Transcutaneous Electrical Nerve Stimulation Therapy


Transcutaneous electrical nerve stimulation therapy is the use of a low-voltage electric current to relieve pain symptoms. It is done with a battery operated TENS device. It has small wires that are connected to sticky pads called electrodes. Electrodes are placed on the body at the site of pain as a medium to deliver energy through the nerve fibers. When the machine is turned on the patient will feel a tingling sensation in the area that the pads are placed. These electrical pulses control pain signals at the nerve site by blocking the pain receptors from being sent to the brain and therefore creating relief from pain. They also stimulate the release of endorphins which are the body’s natural pain killers.

The intensity and frequency of the electrical currents are adjusted to suit the needs of each individual. For patients going home with this treatment, the health care provider would educate the patient on the appropriate settings. Research has shown that a tolerance can be developed in patients consistently using the same frequency and intensity, therefore reducing the pain relief that they are experiencing. With professional guidance, the settings could be increased or alternated to prevent this.

For some people, pain relief is long-lasting, and others have found the need for repeated treatments. TENS sessions are short and can be administered as often as necessary.


TENS therapy has been used to treat a variety of pain symptoms and conditions with great success. These include and are not limited to:

  • arthritis
  • neck and back pain
  • sports related injuries
  • endometriosis
  • Multiple sclerosis
  • Fibromyalgia
  • cancer pain
  • reduce migraines
  • urinary incontinence


There are many benefits to using TENS therapy including:

  • It can be done at home with a small take home TENS unit.
  • Gives the patient control of managing their pain.
  • It is a non-invasive method for treating pain.
  • It can help people to stay away from taking pain medications or narcotics and reducing risk of addictions, overdose or negative side effects.
  • It can be used in addition to pharmaceutical drugs for breakthrough pain.
  • TENS devices are portable and can be carried with you during the day for immediate pain relief.
  • It is an affordable treatment and TENS devices can be found at your local pharmacy or online.


For the most part, TENS therapy is considered a safe treatment. TENS therapy is a relatively new treatment and the effects of it on some groups of people are unknown and therefore best to be avoided at this time. These groups include people with epilepsy, heart problems, pacemakers or other electrical implants, or pregnant women unless otherwise recommended by a doctor or health care professional.

Some people have experienced a rash or itchiness at the placement of the sticky pads which may indicate ultra sensitive skin or an allergic reaction to the pads. Others find the prickling, tingling sensation uncomfortable. Placing the pads on the eyes or neck can have dangerous results. Also placing the pads on irritated or broken skin can further irritate the area. It is important to use the TENS device and pads as instructed for best results and to eliminate possible negative effects.


TENS therapy is still being researched. The results of this treatment have varied from person to person but greatly depends on the type of condition being treated and the treatment schedule.

TENS therapy has been known to reduce pain in a safe and natural way. With little to no side effects, it is a great option to trial. However, speaking with your doctor before trying TENS therapy would be advised.



What does an epidural steroid injection do for neck pain?

Neck Pain

Neck pain is a common issue that impacts physical, social, and mental aspects of an individual. Over 30% of adults in the US are affected by neck pain each year. Neck pain can lead to headaches, depression, low back pain, and decreased physical activity. It is important to try and prevent neck pain as much as possible or to get it treated quickly to reduce effects of neck pain.

Epidural Steroid Injection

An epidural steroid injection is an injection of a local anesthetic followed by a long-lasting steroid medicine into the epidural space of the spine. This is the space outside of the membrane covering the spinal cord and nerve roots. Here the nerves travel from the neck, down your spine and into your legs. When you have a pinched nerve, an injury, or you are experiencing irritation from friction with bony structures of your spine, the nerves swell and cause pain.
At Apex Pain Specialists, the goal of this treatment is to reduce pain so that you could resume normal day to day activities as well as a physical therapy program. This common procedure is minimally invasive and takes place in a hospital, physicians clinic, or surgery center. It is done by specialized physicians, anesthesiologists, neurologists, and surgeons. This is a non-surgical procedure done in a short period of time.

How Does This Help?

Living with chronic neck pain is not fun. Luckily our modern sciences have developed a technique to combat this. Thousands of people have found relief from neck pain with epidural steroid injections. Epidural steroid injections are intended to give relief from pain caused by inflammatory conditions. When the steroid medicine is injected into the site surrounding the inflamed nerves, it helps to reduce inflammation and irritation of the nerves and therefore the pain associated with it.
These injections often provide instant relief but in some cases once the local numbing wears off, you may feel the pain again for up to a few days before the steroid medication begins to take affect. Some find relief for years, others just weeks. The effects of this treatment varies from person to person therefore requiring the amount of treatments to also vary.

Continuing Treatment

Unfortunately in some cases the epidural steroid injections wear off and repeat injections are needed to improve long term effects of the injection.
Often after experiencing pain relief, patients will work with physical therapists to improve spinal condition. At home exercise programs are also recommended in adjunct to the epidural steroid injection to strengthen your muscles and prevent future neck pain episodes.
Talk to your family physician, or your pain specialist for a professional opinion and or referral for an individualized treatment plan related to your pain.

Tumeric for Arthritis

Curcuma longa, Cur­cuma domestica

Origin: A yellow-colored powder ground from the root of the turmeric plant. The turmeric plant grows in India and Indonesia and is related to the ginger family (it is a common ingredient in curries). Curcumin is a key chemical in turmeric.

Claims: Reduces pain, inflammation and stiffness related to rheumatoid arthritis (RA) and osteoarthritis (OA); treats bursitis. Known as a cleansing agent, turmeric often is used as a digestive aid in India.

What we know: Traditionally used in Chinese and Indian Ayurvedic medicine to treat arthritis turmeric/curcumin blocks inflammatory cytokines and enzymes, including cyclooxygenase-2 (COX-2), the target of celecoxib (Celebrex).

Studies: Several recent studies show that turmeric/curcumin has anti-inflammatory properties and modifies immune system responses. A 2006 study showed turmeric was more effective at preventing joint inflammation than reducing joint inflammation.

A 2010 clinical trial found that a turmeric supplement called Meriva (standardized to 75 percent curcumin combined with phosphatidylcholine) provided long-term improvement in pain and function in 100 patients with knee OA.

In a small 2012 pilot study, a curcumin product called BCM-95 reduced joint pain and swelling in patients with active RA better than diclofenac, an nonsteroidal anti-inflammatory drug (NSAID).

Dosage: Capsules, extract (more likely to be free of contaminants) or spice. For OA: Capsule, typically 400 mg to 600 mg, three times per day; or 0.5 g to 1 g of powdered root up to 3 g per day. For RA: 500 mg twice daily.

“Curcumin makes up only about 2 to 6 percent of turmeric, so be sure to check the standardized amount of curcumin,” advises Randy Horowitz, MD, medical director of the University of Arizona Center for Integrative Medicine in Tucson.


Top foods that fight inflammation

One of the most powerful tools to combat inflammation comes not from the pharmacy, but from the grocery store. “Many experimental studies have shown that components of foods or beverages may have anti-inflammatory benefits,” says Dr. Frank Hu, professor of nutrition and epidemiology in the Department of Nutrition at the Harvard School of Public Health.

Choose the right anti-inflammatory foods, and you may be able to reduce your risk of illness. Consistently pick the wrong ones, and you could accelerate the inflammatory disease process.

Foods that cause inflammation

Try to avoid or limit these foods as much as possible:

  • refined carbohydrates, such as white bread and pastries
  • French fries and other fried foods
  • soda and other sugar-sweetened beverages
  • red meat (burgers, steaks) and processed meat (hot dogs, sausage)
  • margarine, shortening, and lard

The health risks of inflammatory foods

Not surprisingly, the same foods on an inflammation diet are generally considered bad for our health, including sodas and refined carbohydrates, as well as red meat and processed meats. Inflammation can cause pain or make chronic pain worse which is why it is important to maintain a healthy diet while participating in a pain management program.

Unhealthy foods also contribute to weight gain, which is itself a risk factor for inflammation. Yet in several studies, even after researchers took obesity into account, the link between foods and inflammation remained, which suggests weight gain isn’t the sole driver. “Some of the food components or ingredients may have independent effects on inflammation over and above increased caloric intake,” Dr. Hu says.

Anti-inflammatory foods

An anti-inflammatory diet should include these foods:

  • tomatoes
  • olive oil
  • green leafy vegetables, such as spinach, kale, and collards
  • nuts like almonds and walnuts
  • fatty fish like salmon, mackerel, tuna, and sardines
  • fruits such as strawberries, blueberries, cherries, and oranges

Benefits of anti-inflammatory foods

On the flip side are beverages and foods that reduce inflammation, and with it, chronic disease, says Dr. Hu. He notes in particular fruits and vegetables such as blueberries, apples, and leafy greens that are high in natural antioxidants and polyphenols—protective compounds found in plants.

Studies have also associated nuts with reduced markers of inflammation and a lower risk of cardiovascular disease and diabetes. Coffee, which contains polyphenols and other anti-inflammatory compounds, may protect against inflammation, as well.

Anti-inflammatory diet

To reduce levels of inflammation, aim for an overall healthy diet. If you’re looking for an eating plan that closely follows the tenets of anti-inflammatory eating, consider the Mediterranean diet, which is high in fruits, vegetables, nuts, whole grains, fish, and healthy oils.

In addition to lowering inflammation, a more natural, less processed diet can have noticeable effects on your physical and emotional health. “A healthy diet is beneficial not only for reducing the risk of chronic diseases, but also for improving mood and overall quality of life,” Dr. Hu says.

Exercise & Chronic Pain

Exercise & Chronic Pain

4 reasons why exercise helps relieve chronic pain:

Exercise is probably going to be part of your treatment plan for your chronic back pain. More often than not, resorting to bedrest can make the symptoms of back pain worse.

There are many benefits to exercise, including:

1. Exercise keeps your joints moving.

That’s especially important for patients with chronic pain caused by a form of spinal arthritis.

2. Your muscles will stay strong.

Your spine needs all the help it can get in cushioning your movements and supporting your weight, so you should work on keeping your back and core muscles in good condition. Strong muscles support your body and bones better, and that’s especially important for patients with chronic back pain.

3. Exercise will improve your mental health.

Chronic pain patients can struggle with depression, anxiety, or other mental health issues. Staying active can help boost self-esteem and make you feel like you’re doing something to fight your pain.

4. Exercise helps you maintain a healthy weight.

Extra weight can add to your pain, particularly if you have chronic back pain. By making healthy diet choices and staying physically fit, you can maintain an ideal weight.

What Kind of Exercise Should You Do?

Speak with your doctor or a physical therapist about what type of exercise would be good for you. A physical therapist can help you develop a regular exercise plan that you can stick with. Contact our Chandler pain management clinic for more information about physical therapy.

6 Treatment Options for Managing Chronic Pain.

6 Treatment Options for Managing Chronic Pain.

Fortunately there are many treatment options for pain management that does not required the use of pain medications. Below is a list of common options that you will find Apex Pain Specialists recommending for their patients. Our Chandler pain management clinic is home to Dr. Reddy MD. & Dr. Massrour MD. Two highly skilled dual-board certified pain management doctors.

Trigger Point Injections

Trigger point injection is a procedure used to treat painful areas of muscle that contain trigger points, or knots of muscle that form when muscles do not relax. During this procedure, a health care professional, using a small needle, injects a local anesthetic that sometimes includes a steroid into a trigger point (sterile salt water is sometimes injected). With the injection, the trigger point is made inactive and the pain is alleviated. Usually, a brief course of treatment will result in sustained relief.

Trigger point injection is used to treat muscle pain in the arms, legs, lower back, and neck. In addition, this approach has been used to treat fibromyalgia, tension headaches, and myofascial pain syndrome (chronic pain involving tissue that surrounds muscle) that does not respond to other treatment.

Transcutaneous Electrical Nerve Stimulation Therapy, (TENS)

Transcutaneous electrical nerve stimulation therapy, more commonly referred to as TENS, uses electrical stimulation to diminish pain. During the procedure, low-voltage electrical current is delivered through electrodes that are placed on the skin near the source of pain. The electricity from the electrodes stimulates the nerves in an affected area and sends signals to the brain that “scramble” normal pain signals. TENS is not painful and may be effective therapy to mask pain such as diabetic neuropathy. However, TENS for chronic low back pain is not effective and cannot be recommended, says the American Academy of Neurology (AAN).

Physical Therapy

Physical therapy helps to relieve pain by using special techniques that improve movement and function impaired by an injury or disability. Along with employing stretching, strengthening, and pain-relieving techniques, a physical therapist may use, among other things, TENS to aid treatment.


Although resting for short periods can alleviate pain, too much rest may actually increase pain and put you at greater risk of injury when you again attempt movement. Research has shown that regular exercise can diminish pain in the long term by improving muscle tone, strength, and flexibility. Exercise may also cause a release of endorphins, the body’s natural painkillers. Some exercises are easier for certain chronic pain sufferers to perform than others; try swimming, biking, walking, rowing, and yoga.

Alternative Therapies

In the past decade, many people have found relief for their pain in mind-body therapies, acupuncture, and some nutritional supplements. Others use massage, chiropractic and osteopathic (bone) manipulation therapies, therapeutic touch, certain herbal therapies, and dietary approaches to alleviate pain. However, there is little if any scientific evidence supporting these therapies for pain relief.

Chiropractic Treatment and Massage

Chiropractic treatment is the most common nonsurgical treatment for back pain. Improvements of people undergoing chiropractic manipulations were noted in some trials. However, the treatment’s effectiveness in treating chronic back and neck pain has not been supported by compelling evidence from the majority of clinical trials. Further studies are currently assessing the effectiveness of chiropractic care for pain management.