If you’re going through the painful stages of a frozen shoulder, a convenient tool for relief is a simple TENS machine.
TENS, or Transcutaneous Electrical Nerve Stimulation, is a drug-free treatment option for pain relief that uses low-voltage electrical current to stimulate the nerves.
Let’s explore the best TENS placements you can try for a frozen shoulder, with info about the following important factors:
- The 3 stages of frozen shoulder
- What are some alternatives to TENS for a frozen shoulder?
- Can I use TENS with other therapies?
Have you got your sticky pads ready to apply? Let’s view some specific placements.
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Using a TENS Machine for Frozen Shoulder
Frozen shoulder pain stems from joint adhesions and a phenomenon known as muscular guarding, where the muscles reflexively contract.
A notable study illustrated TENS effectiveness by highlighting it’s use combined with stretching is effective in reducing pain and decreasing muscle hardness, and is superior to a placebo.
Beware: A common misconception is associating higher intensity with quicker healing. This isn’t the case.
Hence, starting with a milder intensity and gradually increasing it is recommended.
Additionally, as a TENS user, you will get used to the sensation over time. Upping the intensity in increments might be needed to maintain therapeutic benefits.
Where should I place the TENS pads?
1. Anterior (front) and lateral (side) of shoulder
The best access for a chance of some relief is by placing pads front and side of your shoulder, as shown above.
The electric field currents of the TENS machine will meet inside your shoulder, at the most painful location – the ligament capsule.
Feel for the bony protrusion at the front of your shoulder. You can feel it move by turning your hand inwards and outwards. Place a pad just slightly below it.
For the lateral placement, feel for the muscular bulge which is your lateral deltoid muscle. Place the TENS pad at the lower part of this teardrop-shaped muscle.
2. Anterior (front) and top of shoulder
In adhesive capsulitis (frozen shoulder), there is severe pain radiating from the ligament capsule. These are the strong tissues around your ball-and-socket shaped shoulder joint.
During the middle and late stages of frozen shoulder, other structures come under stress from the lack of healthy movement.
With a front and top pad arrangement, pain relief is targeted at anterior shoulder tissues, like:
- Acromio-clavicular joint (the joint where your collarbone joins the shoulder)
- Biceps tendon
- Anterior deltoid muscle
- Supraspinatus tendon attachment
3. Anterior and Posterior shoulder
frozen shoulder front and back TENS pad placements
Sometimes, you might have pain deep and to the back part of your shoulder. This TENS pad arrangement could be the answer.
Most of your shoulder musculature is at the back of the shoulder. Often, the tendons of these muscles can be causing pain during a bout of frozen shoulder.
With the signal intensity turned to the right level, you can penetrate multiple shoulder tissues with this pad arrangement.
This arrangement works great for general shoulder pain or Rotator Cuff pain too.
The Frozen Shoulder Timeline
The length of time you will experience a full cycle of adhesive capsulitis varies, but most episodes are resolved naturally by 18-24 months. It can, however, last longer.
As a guide:
Freezing Phase (1-3 months):
- Pain Increases: The discomfort starts off mild but escalates, becoming more constant and intense.
- Limited Movement: Initially, there’s a bit of stiffness. As the weeks progress, lifting or rotating your arm becomes increasingly difficult.
Frozen Phase (4-12 months):
- Pain Stays or Eases Slightly: The intense pain might find a plateau. While it doesn’t fully disappear, there may be periods where it’s less severe.
- Very Hard to Move: During this long stretch, your shoulder feels like it’s locked in place, making overhead or behind-the-back movements especially challenging.
Thawing Phase (12-36 months):
- Pain Starts to Go Away: Gradually, the sharp stings of pain begin to recede, becoming more manageable.
- Movement Returns Gradually: As the months go by, your shoulder loosens. Day-to-day activities become less of a challenge, however permanent tightness can sometimes be seen when you lift your arm up high.
Duration of a TENS session for Frozen Shoulder
A typical session lasts 20 to 25 minutes, aimed at maximizing pain relief.
For optimal results, using the TENS machine approximately three times a week over a span of 4 to 5 weeks is a good first approach.
Remember: A significant advantage of TENS therapy is its ability to address the core pain, thus paving the way for improved joint movement.
So make sure you’re following the recommended shoulder exercises from your physio, chiro, or other doctor, to get the benefits of post-TENS stretching.
How does TENS work for Frozen Shoulder?
A battery-powered device, TENS units produce electrical currents interfere with pain signals being sent to the brain. This interruption provides pain relief by effectively “blocking” the pain signals from frozen shoulder aches.
As a bonus: the stimulation of the nerves by the electrical current also triggers endorphins, which are natural painkillers produced by the body.
Why does TENS placement matter?
The placement of the TENS pads on the body dictates what nerves are stimulated.
For example, placing the pads around the back and top of your shoulder is ideal for shoulder pain generally, and especially injuries to the rotator cuff.
Lower down at the outside of your forearm just below the elbow, we can target the musculocutaneous nerve (use this for TENS therapy on Tennis Elbow).
Try first to follow the recommended placements, then try different locations to find where you feel the most relief!
Gate control theory
The gate control theory of pain suggests that there are two types of nerve fibers in our skin, fast and slow. The fast fibers are responsible for transmitting pain signals quickly, while the slow fibers transmit information about touch, pressure and vibration.
TENS works by stimulating the slow fibers, which overrides the pain signals from the fast fibers.
This is why TENS can provide relief from chronic pain, as it interrupts the transmission of those pain signals to the brain.
Can TENS make Frozen Shoulder worse?
Using a TENS machine will not make your shoulder worse, because the device does not increase pressure, tension, or inflammation on your nerves.
TENS therapy will either give you some temporarily relief, or not be effective, such as in severe cases.
Who should avoid using TENS?
TENS should not be used by:
– pregnant women
– people with pacemakers or other implanted electrical devices
– anyone with a seizure disorder
What if TENS does not work for me?
If TENS is not the right option for you, there are other drug-free options for sciatica relief. These include:
– massage therapy
– cognitive behavioral therapy (CBT)
Remember to follow manufacturer instructions for proper TENS usage.
Which TENS pad arrangements have you found the best for your frozen shoulder? Let us know below.
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