TENs placment for IC: help with urgency and frequency
We have talked about how to use TENS for IC before. As a reminder, TENS stands for Transcutaneous Electrical Nerve Stimulation. It has predominately been used for treating nerve-related acute or chronic pain. But there is another condition that TENs has been proven to be effective for. And if your IC has you running to pee every 5 mins, you’ll be very interested in reading further.
First, a little medical background. The lumbar-sacral nerves control the bladder detrusor muscles and the perineal floor. This group of nerves, sometimes referred to as the sacral plexus, occupy the spinal cord at levels L4 to S3 which are located towards the base of your spine, between your lower back and, well, your butt crack.
In fact, that same collection of nerves is often targeted by Neuromodulation therapy sacral implants like InterStim. You may have read about these implantable devices since they have been one of the options for treating IC for many years. A major downside of these Neuromodulating implants is that it is highly invasive. Once a patient is deemed to be a “responder” via a test stimulation, the unit is surgically implanted while you are under general anesthesia.
Luckily there is another option for impacting the lumbar-sacral nerves that control your bladder and pelvic floor function. The posterior tibial nerve —the nerve that runs along the inside of your ankle and up your leg— provides access to the sacral plexus.
How? Although the posterior tibial nerve is located in leg, near the ankle, it is derived from the lumbar-sacral nerve group. Stimulating the posterior tibial nerve will also stimulate those L4-S3 nerves we are most interested in.
Anviteri [CC BY-SA 3.0], from Wikimedia Commons
This manipulation of the posterior tibial nerve for the purpose of affecting the bladder and pelvic floor is not a new technique. Percutaneous Tibial Nerve Stimulation (PTNS) has been studied for years and it has shown effectiveness at treating both constipation and voiding dysfunction (e.g. urinary frequency, urgency, and incontinence).
In PTNS a needle electrode is inserted near the tibial nerve right above the ankle bone (the malleolus) on the inside of the leg. Another electrode patch is then applied near the arch of the same foot. A stimulator is then connected to the electrode and sends electrical pulses to the tibial nerve. These impulses travel up the tibial nerve to the sacral nerve plexus, our main target for controlling bladder function.
photo credit: Simon Foundation
The problem with PTNS is that it is invasive…a needle electrode is used. It’s kind of like electronic-accupuncture. You also need a prescription to get one of the PTNS units and supplies.
Which brings us to the point of this article. Transcutaneous is the “T” in TENS. Yes, the TENS units we have talked about before and that you can buy on Amazon.
This is good news because it means you can also target the posterior tibial nerve without a needle electrode by using a simple over-the-counter TENS unit and the electrode pads that come with it. Early research has found some promising results with this non-invasive approach to treating urinary urgency, frequency, and incontinence. It will be interesting to see when this is tested in a population diagnosed with IC
credit: Asian Journal of Urology
By placing the electrode pads in a similar location to where the needle and electrode pad are placed during PTNs, you can get the same tibial nerve —and thus lumbar-sacral nerve— stimulation.
The typical treatment duration used in the studies that have looked at percutaneous TENs and transcutaneous TENS is 12 weeks of a weekly 30-minute treatment session. After the initial treatment period of 12 weeks, occasional intermittent treatments may be needed to sustain control of symptoms. You know you’ve got the right spot when your big toe fans up and you feel a pins-and-needles sensation in your foot.
So, if the urgency and frequency of IC are driving you crazy, maybe you should look into a TENs unit and give it a try. Though these studies involving Percutaneous TENs and transcutaneous TENS weren’t specifically looking at Interstitial Cystitis symptoms, it seems like it could help you control your disease.
There is a lot of info available online to dig through. Do your research and decide for yourself if you think it is worth your time and effort to try. And please, please, please, run it by your doctor to get cleared for TENS therapy. Not everyone is okay to use neuromodulation so though you can buy a unit online, you should make sure that you are good-to-go to experiment..
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**Disclaimer: NO information on this site should be used to diagnose, treat, prevent or cure any disease or condition. See more information here By reading this website, you acknowledge that you are responsible for your own health decisions. Do not take anything from any website, including this one, and try it without proper research and medical supervision.
