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Rheumatoid arthritis is a chronic autoimmune disease where the body's immune system mistakenly begins attacking its healthy tissue and cell, especially within the joints. These changes can cause inflammation and damage the healthy surrounding tissue, leading to pain, swelling and stiffness. Rheumatoid arthritis can also affect other body parts, including the lungs, heart and eyes; symptoms will vary from person to person, depending on the severity of the condition. 

The Australian Institute of Health and Welfare reports that more than 450,000 Australians have rheumatoid arthritis [1]. Additionally, females are twice as likely to develop rheumatoid arthritis than males. These symptoms can lead to ongoing disability and reduced quality of life. 

There is no cure for rheumatoid arthritis, but specific treatments can help reduce pain and symptoms. Caremax has a range of products that can ease joint discomfort, which is the most common symptom of this condition.

 

How Does rheumatoid arthritis Happen?

Usually, a healthy immune system will help your body protect against foreign bodies, such as bacteria and viruses. In those with rheumatoid arthritis, the immune system will begin to attack healthy tissue, such as joints; cells in the immune system cause inflammation within the joints, which leads to swelling and pain. Over time, this can damage the cartilage and bone around the joints. Eventually, it can also lead to inflammation around the organs, including the heart and lungs.

Currently, the exact cause of rheumatoid arthritis is unknown. However, researchers suggest that there may be genetic and environmental factors (e.g. smoking, alcohol, etc.) that may trigger the condition [2]. Overall, this complex condition leads to long-term inflammation and damage within the body, particularly the joints.  

 

Range of Rheumatoid arthritis Symptoms

One of the main symptoms of rheumatoid arthritis is joint stiffness, pain and swelling in multiple joints, including the hands, knees and wrists [3]. 

However, other symptoms may also include:

  • Stiffness in the morning
  • Fatigue and tiredness
  • Accompanying fever
  • Weight loss
  • Weakness
  • Similar symptoms on both sides of the body

 

Common Type of Rheumatoid arthritis

The most common manifestation of rheumatoid arthritis is joint pain, swelling and stiffness around the hand, knees, and wrists. Less commonly, this condition may also lead to symptoms in other body areas, including the skin, eyes, lungs, heart, liver, and blood. You can read more about a large variety of symptoms associated with rheumatoid arthritis on the arthritis.org website.

 

Common Treatment Method for rheumatoid arthritis

The most common form of treatment is medication prescribed by your doctor. While there is no cure, medications such as anti-inflammatories and DMARDs can help relieve symptoms or slow down the condition's progression [3]. Other forms of treatment include weight control, education, exercise, physiotherapy and psychological support.

Electrophysiological devices, such as the TENS conductive knee brace, TENS conductive elbow brace and conventional TENS machines, are modern ways of providing safe, drug-free and effective pain relief [5][7]. For more information about treatment options, always consult your doctor beforehand. 

 

What is a TENS machine, and how can it help relieve rheumatoid arthritis?

A transcutaneous electrical nerve stimulation (TENS) machine is primarily used to alleviate joint pain and stiffness (which are the main symptoms of rheumatoid arthritis). Reducing these symptoms allows the user to become more mobile and active. 

The device transmits electrical pulses through the skin to decrease the activity of the nociceptors, which are responsible for allowing you to feel pain [6]. Let's compare this to a radio. If the signal volume is stronger, the sound becomes louder and more irritating. This is like pain; the greater the nociceptor activity, the more pain. The TENS machine acts like an audio volume adjuster by decreasing the volume of the nociceptors, reducing perceived pain. 

 

What's the best way to use a TENS machine for rheumatoid arthritis?

There are several factors to consider when using the TENS machine for rheumatoid arthritis, including:

  • Location of the gel pads
  • Appropriate settings before treatment, such as pulse width and frequency
  • Appropriate setting during the treatment, such as intensity
  • Duration of treatment

Each of these settings will be ideal, depending on your symptoms and presentation. However, this study showed that high-frequency treatment (>100Hz) was more effective for pain relief when compared to lower-frequency settings. Always speak to a relevant health professional before setting up the TENS.

 

  • Here are the best practices for using a TENS unit:

There are several practices and settings that you need to consider when using the TENS machine. Optimising these settings allows you to expect a more effective treatment for your rheumatoid arthritis. 

 

  • Position of electrode pads for rheumatoid arthritis

Rheumatoid arthritis affects everyone differently. While the knees, hands and wrists are common areas, this will vary from person to person. The placement of the TENS machine is typically above and below the joint that requires treatment [9]. These placement locations will be highlighted in the free guidebook that will accompany the TENS unit.

Those experiencing elbow and knee pain will no longer have to worry about placement as the TENS conductive knee brace and TENS conductive elbow brace will be able to receive treatment without needing to position the pads.

 

  • Conductive garments as an alternative to Electrode Pads 

Conductive garments are a great alternative to electrode pads. Instead of fixed gel pads, conductive garments can be worn over the affected joint area. After connecting it to the TENS machine, electrical impulses can be delivered across the location of the garment that is touching the skin. This avoids the need to place the gel pads around the affected joint accurately. 

 

  • Setting the TENS Mode for rheumatoid arthritis

Depending on the TENS machine that you purchase, there may be several modes on the device, including burst, acupuncture and conventional treatment. Every person may have a different reaction to the TENS mode. While conventional TENS is the most common setting, speak to your health professional about which setting may be appropriate for you. 

 

  • Setting the Pulse Rate (Frequency) for rheumatoid arthritis

The pulse rate for acute pain is between 80-120Hz. This will help provide stimulation to reduce pain across the treatment area [9] immediately. On the other hand, a pulse rate between 2-5Hz will help alleviate chronic pain by providing longer-lasting pain relief. You may have to try different settings or speak to a health professional about which setting is the most appropriate for your rheumatoid arthritis treatment. However, studies have used 10Hz to help alleviate rheumatoid arthritis pain [10]. 

 

  • Setting the Pulse Width for rheumatoid arthritis

More research needs to be conducted about which pulse width is effective for rheumatoid arthritis. You may have to try different settings to determine what is the most effective for you. However, research suggests that pulse width is not as crucial as pulse rate or intensity [9].

 

  • How Often Should You Use Your TENS Machine for rheumatoid arthritis?

Treatment time between 15-30 minutes with your TENS machine has shown to be effective for pain relief [9]. Research has shown that TENS treatment is clinically effective for increasing muscle power and reducing strength for as little as one session a week for three consecutive weeks [9]. There is generally no limit on how many sessions you can receive treatment from your TENS machine, as long as you are not experiencing side effects, such as tingling sensations or skin reactions. If you are unsure, please consult your local doctor.

 

Using Caremax TENS machine for Arthritis Pain Mangement


We provide a comprehensive packaging solution for Arthritis Pain Relief. Discover the most sought-after products below essential for effective TENS therapy treatment.

 Caremax 2.0 Classic TENS machine   Caremax 2.0 Pro TENS Machine

 

 

Where and when to not use TENS machines

Treatment from TENS machines (including TENS conductive knee brace and TENS conductive elbow brace) is generally well tolerated. As with most medical treatments, there are situations where TENS treatment is not recommended and may lead to side effects. However, this is generally not a common problem. Please avoid placing your TENS machine over sensitive areas, such as the genitals, eyes, mouth, carotid sinus or around the chest area. 

Those with the following conditions or situations have a higher risk of developing side effects and should consult their doctor before considering using TENS [10]:

  • If you have any electrical implants (e.g. pacemaker, cardioverter defibrillators, etc.)
  • Over damaged skin 
  • Over areas with reduced or no sensation/feeling
  • Around cancerous areas of over tumours
  • During pregnancy
  • Those with skin allergies or condition
  • Thrombosis
  • Haemmhorage
  • Experiencing an infection (e.g. osteomyelitis, tuberculosis, etc.)
  • Any cognitive impairments where consent cannot be provided
  • Anyone who has had a history of side effects after using a TENS and/or EMS machine
  • Over scar tissue or wounds
  • Other medical conditions which may not tolerate electrical impulses

 

Are there any risks of side effects when using a TENS Machine?

The most common effect after TENS machine treatment is skin irritation and changed sensation around the treatment area [12]:. Other side effects are generally uncommon and/or mild, including nausea, dizziness, muscle spasms and headaches. 

 

References

  1. https://www.aihw.gov.au/reports/chronic-musculoskeletal-conditions/musculoskeletal-conditions/contents/arthritis/rheumatoid-arthritis
  2. https://www.uptodate.com/contents/pathogenesis-of-rheumatoid-arthritis
  3. https://www.racgp.org.au/FSDEDEV/media/documents/Clinical%20Resources/Guidelines/Joint%20replacement/Algorithm-for-the-diagnosis-and-management-of-early-rheumatoid-arthritis.pdf
  4. https://www.arthritis.org/diseases/more-about/how-rheumatoid-arthritis-affects-more-than-joints
  1. Johnson, M. I., Paley, C. A., Jones, G., Mulvey, M. R., & Wittkopf, P. G. (2022). Efficacy and safety of transcutaneous electrical nerve stimulation (TENS) for acute and chronic pain in adults: A systematic review and meta-analysis of 381 studies (the meta-TENS study). BMJ open, 12(2), e051073.Teoli D, An J. Transcutaneous Electrical Nerve Stimulation. [Updated 2021 Aug 31]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-.
  1. Brosseau, L., Yonge, K., Marchand, S., Robinson, V., Wells, G., & Tugwell, P. (2002). Efficacy of transcutaneous electrical nerve stimulation (TENS) for rheumatoid arthritis: A systematic review. Physical therapy reviews, 7(4), 199-208.
  2. Gopalkrishnan, P., & Sluka, K. A. (2000). Effect of varying frequency, intensity, and pulse duration of transcutaneous electrical nerve stimulation on primary hyperalgesia in inflamed rats. Archives of physical medicine and rehabilitation, 81(7), 984-990.Watson, T. (2018). Transcutaneous electrical nerve stimulation (TENS). printed on, 1-17.
  3. Pelland, L., Brosseau, L., Casimiro, L., Welch, V., Tugwell, P., Wells, G. A., & Cochrane Musculoskeletal Group. (1996). Electrical stimulation for the treatment of rheumatoid arthritis. Cochrane Database of Systematic Reviews, 2010(7).
  4. Brosseau, L., Yonge, K. A., Welch, V., Marchand, S., Judd, M., Wells, G. A., ... & Cochrane Musculoskeletal Group. (1996). Transcutaneous electrical nerve stimulation (TENS) for the treatment of rheumatoid arthritis in the hand. Cochrane Database of Systematic Reviews, 2010(7).
  5. https://www.healthcare.uiowa.edu/marcom/uihc/pain_medicine/contraindication_precautions_best062018.pdf