If you’re one of the many people who suffer from sciatica, you may have turned to a TENS machine by now.
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 sciatic pain relief.
Where should I place the TENS Pads for Sciatica?
Before you begin:
Place the electrodes directly on your skin – the photos below are showing the sticky pad locations only. Don’t wear any layers between your skin and the pads.
- The Lumbar spine (L5 spinal nerves)
The nerve roots exiting the L5 vertebra play a big role in sciatic pain, as they join with other nerves to form the sciatic nerve. The L5 nerve roots emerge from the spinal cord in the lower back region.
They then pass through small openings between your vertebrae, known as the intervertebral foramina.
By targeting the lower back and buttocks with this pad arrangement, you effectively stimulate the nerves in the region of pain referral.
To locate pad placement, identify the bony protrusions on both sides of your lower back, known as the posterior superior iliac spines (PSIS). These landmarks are like bony dimples.
Position the TENS pads just above the PSIS, as shown below. Place them symmetrically on both sides of the spine, maintaining an equal distance from center.
2. Posterior and lateral hip (Piriformis)
As the Sciatic nerve makes its way from your lumbar spine to your leg, it passes underneath a hip muscle, the piriformis. Its position is deep, under your glute max.
So, place a pad over your glute. A lateral (outer) hip pad will sometimes help with sciatica pain even thought the nerve does not directly pass through here.
3. Posterior thigh
Since your Sciatic nerve runs down the back of your thigh, this can be a good access point for the TENS pads.
First, identify your upper thigh: feel downwards from your sitting bone (ischium) and you will land on the right location for he TENS placement. This will generally be just below the fold of your buttock.
Secondly, place a TENS pad over the distal (lower) thigh, a couple of inches above your knee.
We are getting quite far down the sciatic nerve here.
The great thing about TENS is you can quickly feel which pad arrangement gives you the best relief.
4. Above and below the back of the knee
If your Sciatica pain runs far down your leg, use these pad positions with any of the above ones that prove useful.
Pinched nerves can show up anywhere in the body. For a pinched nerve in the leg, TENS pads here can help symptoms, while you treat the underlying cause.
Why does TENS placement matter?
The placement of the TENS pads on the body dictates what nerves are stimulated. For example, placing the pads on the front of the head, and the face, will primarily stimulate the trigeminal nerve, which has been shown to play a role in migraine.
At the outside of your forearm just below the elbow, we can target the musculocutaneous nerve which can be addressed with TENS therapy for Tennis Elbow.
Try first to follow the recommended placements, then try different locations to find where you feel the most relief!
TENS pad placement for Migraine
- The back of the neck
- Across the forehead
- Over the temples and TMJ…
How does TENS work for Sciatica?
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 a sciatica attack.
As additional bonuses, the stimulation of the nerves by the electrical current also triggers endorphins, which are natural painkillers produced by the body.
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.
Using a TENS machine will not make your Sciatica 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.
TENS should not be used by:
– pregnant women
– people with pacemakers or other implanted electrical devices
– anyone with a seizure disorder
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)
A TENS unit for sciatica should be used for 15 minutes at a time. It can be safely be used for up to an hour at a time. It is recommended to lay on your front while using the TENS machine.
You can alternate this with standing up to change position, which may increase the relief you feel.
What are some electrical TENS alternatives for Sciatica?
TENS vs. EMS for Sciatica
EMS stands for Electrical Muscle Stimulation. It is a therapeutic modality that involves using electrical impulses to stimulate muscle contractions. The difference is, TENS machines do not cause any actual movement in your muscle fibers.
EMS devices deliver controlled electrical currents through electrodes placed over your muscles. These electrical impulses mimic nerve signals, so your muscles contract.
The purpose of EMS is to improve muscle strength, enhance muscle performance, and promote muscle recovery. TENS therapy is for temporary pain relief only.
Electrical Muscle Stimulation (EMS)
EMS, also known as neuromuscular electrical stimulation, focuses on stimulating muscle contractions directly.
By using electrical impulses to activate motor nerves, EMS can help strengthen weakened muscles, improve muscle coordination, and reduce muscle spasms.
EMS is particularly useful for rehabilitation and muscle re-education after injuries.
Interferential Current (IFC)
IFC involves using four electrodes to deliver two high-frequency electrical currents that intersect and create a low-frequency current deep within the affected tissues.
This technique allows for deeper tissue penetration, making it beneficial for managing deep-seated or chronic sciatic pain.
High-Voltage Electrical Stimulation (HVES)
HVES delivers short, high-voltage pulses to stimulate sensory and motor nerves. This therapy can be helpful in reducing pain and promoting muscle relaxation, similar to TENS, but with the ability to target deeper tissues and larger muscle groups.
Percutaneous Electrical Nerve Stimulation (PENS)
PENS involves inserting small needles into specific points near the affected nerves and applying electrical stimulation directly at the site of pain.
This technique allows for precise targeting of nerve pain, making it potentially effective for refractory or severe sciatica cases.
Spinal Cord Stimulation (SCS)
SCS is a more invasive electrical therapy used in cases of chronic or severe sciatica that does not respond well to other treatments.
It involves placing electrodes near the spinal cord to deliver electrical impulses, which can block pain signals from reaching the brain.
Understanding Your Sciatica’s Origins
The most common cause of sciatica is a herniated disc in the lumbar spine, compressing the sciatic nerve roots.
Other causes can be degeneration in the spine, causing spinal stenosis or facet joint arthritis.
A less common cause is piriformis syndrome – where the muscle squeezes the nerve.
Muscle spasms, lower back pain, and radiating pain are all common with sciatica.
It is important to avoid placing the electrode pads directly on top of the spine or on any area with broken skin, or near your eyes. If you have any questions about where to place the sticky pads, be sure to consult your doctor or other medical professional before using TENS.
Remember to follow manufacturer instructions for proper TENS usage.
Which TENS pad arrangements have you found give you relief? Let us know below.
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