Question
I HAVE A FRIEND WHO HAS BEEN HAVING PROBLEMS WITH CHEST PAINS (NOT HEART RELATED!!  PULLED MUSCLE) AND HE HAS BEEN USING HIS TENS UNIT ACROSS THE CHEST WALL.  I HAD READ ONLINE THAT THIS WAS UNSAFE AS IT COULD STOP THE HEART, AND ALSO FROM MANY OTHERS, THAT THEY DO IT WITH NO ILL EFFECTS AND ARE INSTRUCATED TO DO SO.  COULD I HAVE YOUR OPINION ON THIS?  IS IT SAFE, AND IF SO, IS THERE A PROPER AND IMPROPER WAY HE SHOULD BE DOING THIS?  THANK YOU!!

Answer
Dear Krystie,

I was taught in school that utilization of a TENS unit superficially across the front of the chest wall is okay due to the fact that the current doesn't penetrate deep enough to effect cardiac activity.  However, this is only to be used for a superficial muscle pull or strain sprain type of injury only, and realize no medical device is without potential side effects or complications.

Having said that, I need to stress that if there is any indication of a heart abnormality at all, that the device should NOT be used over the chest cavity.  Even a heart murmur would disqualify usage of the TENS on the anterior or posterior chest wall.  Pacemaker, arrhythmia, valve problem, etc...no TENS.

Now, pad placement is key as well...the pads should NOT be placed from to back so that current goes through the chest, and they should NOT be placed on the front and the side of the chest either.  This could lead to electrical current flowing deep through the tissue rather than superficially, and this could end in disruptive electrical currents to the heart.  You should also NOT use TENS on the front of the neck.

I can tell you this, be careful with the device...they can actually generate enough current to cause electrocution.  Read the directions of the unit...often they have different strengths from one to the next concerning intensity levels, frequency, rate, amplitude etc...  Make sure that you have read what the manufacturer says about the product.  If it says do not use on the anterior chest wall, then don't do it.

Hope this helps Krystie.

Respectfully,
Dr. J. Shawn Leatherman
www.suncoasthealthcare.net