Cancer Treatment Today

The Rebuilder Neuropathy Treatment System is primarily a TENS unit, except that it adds an EMS signal to passively exercise the calf muscles to stimulate the venous muscle pump to increase local blood flow. Transcutaneous electrical nerve stimulation (TENS) uses a battery operated device that applies electrical stimulation at the site of the pain by wired electrodes that are taped to the surface of the skin. TENS can also be delivered by a form-fitting conductive garment (i.e., a garment with conductive fibers which are separated from the patients’ skin by layers of fabric) and is used when a condition exists that precludes conventional TENS electrode placement. TENS has been used to relieve pain related to musculoskeletal conditions, or pain associated with active or post trauma injury. Percutaneous electrical nerve stimulation (PENS) is similar in concept to TENS, but differs in that needle electrodes are implanted just beneath the skin instead of being taped to the surface of the skin. There are many published reports regarding the use of TENS (1-12) and PENS (13-21) for various types of conditions such as low back pain (LBP), myofascial and arthritic pain, sympathetically mediated pain, neurogenic pain, visceral pain, diabetic neuropathy and postsurgical pain. While randomized trials have focused on both TENS and PENS, all of the studies have methodologic flaws limiting interpretation, including adequate blinding, drop outs, stimulation variables and outcome measures. It is guideline recommended for post-stroke rehab. However, it is recognized that both TENS and PENS are widely accepted in the physician community as a treatment of a variety of etiologies of pain, including chemotherapy induced neuropathy, and it is so stated by reviews and guidelines.

There advantages for either buying or leasing TENS. I was able to find one discussion of the issue in Fauser PE. TENS: for lease or sale?Phys Ther. 1989 Apr;69(4):299. It is not expected that TENS use is long-term and leasing the unit or using it in an outpatient PT facility appears more appropriate than third party covered purchase.

Brosseau L, Wells GA, Finestone HM, Egan M, Dubouloz CJ, Graham I, Casimiro L, Robinson VA, Bilodeau M, McGowan J. Clinical practice guidelines for transcutaneous electrical nerve stimulation (TENS). Top Stroke Rehabil 2006 Spring;13(2):61-3.

Carroll D, Moore RA, McQuay HJ, et al. Transcutaneous electrical nerve stimulation (TENS) for chronic pain (Cochrane Review). In: The Cochrane Library, Issue 3, 2002. Oxford: Update Software.

Putting Evidence Into Practice®: Evidence-Based Interventions for Chemotherapy-Induced Peripheral Neuropathy, Journal Clinical Journal of Oncology Nursing
Pages 901-913
Online Date Thursday, December 06, 2007

B. Laird, L. Colvin, M. Fallon Management of Cancer Pain: Basic Principles and Neuropathic Cancer Pain European Journal of Cancer, Volume 44, Issue 8, Pages 1078-1082, 2008