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Can TENS Therapy identify damaged Peroneal nerve

Foot drop, EMG shows functionality in peroneal nerve and EHL. TENS when used on nerves shows inactivity.

Doreen Agyemang

1 month ago

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Prof Tim Watson
Prof Tim Watson

Agree with Ethne - so no need to repeat what she has included. It could be useful to 'teat' (in a somewhat cruse fashion) a nerve conduction using a TENS device - in that TENS operates by stimulating an intact nerve. If the nerve is damaged and therefore not conducting, there will be no sensation when locally stimulated with a TENS device. If you employ an NMES stimulator, you would expect to achieve a motor response - this stim is also stimulating the nerve, not the muscle directly. If you try NMES and fail to get a muscle response, it may be that the nerve is not functioning. As I say, these are really crude (not sophisticated) ways of testing a nerve - but play the same principle as a nerve conduction test or a strength duration curve - which will give you better quality information

Dr Ethne Nussbaum
Dr Ethne Nussbaum

Dear Doreen The current settings you are using may be the problem. Generally, we refer to TENS when using short duration pulses and NMES when using pulses around 300 microsecs and frequency around 50HZ (lower if dealing with rapid muscle fatigue in response to stimulation and higher in cases of athletes where strength is a priority). In contrast, you might use TENS at non-tetanizing rates for pain relief (3-5 Hz) or Conventional TENS at higher rates also for pain relief (80-100 HZ) but lower amplitude and for both TENS types pulse duration 100-250 microsecs. Even when using TENS, if you use enough amplitude you should see at least a muscle twitch. Given that the patient has an obvious foot drop, I suggest you position the muscle in its mid-length to facilitate activation (foot supported in neutral dorsiflexion). One last thought, if too few motor units are intact you may be able to see or feel activity at the peroneal and EHL tendons without enough response for active ROM. Hope all this helps your thinking. Ethne

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