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TENS For Pain Relief

I bit the bullet and bought a high-end TENS/EMS (transcutaneous electrical nerve stimulation/electrical muscle stimulation) unit for dealing with my chronic buttock pain that was occasionally blinding and I was immediately glad that I did.

The pandemic had cut me off from my usual pain antidote, which is professional massage. Bill had heroically been tackling the knots in my buttocks for months by bearing down on his bent elbow to apply maximal force to the irritated muscles and I’d migrated to smaller and harder balls for my own myofascial release of the same muscles. My tissues were definitely healthier when measured by the decreased number of lumps, bumps, and densities but my capacity to hike was still compromised by pain and dysfunction. And, inexplicably, the number of intense pain episodes I experienced suddenly skyrocketed.

Quite out of the blue, I had an “over the top” pain episode with my chronically irritated buttock muscles (Gluteus medius) only days after a similarly intense event with the Serratus anterior muscle on the same side. The Serratus is a shoulder muscle and I believe its acute distress was a one-off triggered by exaggerated breathing in response to having smoke-induced asthma on a hard hike at 10,000’. I was horrified that my body had so little resilience, that it couldn’t tolerate using deeper breathing and more intense arm pumping for 2 miles without a tantrum, but a tantrum it had. As expected, it was all but gone 3 days later after considerable release work from Bill.

Two extraordinary pain events in a week terrified me. I was concerned that my pain threshold had suddenly diminished and that this level of pain would become ordinary for me. My new antihypertensive drug came to mind as a culprit but nothing in the patient leaflet supported the theory that it could be causal. The pain intensity matched the pain I experienced with shingles last fall but it had a different quality. Regardless, two immobilizing episodes of muscle pain was two too many and I was determined to fortify my arsenal for immediately combatting future pain episodes.

What I Learned in 24 Hours
..It’s a “trial & error” process to discover where you need to put the treatment pads, what settings to use, and for how long.
..It definitely worked for muting my pain but didn’t initially improve the underlying problem, whatever it was.
..I was glad I bought-up for a wireless model because it was easier to use.
..I won’t ever be without one again.

Subtle But Real Effect
It was hard to answer Bill’s question “Is it helping?” “I think so” was the best I could do after my first 30 minute session with the TENS unit but I was drawn to treat a second area that same evening. The next day, on return from a hike, I could more precisely assess and verbalize the benefit. After I struggled up the 3 steps into our trailer because of buttock pain and stiffness, I slapped the 2 large patches on my butt and cranked-up the TENS unit to deliver its electrical stimulation. I slumped on my side so as not to sit on the patches, supported my heavy head with a pillow, and closed my eyes in pain. After 6 minutes, when Bill asked if I was feeling better, I could say “Yes.” A couple of minutes later, I spontaneously opened my eyes and held my head up. The brain fog and energy suppressing effect of the pain was receding. I still had pain in my butt, but I was again more than my pain. I was able to eat my late lunch and organize for a quick marketing trip. Two hours later, I slapped the TENS pads on again to interrupt the crescendoing pain. The TENS treatments were definitely controlling my pain but I was needing frequent sessions to do so.

At 48 Hours
The next morning, my usual limp and achiness upon arising were all but gone. It was surprising because I’d ended the day before in a draw, I’d barely kept the pain at bay. I did a light round of exercises to assess and gently treat latent muscle spasms and my buttock and leg muscles felt unusually healthy. I noticed that my now-typical pattern of tightness in my back muscles was gone. I felt cautiously optimistic that I could do the planned 4 mile hike with 1,300’ of gain on difficult footing. I took my new TENS unit with me to treat muscle spasms on the trail if they flattened me. Quite unexpectedly, my glute muscles were the quietest they’d been on a hike in months.

Back at the trailer, I was able to exit the truck and walk to the door with only a slight limp. Once inside, I puttered doing chores to give the muscles time to reorganize on their own in the presence of gentle movement. After 15 minutes, I decided that I was doing well enough to skip a TENS session and instead elected to do gentle, symmetrical, post-exercise movements to give control back to my body. I was stunned: I’d used 7-8 TENS/EMS treatments in the first 24 hours to subdue very distracting pain and then on this, the following day, I could again manage without that electrical stimulation intervention at all. Clearly, the prior treatments aided in healing when I initially only sensed pain control.

I hope not to be a chronic pain sufferer. I don’t use pain pills and I hope not to become dependent on electrical stimulation treatments to my muscles to live comfortably. I hope that using the TENS unit to control my pain is one of the unfortunate, temporary, aspects of adapting to the pandemic. I hope that once we get the vaccine, once we get our lives back, that professional massages several times a year will result in this type of muscle pain being a thing of the past for me.

Weighing a little less than 7 oz, which is about an ounce less than my phone with a case on it, my TENS unit will go everywhere with me if I am having bouts of pain. It will find a place in my suitcase and panniers when cyclotouring and in my packs, whether backpacking or day hiking.

In late August 2020, I bought the iReliev Premium TENS + EMS Therapeutic Wearable System #ET5050. Regularly $249.95, it was on (permanent?) sale for $179.95, and I received a 10% discount on that price. I received free shipping from Their product is latex free.

TENS units should not be used by people with certain cardiac conditions.
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TENS in white, massage gun in black, & hand tool in jade green.

Massage Gun
What & Why
Months ago, a new online friend commented that she used a Hypervolt massage gun for her intractable muscle pain and I finally decided to buy a similar product, though this was the first I’d heard of them. I was stepping-up my effort to do everything possible to fix this buttock problem or at least, control the pain. There was a dizzying assortment of products to sift through and I truncated the process after reading that Amazon alone sold 2000 different massage guns. These devices deliver deep, pinpoint, percussion-type of massage, as opposed to traditional Swedish massage which involves repeated stroking with varying amounts of pressure from the hands. To me, the effect is very similar to the myofascial release work I’d been doing with moderately hard balls for almost 6 years but much faster.

I bought a high-end TENS/EMS unit and a low end massage gun because, with the TENS unit, I could see what I was getting for the extra money and I could not see much difference between massage guns with the increasing price. Also, unlike the TENS market, the competition between massage guns had exploded. Pushing the price and the noise level down looked like the hot marketing edges when I bought the massage gun and I appreciated the range of resulting options.

The First 24 Hours
I LOVED this thing! And Bill LOVED it too. Where had this been all of our lives? Like the TENS, we’d never be without it again. The massage gun arrived about 2 hours before bedtime 3 days after receiving the TENS unit. Fortunately, it was fully charged, so we could use it right away.

I was in pain. I’d been holding-off on using the TENS on my irritated buttock muscles for about 48 hours, hoping my body was ready to heal itself. In addition, resuming hiking after a 10 day hiatus because of wildfire smoke and driving days, had nearly crippled me with quad and calf pain. There were more muscles in spasm than Bill could possibly deal with until he was armed with our new massage gun. Suddenly, he was the master healer!

This puppy was fast. Bill could go deeply into my sore muscles and cover a lot of territory in a hurry, which was exactly what I needed. My entire lower body ached. Pounding force is a big marketing point with these devices and I could only tolerate Level 1 of 5, 20 Hz. Bill thought that as my muscles recovered, I’d probably advance to Level 2, but that would be it. Years ago, one of our massage people admonished me to never let anyone who worked on ‘dense bodies’ touch me because they might do more damage than good. With thought, I concluded that ‘dense bodies’ must be athletes like football players. I am clearly at the other end of the tissue spectrum from dense. It must be the dense body crowd that covets the high-end, monster pile drivers for their muscles—devices that I didn’t need.

In the first 24 hours with the massage gun, as hoped, I gained new insight, a possible new hypothesis for my chronic buttock pain in the Gluteus medius. Bill was whaling on my outer hamstring (Biceps femoris) and found a very deep, extremely painful density. We agreed that it was out of reach from his elbow therapy and from my myofascial release work using a hard ball. I’d become acutely aware that since my work is always done lying down on the ball, I didn’t have the same access to tissues as when face up. Anyway…I’d always wondered if the persistently painful buttock muscles might not be the origin of my problems but rather that they were “victims” of tugging from elsewhere. Time would tell, but it was wonderful to have a new modality to aid in exploring, in answering my questions. This hamstring knot was a promising culprit.

Bill tested the gun on an issue in his traps and on his arthritic hands. He lacks the exuberant recklessness that I have with new toys like this for his body, but he was looking forward to using it on some of his old problem areas. He’d likely be using Level 2 on the big muscles in his legs.

My product came with 5 attachments, with 4 or 5 attachments being the norm with these guns. It was easy to decide that the spherical attachment was the safe way to start. The flat disc looked great for thin, flat muscles like the Serratus anterior and the 3 pointed attachments looked like good ways to hurt myself. There would be time to experiment with those later but the ball looked like the go-to attachment for me: penetrating but easy to maneuver.

I was a bit put-off by the weight of the unit but Bill liked it. He felt that the extra heft added to the therapeutic effect without him needing to work harder. He was kneeling above me, so the weight wasn’t tiring for him. I was in more awkward positions when using it myself, so the weight could be tiring for me. However, I used it for 30 minutes in one session on the first full day of ownership without trouble.

At 2 ¼ pounds, this massage gun will strictly be used at home, either in our apartment or trailer. It’s too heavy, too bulky to win a coveted position in our traveling gear. And it is rated as light weight in the range of what’s available. Down the road, I might purchase a cute little number marketed to us girls (in a light rose tone like Apple’s gold cases): at a little over a half pound and $55, it is tempting.

LifePro Sonic from Amazon. Was $129.99, now regularly $119.99 but with a $10 discount coupon and taxes, it was about $116. I saw a Theragun product for $600.

Hand Tool For Massage
I actually started on the cheap with my new pain-relief tools by first buying a Deep Tissue Massage Tool for $6. It does exactly what I wanted: it allowed Bill to do deeper massage on me without hurting his vulnerable hands, especially his thumbs. We discovered that it was especially effective (easy for him to use, deep work for me to recieve) on the low back muscle Quadratus lumborum, called QL, by many. It was also the perfect tool for working on his tibula-fibular joint below the knee that he injured several years ago and still requires regular care.

The Deep Tissue Massage Tool is a great, tiny tool that weighs under 3 oz. I carry with me on the trail to calm irritated muscles. I can hold it on the upper edge of the Gluteus medius (buttock) with one hand and let the weight of my moving pack gently massage the muscle with a limited effect. The massage gun can run circles around this hand tool for what it can do, but I can carry this one in a pocket.

Two Weeks On
After 2 weeks, we still loved our new pain abatement tools, especially the electrical ones that did all of the work for us! We were pleased to have both devices. If you are only going to buy 1, I’d recommend the massage gun IF you have a helper to assist with the back side of your body; if no one is handy to help you, the TENS is a better choice because it can be managed alone. The TENS is likely a better choice if you have chronic pain from a source that you do not expect to ever heal; the massage gun is probably most useful for reversible muscle conditions.

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My new mini-massage gun next to the big guy.

At the 2 week point, I learned a potent new trick, which was to use my old standby, a 5” massage ball, to survey the knots and densities in my chronically painful buttock, especially immediately after a bike ride or hike. We’d been “peeling the onion” for months and so the more superficial muscles were soft and healthy. When I laid on the floor with my feet on a chair and placed the massage ball under my buttock, I could instantly find the tiny bits of ropey muscles causing the current distress, areas which also had been unyielding densities during my years of self-treatment. I held my finger on the culprit to mark it and Bill then tackled it with the massage gun. Interestingly, the ropey bit of muscle was imperceivable to either of us while he applied the percussive forces even though it was a clear “bump in the road” when I rolled it over the ball.

What was most tender under the massage gun head were the attachments, the ligaments, that bind this Quadratus femoris muscle to the bone. We knew that attachments typically are sore because the muscle itself is short, tight, or in spasm. Usually treating the muscle is sufficient: if you can interrupt the tugging on the attachments by the irritated muscle, the attachments will stop hurting. It was soothing to me and easy for Bill to do both the muscle itself and the attachments, so that’s what he did. Given this muscle attaches on the sit bone, I could not have done the treatment myself with the massage gun.

Bill spent about 10 minutes using the massage gun on both the tender attachments and the sometimes imperceivable, ropey muscle. When he stopped, I returned to the massage ball and discovered that the ropiness of the muscle was completely gone. He could easily go on a massive attack of all of the buttock muscles to make me more comfortable, but using the massage ball as a diagnostic tool allowed us to be much more targeted and more effective with the massage gun, saving us both time.

A knowledgable person using their hands can ‘read’ the muscles and, with experience, anticipate which other muscles might be collaborators in the pain cycle. With the pandemic, we lost access to those folks and this “search” with the massage ball and “destroy” with the massage gun was the best substitute available, though not nearly as refined as a professional. In comparison with trained hands, both the TENS and massage gun were blunt treatment instruments but they allowed me to obtain the relief I had desperately longed for for months.

About a week after the above assessment, my impulse buy, the $55 women's massage gun, arrived (in silver, not Apple's rose tone). This mini version saved the day less than 24 hours later when we returned from a big hike and I was barely able to walk. My buttock muscles were still an issue but, in addition, I had a bizarre, shrapnel-like, sharp pain in my ankle during part of every step with that foot. I went after the ankle muscles and associated connective tissue with the mini gun, already having learned that the big guy was too bulky and intense to work on finer tissues over bone.

This mini-massage gun was ideal! I could calibrate the pressure and intensity perfectly because it was lower powered, light wieght, and small. I worked on the target tissues several times that evening and the next morning and then enjoyed my 6 mile hike on rough terrain without a hint of the previous pain. It was clearly the right tool for the job.

We will continue to use the standard-sized massage gun for the big muscle groups, like the legs and buttocks. The mini will be our go-to tool for boney areas like ankles, forearms, and hands. If you have a lean body and only want to buy one gun, I'd recommend a mini because it packs enough power for my large muscle groups as well.