How to use a TENS units & EMS machines for Carpal Tunnel Syndrome? Placement of electrode pads

The hands are indispensable extremities for the performance of most daily tasks, regardless of their type. For both office workers and top athletes, the hands and wrists are subjected to an almost constant amount of stress, in the form of physical activities of varying intensity performed in usually inadequate positions.

One of the most common effects of this stress is carpal tunnel syndrome, an ailment that can cause painful and debilitating effects on the hand and arm, necessitating the application of therapies to alleviate the ailments. This is where TENS and EMS electrotherapy modalities come in. In the following paragraphs, we will teach you everything you need to know about carpal tunnel syndrome and how you can address the symptoms of this disorder through TENS and EMS therapies.

How to use TENS machines to relieve wrist pain?

The main function of TENS units is to numb the nociceptors on the nerves in the affected area in order to mitigate the sensation of pain in the patient. For cases such as carpal tunnel syndrome, in which the area of application is considerably reduced, it is necessary to take into account several factors in order to apply a TENS session effectively.

Where to place the electrodes?

Due to the small surface area available for electrodes in the hand and wrist areas, it is necessary to position the pads in specific areas to obtain the fullest possible effect.

Therefore, the ideal positions are as follows:

• Palm of the hand, at the junction of the hypothenar eminence and the tenar eminence, where the branching of the median nerve begins.
• Dorsal area of the forearm, above the wrist joint.

Which current to use?

The hand and wrist are among the most sensitive areas of the body, with a fairly abundant innervation, so electrical impulses should be applied at low frequencies so as not to negatively stimulate the nerves.

For carpal tunnel syndrome, the ideal frequency is between 30 and 50 Hz, high enough to promote relaxation of the fibrous tissue of the wrist and endorphin production, without overstimulating the nerves.

Best TENS units to treat carpal tunnel syndrome

The effectiveness of Transcutaneous Electrical Nerve Stimulation therapy is proven for the treatment of carpal tunnel syndrome symptoms, so we can find a large number of devices that we can use to apply this therapy. Among the most effective, we can highlight the following:

How to use EMS to strengthen muscles and avoid carpal tunnel syndrome?

The use of EMS devices is contraindicated for most ailments focused on the hand and wrist. However, it is possible to take advantage of its effects for the prevention of most of these.

Where to place the electrodes?

Mobility of the forearm is made possible by a large number of muscles of various sizes and functions, but wrist mobility is attributed to three muscles in particular, on which the electrodes should be positioned. These are:

• Muscular belly of the brachioradialis muscle.
• Palmaris major muscle, on the dorsal portion of the hand.
• Deep flexor muscle of the fingers, positioning the electrode on the anterior aspect of the forearm.

What intensity to use?

Training the muscle tissue of the forearm is a very important factor in the prevention of carpal tunnel syndrome, because it helps to reduce the stress applied to the wrist, thus minimizing the likelihood of excessive pressure on the median nerve.

To obtain optimal results from this training, the ideal intensity varies between 65 and 85 Hz, which are sufficient to generate contractions that contribute to the strengthening of the brachioradialis and palmaris major muscles, improving grip strength and reducing the likelihood of developing wrist pain.

Best EMS machines to avoid hand and wrist injuries

Ailments caused by carpal tunnel syndrome can be largely avoided through strengthening the muscles, applying as little tension as possible on the wrist in order to prevent inflammation. To do this, you can make use of the following EMS devices:

This is a precise and compact wireless TENS electrostimulation device, brought to you by the iReliev brand, intended for the treatment of pain at precise points of the body. Thanks to its size and the fact that it does not require any wires to operate, it is completely discreet and can be used anywhere, while traveling and under clothing.

Its efficient use of TENS technology allows it to block pain signals before they reach the brain, making it a safe method of treating ailments. It also has a long-lasting lithium battery and an energy-efficient function, which turns the device off every 20 minutes. One of the best devices on the market in terms of portability, discretion and functionality.

The compact electrostimulator of the iRest brand offers a combination of electrostimulation modalities, combining the benefits of TENS and EMS therapy, providing its users with a safe and drug-free method to treat ailments caused by different injuries or diseases, through the application of low-intensity electrical impulses.

It has 6 modes of use that emulate different types of massages to achieve different objectives, along with 10 levels of intensity that provides greater effectiveness. The package includes 1 control, 2 large electrodes, 2 small electrodes, 2 guide cables, 1 user's manual, 1 cable case and 1 treatment guide.

The Belifu muscle stimulator is the perfect combination of TENS and EMS electrostimulation modalities, through which you can apply massages to relieve pain in a natural way, as well as generate muscle contractions that increase the size, strength and tone of the muscle, all in a completely safe and natural way, stimulating the body's natural processes.

It has 24 modes of use and 20 intensity levels that can be applied in isolation to each of the device's channels thanks to its dual channel function, allowing different therapies to be applied to separate areas of the body. In addition, it has a session timer mode and automatic shut-off that will allow you to give greater efficiency to your sessions and make better use of the energy of its high-capacity lithium battery.

The AUVON electro stimulator is at the forefront of electro stimulation technology, combining TENS and EMS stimulation technologies to obtain one of the most complete treatments for acute and chronic pain, caused by injuries or illnesses, as well as an incredible complement for physical conditioning thanks to its muscle stimulation technology.

It has 20 modes of use that apply different types of massages oriented to treat a wide variety of ailments, and with its independent channel control mode you will have the possibility of configuring different programs for each of the channels individually, to apply different types of massages in various areas of the body.

Massage Therapy Concepts presents its TENS/EMS electrostimulation machine, which combines the best qualities of both technologies to generate a viable option with which to treat pain caused by various injuries and diseases, as well as stimulate muscle mass to increase strength and definition. All this integrated in 12 modes of use with different intensities and levels, designed for different types of ailments.

Its dual channel function allows you to treat multiple areas of the body simultaneously, and its easy to use mode allows you to set the massage modes without any problems. It has a timer that you can set up to 60 minutes, and an LCD display that allows you to visualize all the procedures very easily.

One of the most versatile products of the Compex brand is its Compex Mini electro stimulator, which is focused on providing the greatest possible comfort to the user, thanks to its compact size and its convenient application, which allows you to control it very easily from your mobile device. It consists of 2 pods that use TENS technology controllable from the app, which is compatible for Android and Apple.

It has a rechargeable battery that can provide an autonomy of up to 7 hours per charge, 6 unique training programs focused on different branches of fitness to help you achieve your goals, and compatibility with your mobile for easy use. It is recommended for those physically active people looking for a compact, portable and natural way to deal with workout-related ailments.

HiDOw presents its XP-Micro 8 electrostimulator, a versatile and compact electrotherapy unit that combines the best of TENS and EMS technologies with a dual channel function that allows you to apply treatment and stimulation to different parts of the body simultaneously. Its function is based on the emission of electrical impulses that block pain signals, and generate muscle stimulation to help develop strength and toning.

It has 8 preset programs and 20 intensity levels, along with a session timer function that you can set between 10 and 60 minutes. Its built-in rechargeable lithium battery provides excellent durability, and the package contains 1 XP Micro 8 electrostimulator, 1 set of large pads, 1 set of small pads, 2 cables, 1 power adapter, 1 user manual and 1 carrying case to take it wherever you need it.

The Belifu electrostimulator has several features that make it stand out from other devices of this type. One of these is its function of 4 independent channels that will allow you to individually treat different areas of the body. It has 24 massage modes and 20 intensity levels that allow for a wide range of ailment relief.

The Belifu electrotherapy device includes 10 reusable self-adhesive conductive pads and 5 sets of guide wires. The electrodes are coated with an adhesive layer that gives them perfect adhesion to the skin, and with proper care, can withstand a large number of uses before they need to be replaced.

Xpoin has one of the best electrostimulation machines on the market. This is the Xpoint Luxury unit, which has a dual channel function that maximizes its effectiveness in different areas of the body simultaneously, and includes a large supply of pads included with your purchase, with 16 units. It is one of the best options for the treatment of acute and chronic joint and muscle ailments.

What distinguishes this electrostimulator from others on the market is its lightweight design with black and gold finishes, its high quality materials and the inclusion of a dust-proof leather bag with which you can take it wherever you want safely. The compact size in which you can find this device will allow you to take it with you and use it wherever you like very easily, as it is incredibly discreet.

The NURSAL electro stimulator features advanced dual channel technology, which allows you to set separate modes of use for channels A and B of the electro stimulator, in addition to having a memory function that allows the device to remember your preferred settings and apply them instantly, so you don't have to search through the 24 modes of use.

It has a powerful rechargeable lithium battery that gives it an incredible autonomy of up to 24 hours of continuous use, thus eliminating any worry that your sessions will be interrupted or that the AA batteries will run out. Additionally, it contains an adjustable timer that allows you to set the duration of your sessions from 10 to 60 minutes and has 20 adjustable intensity levels.

Video: How to place electrodes pads on hands and wrists?

Electrodes for hands & arms

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What is carpal tunnel syndrome and what are the causes?

Carpal tunnel syndrome is an ailment caused by excessive pressure on the median nerve. This nerve is a crucial part of both the innervation and motor function of the hand and wrist, and its condition can cause a variety of symptoms among which we can highlight:

• Numbness
• Stiffness
• Tingling
• Weakness
• Muscle damage

This syndrome can occur for a variety of both genetic and environmental causes. Among its main causes we can highlight:

• Repetitive hand and wrist movements
• Constant use of vibrating hand tools
• Alcoholism
• Fractures
• Infections
• Obesity
• Abnormal calcium or protein deposits

What are the most common types of wrist pain?

The wrists are very resistant joints that can withstand quite considerable loads. However, prolonged and excessive strain can lead to a wide variety of wrist ailments and diseases.

The most common are the following:

• Ganglion cysts: are noncancerous nodules that can limit wrist mobility and cause considerable pain.
• Gout: is a form of arthritis caused by uric acid buildup in the joints.
• Fractures: are caused by trauma to any of the bones of the wrist, which break, causing a lot of pain and considerably limiting movement.
• Sprains: is an injury that affects tendons, muscles and ligaments that can cause other disorders.
• Osteoarthritis: one of the most common types of arthritis caused by wear and tear of the bones in the joints.
• Tendonitis: consists of inflammation of the tendons, caused mainly by overuse and performing activities with incorrect technique.

Differences between TENS and EMS: Which is better for treating carpal tunnel?

Electrotherapy is one of the best options for treating pain caused by disorders such as carpal tunnel syndrome. However, it is necessary to make the distinction between the different electrotherapy modalities, as they are not all intended for the same purposes.

In the case of physical therapy, the most commonly used electrotherapy modalities are Transcutaneous Electrical Nerve Stimulation (TENS) and Electrical Muscle Stimulation (EMS).

TENS (Transcutaneous Electrical Nerve Stimulation) is a physiotherapeutic technique focused on the treatment of pain resulting from injury, trauma or disease. It is distinguishable by very specific characteristics, among which we can highlight:

• It interacts directly on the nerve branches of the median nerve, in order to mitigate the sensation of pain caused by pressure on it.
• It uses low frequency and intensity electric currents, which vary between 1 and 250 Hz.
• It is intended as a method to alleviate the symptoms of injuries and painful disorders, it is not a method to cure the origin of these symptoms.
• It is a widespread and versatile technique in the field of physiotherapy.

In contrast, EMS (Electrical Muscle Stimulation) is defined less as a therapy and more as a low-impact fitness method, which is easily distinguished from TENS therapy by the following properties:

• It applies electric shocks of higher intensity than TENS, between 70 and 150 Hz.
• It interacts with the muscle tissue by means of contractions of different intensity.
• It can indirectly affect the nerves due to the intensity of the contractions.
• It is a widely used method to develop the musculature with minimal impact on the joints.

The optimal treatment for wrist pain caused by carpal tunnel syndrome is Transcutaneous Electrical Nerve Stimulation (TENS), thanks to its numbing effect on the radial nerve and sensory branches of the median nerve, coupled with its ability to relax the fibrous tissue of the wrist, i.e., cartilage and ligament.

On the other hand, EMS therapy has a very limited effect on the wrist area because this modality interacts with muscle tissue, which is very scarce in this joint. In addition, the minimum frequencies of EMS devices are too high for the amount of fibrous tissue in the wrist, so their use can overstimulate this tissue and cause considerable pain in the joint.

Contraindications in the use of electrodes and electrotherapy