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I am looking for the most up to date information about the contra indications for using TENS for chronic pain.

In someone with epilepsy I have read that the reports of seizure events are anecdotal. I am looking for more evidence, if there is any, for safety, risks with use. Can TENS be safely used with a non epileptic seizure history?

Cara Ewart

6 months ago

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cara.ewart202
cara.ewart202

Thank you very much Tim for your response. I will have a look at the references. I am grateful for the opportunities in learning which this forum provides and so thanks to all involved.

Prof Tim Watson
Prof Tim Watson

Cara. Thanks for your query. I have a section on the web pages on each modality (TENS is at : http://www.electrotherapy.org/modality/transcutaneous-electrical-nerve-stimulation-tens) and there is also a section on contraindication (at : http://www.electrotherapy.org/contraindications) and a Frequently asked questions (at : http://www.electrotherapy.org/faqs), though appreciate that they are probably not going to deal with the absolute specifics of this enquiry. It is difficult to find absolute evidence one way or the other in the literature unless someone has sent in a letter or some adverse effects report

Just checked database and I have 160 papers in the TENS section which also mention epilepsy (clearly too many to list here)

There is a 2013 paper (Papuc, E. and K. Rejdak (2013). "The role of neurostimulation in the treatment of neuropathic pain." Ann Agric Environ Med Spec no. 1: 14-17.) which talks about using TENS for neuropathic pain in such a patient group - might be worth a read

Most of the literature is talking about using E Stim as a deep brain stimulation option - clearly different from TENS with surface electrodes (i.e. non-invasive) The anecdotal reports that I am aware of have indicated that for patients with a history of epilepsy - even if currently controlled - CAN have a seizure in response to elec stim - including TENS - in the neck/shoulder region.

There are plenty of patients which such a seizure history who use TENS to neck/upper quadrant with no problems at all - so it is not a 100% response by any means - just that it is reported to happen

The Canadian Guidelines (2010) which are the most recent published list the use of Elect Stim to the Head or Neck region as a contraindication when a patient is known to have seizures. In the detailed section that follows (section 4.14) it says contraindication to head and trunk and a precaution to neck and limbs - which seems a tad inconsistent, but I know a couple of the authors of that paper are in the Panel for this forum - they might be able to explain????

Would be interesting to see what others have experienced

Tim

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