What are common indicators of adequate analgesia with TENS and when would you adjust therapy?

• A. Increase in pain scores and decreased function
• B. Notable reduction in pain ratings (e.g., ≥30% on a VAS) and improved function; adjust if relief wanes, if skin tolerates, or if current settings plateau
• C. No change in pain but improved mood
• D. Pain completely eliminated; never adjust

Answer: (B)

The key idea is that adequate analgesia from TENS shows a meaningful, real-world improvement in the patient’s experience and function. A common and practical benchmark is a notable reduction in pain intensity on a standard scale—about 30% or more—paired with improved function. When a patient can move more comfortably, sleep better, or participate in activities with less pain, that combination indicates the therapy is working.

You would consider adjusting the therapy when relief starts to wane (tachyphylaxis or diminishing benefit), when the patient’s pain returns or adapts over time, or when the response plateaus and additional relief is desired. Adjustments might involve changing how long you treat, the intensity, the pulse width, frequency, or electrode placement, and you’d also check for skin tolerance or irritation so the treatment remains safe and comfortable.

Notes about other scenarios: simply mood improvement without a clear reduction in pain doesn’t confirm adequate analgesia, and expecting total pain elimination with no need to adjust is not realistic; even with good relief, ongoing evaluation and occasional adjustment help maintain benefit.