Given that TENS stimulates superficial sensory nerves and essentially serves as
a nervous system distraction from pain, I don’t see how it would be harmful as
long as the imaging- x rays/MRI of the knee are clear. When applying TENS it’s
important to recognize its greatest power comes from distraction & placebo
effect- encourage your patient to switch up the settings often and sell it as a
super helpful device for some people.
Best wishes to all here,
Heidi
Sent from my iPhone
On May 3, 2022, at 5:39 PM, Squarize, Fabiana L
<Fabiana.Squarize@xxxxxxxxxxxxxxxx> wrote:
Hi Shai,
She has a PMH of remote RCC (nephrectomy 1978), CVA (1988 with residual
cog/memory impairment and mild right hemiparesis), COPD, myelofibrosis
syndrome (2019), and arthritic changes to B knees.
She was diagnosed with Multiple Myeloma after she presented to the hospital
for a fall work up and pathological L femur fracture. She underwent
hemiarthroplasty and was transferred to inpatient rehab. Plans to follow up
with hematologist for MM management after her rehab stay and functional
status progression.
She reports baseline knee pain, but able to ambulate at home. We have been
limited in her ability to tolerate wt bearing due to knee pain. No known
lytic lesion to B knees at this point.
She is currently under the care of the physiatrist as she is at rehab. But
maybe we can reach out to palliative care to seek other options.
Thank you in advance for your expertise
Fabiana Squarize, PT, DPT
Oncology Clinical Specialist
Carolinas Rehabilitation- Charlotte
1100 Blythe Boulevard
Charlotte, North Carolina 28203
PT Department: 704-355-4461
Halo: 704-446-8938
Fax: 704-355-1858
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From: aptaoncology-bounce@xxxxxxxxxxxxx <aptaoncology-bounce@xxxxxxxxxxxxx>
on behalf of Shai <ssewell1989@xxxxxxxxx>
Sent: Tuesday, May 3, 2022 4:00 PM
To: aptaoncology@xxxxxxxxxxxxx <aptaoncology@xxxxxxxxxxxxx>
Subject: [aptaoncology] Re: TENS and liquid Cancer
WARNING: This email originated from outside of Atrium Health
(aptaoncology-bounce@xxxxxxxxxxxxx).
Do not click links or open attachments unless you recognize the sender and
are expecting the message. Never provide your password to anyone.
Can you give us a little more on her history? Is this chronic knee pain due
to OA? Due to a met? By inpatient due you mean acute or inpatient rehab? Is
she getting any chemo/cancer related treatment or has she already gone
through some?
Maltser et al (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5627359/) discuss
precautions for malignancies. Unfortunately it does not directly review
hematological malignancies as it relates to TENS. It does say that active
tumor should not have TENS placed over it but again this does not relate
specifically to hematological malignancies.
I ask for the history because if for instance this is during transplant and
she has a history of knee OA, maybe this could be helpful. If this is due to
bony metastasis, maybe less so.
I would say getting palliative care on board or a physiatrist who specialized
in cancer care due to the chronicity of the issue may be very helpful (if
either are accessible). Unfortunately MM patients tend to have lots of bony
pain in general due to the nature of their disease.
Hope my ambiguity was somewhat helpful.
Shai Sewell
On May 3, 2022, at 15:07, Squarize, Fabiana L
<Fabiana.Squarize@xxxxxxxxxxxxxxxx> wrote:
Hi all,
Hope all is well.
Has anyone used TENS on patients with Multiple Myeloma? I have a pt with
chronic knee pain limiting functional progression during her inpatient rehab
stay. We have failed other modalities and I was not able to find a lot of
evidence on TENs and liquid cancers.
Would appreciate any feedback and or possible articles to support using or
not using it.
Thank you,
Fabiana Squarize, PT, DPT
Oncology Clinical Specialist
Carolinas Rehabilitation- Charlotte
1100 Blythe Boulevard
Charlotte, North Carolina 28203
PT Department: 704-355-4461
Halo: 704-446-8938
Fax: 704-355-1858
Questions about COVID-19?
Learn how you can help
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