Sunday, February 08, 2009

TENS and cesarean recovery

I checked out physical therapist Elizabeth Noble's Essential Exercises for the Childbearing Year last month. She wrote about using TENS for post-cesarean pain relief (p. 203):
TENS (Transcutaenous Electrical Nerve Stimulation)
This physical therapy modality works on the same principle as scratching an itch. Another message gets to your brain before the pain, traveling over nerves with faster transmission speed. Electrodes are taped above and below your incision. These electrodes are then connected to a hand-held unit with adjustable controls. You can choose the type and speed of electrical current to meet your needs. Patients who use TENS after any kind of abdominal surgery require less or no pain medication, an important advantage to breastfeeding mothers. The stimulation also reduces the incidence of paralytic ileus (intestinal distention and symptoms of obstruction). I also believe it helps to prevent the formation of a dead zone around the scar. A dead zone occurs from pain, disuse, and the mother’s reluctance to examine or palpate this area. The tissues are like dough, many women feel “cut off” from that part of the body, and nerves to the skin may indeed be injured and take many months to recover.
Another (older) book also mentioned TENS for post-cesarean recovery and pain relief. In Adrienne B. Lieberman's Easing Labor Pain, she wrote:
Transcutaneous electrical nerve stimulation (TENS), occasionally used to alleviate labor pain, also offers many benefits to the woman who is recovering from a cesarean delivery. Russsel Foley, TENS expert, comments, “Taking patients’ pain away with TENS gives them better mobility, and that’s important because the most traumatic thing to the body after an operation is immobilization. The longer a person is immobilized, the harder it is to recover.”

Using TENS can mean you’ll need fewer narcotic painkillers after your surgery. Indeed, a study published in Physical Therapy in 1986 showed that women who used TENS following cesarean birth used significantly less Demerol for pain relief. Narcotics such as Demerol, says Russel Foley, “suppress gastrointestinal motility, change respiration, and alter heart rate. If you remove the need for medication by using TENS, you can also remove the side effects of medications.”

If you use TENS for your post-cesarean recovery, the electrodes can be positioned immediately after suturing, and taped to your abdomen under the dressing. You’ll be taught to use the monitor in order to control the amount of electrical stimulation you receive. The monitor can be detached so that you can shower normally. TENS is usually used just for the first two post-cesarean days. (237)
A quick search about TENS and cesarean recovery led me to this small but promising study done last year in Iran: The Analgesic Effect of Transcutaneous Electrical Nerve Stimulation (TENS) on Caesarean Under Spinal Anaesthesia. The authors concluded that "TENS may be used as an effective, non invasive and non pharmacological approach for reducing post caesarian section pain with reduced use of analgesics. This might lead to better outcomes in pain control and facilitating development of bonding between mother and baby."

If you are planning to give birth in a hospital (or even if you aren't, in the event that you end up transferring), you might want to inquire beforehand about the availability of a TENS unit for either laboring or post-cesarean recovery. Ask the staff if they have ever used TENS for post-cesarean pain relief and if they would be willing to try it if you have a surgical birth.


  1. This is fantastic! I had a c-section with my first, and am now planning a VBAC, but it is good to know that there are other options available for recovery. This is going to be useful for me in the future.

  2. So do you suppose that the billing for the TENS treatment will be done by the minute to make up for lost revenue due to a decrease in pharma use? Call me cynical, but I'm a firm believer that one of the biggest reasons why the cesarean rate is so high is due to $$$. This is going to hit every hospital's bottom line very hard and I can almost guarantee you that in the near future we will see information from ACOG that denies TENS' efficacy.

    But that's just me...

  3. Thanks for including c-section info on your blog. I'm not even pregnant yet, but I already know that I will need a c-section due to previous uterine surgery. I am going to look into this option when the time comes.

  4. Oh, thanks for the heads up! That would have been so nice after my first, so interesting that it may help with the "dead zone!". (I hate that damn spot, feel like I'm going to accidentally cause damage because I can't feel anything around it)

    I'm planning an HBAC in october but in case things don't go as planned, I'll definitely be discussing this option with my midwife and backup!

  5. This sounds really interesting and I wish I had of known to do this with it after my c-section because i did have a TENS.

    But, I'd add that I can't even imagine what it would be like to stick those electrodes over the incision!

    the incision feels like it's going to open right up for ages afterwards, and the electrodes are SO sticky. When I was imagining how this would work, I was surprised to see that the electrodes go right over the incision.

    I gave a shudder imagining what it would be like to pull the sticker pads off!


  6. Erin, I don't think they go directly over the incision, but rather you'd tape 2 below and 2 above as Noble mentioned (usually there are 4 electrodes total, although I suppose that might vary).

  7. At my osteopathic medical school, they are doing research into using an osteopathic manipulation technique called myofascial release on cesarean scars. I will keep you up to date.

  8. Sounds very hopeful. I would also like to find out more about myoifascial release on my scars, they are certqinly dead zones and I do feel a fear and vulnerability in regards to accidentally hurting my belly.

    I am cynical about this being used in our hospitals, only for the reason that TENS machines are used in the UK at births routinely for the laboring mother yet here, almost never.

    I remember years ago when I was first trolling the 'net for "birth stories", especially homebirth stories, I would come up to the "TENS Machine" parts and was very confused ! : )

    It all sounds interesting. I never thought of why my abdomen was numb, or that it could have been prevented. Just thought it was part of the surgical experience :(

  9. The thing about TENS is that even though it can be very awesome, it can be hard to get approval for in hospitals. which I suppose is ok if you only plan on using it once you get home.

    But really this article was great!! I'm keeping it for later reference.

    I've had clients use TENS (as well as my dad for back pain) and I was so intrigued! it surely didn't take away pain in the way that meds do - but it obviously doesn't effect one in the way meds do! (which is awesome!)

    the only thing to consider if a person would do well with the TENS is if they have the ability to concentrate and take the time to work with it. it's not a pill one can simply pop and move on. it takes concentration and dedication to use it properly. which is why most unnatural minded birthing mamas just wouldn't work out for. but... again who that isn't natural minded would even consider it?

    I wish I had known this with my cesarean 9 years ago!! I still have residual muscle paralysis!

  10. I used TENS for a muscle tear, my doctor told me TENS wouldn't work and I would definitely need surgery. I was on progressively stronger pain meds for about six months. After 1 treatment I felt great. After 3 I forgot I was even hurt at all. I never had a c section, but if I ever do, definitely doing TENS.

  11. i bought the tens unit from this site →


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