A constant shoulder pain.

2. A decreased range of motion will lead to an inability to move the shoulder joint freely.

3. Joint stiffness and resistance while you will try to move the shoulder joint.

Why? “Transcutaneous Electrical Nerve Stimulation,” Know the Difference:

The main goal of your doctor is to relieve you from the pain and suffering associated with a frozen shoulder. Traditionally, doctors will prescribe you painkillers like non-steroidal anti-inflammatory drugs for frozen shoulder treatment. These drugs will reduce the pain and discomfort related to a frozen shoulder. Along with the medications, the doctor will advise physical therapy. Further, they may prescribe oral or injectable steroids to reduce joint inflammation.

If the condition is severe, doctors either try manipulating the joint through anesthesia or use minimally invasive methods, such as arthroscopic capsular release (a procedure to remove fibrous tissue from a capsule), to treat it.

While the traditional non-surgical methods have failed to provide quick and long-term relief, many patients do not want any surgical procedure.

Transcutaneous Electrical Nerve Stimulation (TENS) is a new non-invasive technique that uses mild electrical currents to rejuvenate tissues. These electrical impulses act on muscles, tendons, and nerve endings and help in their repairing process. As a result, your tissues regain their normal functioning. Also, this process will help you avoid side effects from drugs or surgical techniques. Also, due to the handyness of this device, you can easily use it at home.

How Effective Is Transcutaneous Electrical Nerve Stimulation for Managing Frozen Shoulders?

Transcutaneous electrical nerve stimulation (TENS) uses low-voltage current over the intact surface of the skin where the nerve pathways flow.

The TENS for the pain management of a frozen shoulder operates in the following two ways:

1. Blocking Pain Signals: The TENS stimulates the nerve concerned about pain while applying anelectric current. The underlying stimulated nerve straightly sends the signals to the brain and spinal cord.

2. Production of the Body’s Opioids: In another way, the stimulation through electric impulses stimulates the production of certain chemicals in the human body. These chemicals are primarily endorphins (natural painkillers) or natural hormones that relieve pain and stress. Not only that, these chemicals reduce muscle spasms and increase the range of motion.

3. Faster Healing: Electrical impulses act on the injured or damaged tissue of the shoulder capsule, increasing blood flow in the affected areas. As a result, rejuvenated cells regain their normal form and functions.

How Does Transcutaneous Electrical Nerve Stimulation Work?

A transcutaneous electrical nerve stimulator, a device for TENS, is a compact battery-powered device connected to the skin's target points through electrodes. So, the device has leads attached to the electrodes or sticky pads. The therapist first attaches the sticky pads directly to the skin of the shoulder aspects concerning the nerve behind. Usually, four pads are placed in your should region. Two pads are above and below the shoulder joint, and the other is at the front and back of your shoulder joint. These four pads use two channels to provide electrical impulses. During placement, these two channels should be placed in a crisscross fashion. Next, the machine is switched on, and the low-energy or tiny electrical impulses are delivered to the targeted area. You can feel tingling due to electrical impulses, not pain. Then, the nerve is stimulated, attaining a gradual relief from pain.

It should be kept in mind that the pads should not be placed over the pain site or sensitive area. However, it should be placed as close to the pain site as possible. In most cases, the pads are placed at the lower border of your deltoid muscle or the peripheral or superficial aspect of the underlying nerve. You can always increase or decrease the amount of electrical stimulation based on your comfort level.

If you notice any discomfort, like muscle contraction or pain, you should immediately stop or reduce the amount of electrical stimulation. Also, you can take an intermittent break if you sense any skin irritation or redness. Generally, it is a safe procedure you can take throughout the day with a few on and off.

Is Everyone Suitable for Transcutaneous Electrical Nerve Stimulation Technique?

Only some people are suitable for TENS. You should always get advice from doctors before using it. Medical healthcare professionals wholly assess your pain, medical history, and medical status before employing a transcutaneous electrical nerve stimulation (TENS) trial. In addition, TENS eventually holds specific safety guidelines for certain contraindications. Therefore, TENS is contraindicated in the following people for any aspect of the body:

• People who seem allergic to the gel, tapes, and electrodes.

• People with pacemakers as electrical impulses may interfere with the heart rate.

• Severe heart disorders.

• Cognition and comprehension impairment or any other cognitive disorders.

Subsequently, TENS is contraindicated concerning local areas or regions with the following states:

• The neck and head regions of people with epilepsy and stroke.

• Areas with any recent hemorrhage should be avoided to avoid further risks.

• Patients suffering from blood vessel disorders like varicose veins.

• Bleeding disorders.

• If the area has thrombosis and ischemia (diminished blood flow).

• Skin with irritation, inflammation, and dermatological lesions.

Things to Keep in Mind While Using TENS:

Transcutaneous electrical nerve stimulation is employed in a safe setting, though. Nevertheless, some precautions are to be taken to avoid risks.

• Electrodes are not to be positioned over or through the eyes.

• Electrodes should not be inserted through the mouth.

• TENS should not be employed while driving.

• Also, it should not be used in water, and the device should be kept away from water.

Conclusion:

Many elderly people suffer from shoulder-related complications due to a frozen shoulder. Most of them do not want to take medication regularly and also avoid going under the knife. In such cases, transcutaneous electrical nerve stimulation (TENS) can be an excellent option to treat a frozen shoulder. TENS uses electrical impulses to reduce pain and muscle spasms. Also, one can avail of this protocol at home. However, you should consult the physician to start TENS for your frozen shoulder.