Overactive bladder (OAB) can be a frustrating and disruptive condition, but there's growing interest in a simple, drug-free treatment option: TENS (transcutaneous electrical nerve stimulation). In this post, we explore how TENS works, why it may help reduce OAB symptoms, and how you can safely try it under the guidance of a pelvic health physiotherapist.
What is Overactive Bladder Syndrome?
Overactive bladder syndrome (OAB) is a condition that is characterised by 3 main symptoms:
- Urinary frequency: needing to go to the toilet to empty the bladder over 7 times per day
- Urinary urgency: having an increased urge to empty the bladder which can often happen very suddenly and cause someone to rush to the toilet
- +/- nocturia: needing to go to the toilet more than once per night
OAB can be further divided into 2 categories:
- OAB dry: no leakage
- OAB wet: leakage when rushing to the toilet
What is a TENS machine?
TENS stands for transcutaneous electrical nerve stimulation. It’s a device that transmits light electrical signals via sticky electrodes on the skin. The sensation is a light tingling or buzzing sensation on the skin.
For a long time TENS machines have been used to help with pain (such as Obstetric TENS machines for labour). However, there is some compelling research that TENS can be effective in helping relieve OAB symptoms.
How can a TENS machine help with OAB?
When using a TENS machine for OAB the electrodes are most commonly put on the inside of the ankle - where the posterior tibial nerve is. The posterior tibial nerve is at the same level of the spinal cord as the bladder. When the posterior tibial nerve is stimulated this may inhibit the bladder from spasming via neuromodulation. The way I think about it is like the brain is a child that can’t pay attention to 2 things at once. If you have stimulation from the bladder and stimulation from the tibial nerve happening at the same time - the brain can’t think about both so you feel the bladder sensation less. Overtime, the brain becomes used to this stimulation and is less aware of the sensation of the bladder.
Does it work?
The majority of studies that have assessed the effectiveness of TENS for OAB have been on the smaller side. However the data has shown that TENS is more effective than no active treatment for improving symptoms. There were no serious adverse effects associated with the treatment.
The International Consensus on Incontinence (basically the Bible for pelvic health physios!) recommends that TENS should be considered for women with OAB. However, larger studies should be run in the future to further identify the effectiveness of the treatment.
What I really like about TENS is that it is very straight-forward to use - you put it on for ~30 mins at least 3 times per week. You can watch TV, read a book - maybe even do your pelvic floor exercises whilst it’s on! For women who have tried other options without success, it’s definitely worth giving a try!
How can I try one?
It is best to see one of the Pelvic Health Physiotherapists at FitRight to get a proper diagnosis of OAB prior to consideration of a TENS machine. This involves doing a thorough assessment to determine if OAB is the correct diagnosis for you and address the multitude of other factors involved in this condition. Use of a TENS machine is a small component of the management of OAB - and we have to make sure it is safe for you to use.
