Vagus Nerve Stimulation (t-VNS) using TENS (non-invasive)

[Avengers26]

I have been reading on Vagus Nerve Stimulation using TENS. It's a non-invasive treatment. I have been searching on this website & also read the following articles -

http://www.cortjohnson.org/blog/2014/08/29/system-reset-reduce-fight-flight-response/

http://www.cortjohnson.org/blog/201...ng-fibromyalgia-with-vagus-nerve-stimulation/

I do have a TENS machine. This is the one I have -

http://www.amazon.com/Tens-Handheld...c&ie=UTF8&qid=1439587430&sr=1-4&keywords=tens

I learnt you can get the crocodile electro-stim ear clips from here -

http://www.tenspros.com/Electro-Stim-Ear-Clips-for-Depression-Anxiety-Pain-and-More_p_196.html

This is one study but it's for CAD patients -

http://www.ncbi.nlm.nih.gov/pubmed/?term=coronary artery vagus nerve stimulation ear

Abstract from another study -

http://www.brainstimjrnl.com/article/S1935-861X(14)00260-5/abstract

This has a picture with a clip on the ear -

http://www.sciencedaily.com/releases/2014/08/140819200211.htm

Another picture -

http://www.biomedcentral.com/1472-6882/12/255/figure/F2

Has any one done it yet? Did you find it useful? Pros & Cons? Any tips on what's the best way to do it.

 

[Mary]

@Avengers26 - this all looks very interesting but I would be afraid to be a guinea pig with something potentially so powerful ... I have a TENS unit too, for a shoulder problem. It's amazingly powerful for such a small thing which runs on a 9 volt battery. They use a TENS unit on my shoulder at PT - it feels sooo good, like a deep massage.

There was another post about stimulating the vagus nerve and I think Rheumatoid arthritis. It's all very interesting but a little scary to try on one's own. I'm good at educating myself about and trying supplements but this is different. I need to do more reading. I have a sister who has RA who could potentially benefit from this.,

Though I really have a hard time seeing how this would help with PEM, my chief problem, but I need to read your links more carefully, I just scanned it all quickly.

Keep us posted if you try it -

 

[Lou]

Post deleted.

 

[Avengers26]

@Mary When I read the 'comments' section in those links, a couple of people mentioned finding it very helpful. This could be another tool in the arsenal. I was trying to find out if any others had any experience with it. For the reasons you mentioned, I still am on the fence. If I come across more info, I will post it here.

 

[alkt]

tried a tens machine many years ago found it very difficult to get the right frequency and ended up making the pain in my neck (from arthritis) much worse fortunately only temporarily . so i think it might be better to try it out at a pain clinic with a person with a lot of experience using a tens device. many people did report that it was of some help.perhaps your gp can refer you to a local pain clinic.best wishes.

 

[Jonathan Edwards]

I have been reading on Vagus Nerve Stimulation using TENS. It's a non-invasive treatment. I have been searching on this website & also read the following articles -

http://www.cortjohnson.org/blog/2014/08/29/system-reset-reduce-fight-flight-response/

http://www.cortjohnson.org/blog/201...ng-fibromyalgia-with-vagus-nerve-stimulation/

I do have a TENS machine. This is the one I have -

http://www.amazon.com/Tens-Handheld...c&ie=UTF8&qid=1439587430&sr=1-4&keywords=tens

I learnt you can get the crocodile electro-stim ear clips from here -

http://www.tenspros.com/Electro-Stim-Ear-Clips-for-Depression-Anxiety-Pain-and-More_p_196.html

This is one study but it's for CAD patients -

http://www.ncbi.nlm.nih.gov/pubmed/?term=coronary artery vagus nerve stimulation ear

Abstract from another study -

http://www.brainstimjrnl.com/article/S1935-861X(14)00260-5/abstract

This has a picture with a clip on the ear -

http://www.sciencedaily.com/releases/2014/08/140819200211.htm

Another picture -

http://www.biomedcentral.com/1472-6882/12/255/figure/F2

Has any one done it yet? Did you find it useful? Pros & Cons? Any tips on what's the best way to do it.

Er, yes, but I don't think the vagus nerve goes to the ear!!!
This sounds like nonsense to me. TENS machines produce a tingly sensation, maybe through spinothalamic tract nerves, wherever you put them, and that seems to offset pain in various situations at least temporarily, but I don't think you can get at the vagus nerve through the earlobe.

 

[Sasha]

but I don't think you can get at the vagus nerve through the earlobe.

This is one of the many reasons we need you on the forum.

 

[maryb]

I know little about the vagus nerve other than there is a link for people who feel ill after evacuating their bowels, myself being one of them. I saw this after doing a quick search.

 

[Jonathan Edwards]

I know little about the vagus nerve other than there is a link for people who feel ill after evacuating their bowels, myself being one of them. I saw this after doing a quick search.

Well that's interesting. The diagram on the site about vagal nerve stimulation didn't have that branch. But it sounds as if it only innervates the auditory meatus. You would need to stick the TENS machine in your ear it seems - or at least clip it on the inside of the tragus.

 

[Avengers26]

@Jonathan Edwards That's what they did in the Leeds? study. Or, at least that's what it seemed to me. I will try to find the study & post more details later today. If I remember right, results were quite encouraging. Even the 2-3 people who have done it so far (per the "comments" in the links i posted) found it quite useful.

Also, I learnt that there are other ways to stimulate the vagus nerve. Eg. Some one posted that some studies showed that practicing breathing at 6 breaths per minute stimulates the vagus nerve. 4-7-8 breathing would be a good example of that. 3 days ago, I started doing a modified form of it, where I skip the 'hold' part which is for 7 seconds because it stimulates my SNS. I have been doing the 4 sec (inhale) & 8 sec (exhale) & it's been only 3 days @ 5 min/day, but I am liking it.

I haven't tried the t-VNS (on ear) yet.

Some one also mentioned that the upper part of the ear is innervated by the Trigeminal nerve & Trigeminal stimulation is studied for migraines and other headaches.

 

[maryb]

@Avengers26
Good tip on the breathing, its good for a number of things.

 

[Jonathan Edwards]

Also, I learnt that there are other ways to stimulate the vagus nerve. Eg. Some one posted that some studies showed that practicing breathing at 6 breaths per minute stimulates the vagus nerve.

Yes, but I have to say I am still pretty sceptical about this. It is important to remember that the vagus nerve is just a bundle that takes a particular route. It includes incoming and outgoing nerves that do all sorts of different jobs. So tickle your ear passage will affect certain types of input nerves and breathing will affect quite different nerves in your chest. Whether or not either of these have much to do with the outgoing nerves in the vagus that mediate heart rate etc goodness knows. And they may not be particularly good for that. One of the best ways to stimulate the vagus output nerves is the sight of blood - through the retina. Quite a few people collapse as a result of the vagal stimulation - through their eyes.

The other thing is that if you are stimulating nerve endings in the ear canal then you would probably do better to stimulate them physiologically through the receptors themselves - which you could probably do by twirling a cotton bud in your ear. Electrical stimulation makes sense if you are stimulating half way along a nerve but seems a bit like overkill if you are stimulating the sensory endings.

 

[2Cor.12:9]

The other thing is that if you are stimulating nerve endings in the ear canal then you would probably do better to stimulate them physiologically through the receptors themselves - which you could probably do by twirling a cotton bud in your ear. Electrical stimulation makes sense if you are stimulating half way along a nerve but seems a bit like overkill if you are stimulating the sensory endings.

I've used a TENS unit for years both at home and along with my PT. It's my understanding that you should never place the pads on your head, over the carotid artery, directly on the spine or near the heart, or inside the body. And it is also contraindicated for epilepsy and pacemakers. As for Vagus Nerve stimulation, here's a good article on the electrical implants used for seizures - not something anyone could do at home.

http://umm.edu/programs/neurosciences/treatment-programs/vagus-nerve-stimulation

I definitely would not want to place TENS pad anywhere they're not recommended.

 

[garcia]

Er, yes, but I don't think the vagus nerve goes to the ear!!!
This sounds like nonsense to me. TENS machines produce a tingly sensation, maybe through spinothalamic tract nerves, wherever you put them, and that seems to offset pain in various situations at least temporarily, but I don't think you can get at the vagus nerve through the earlobe.

The Ceromed NEMOS is a medically approved commercially available in-ear Vagus nerve stimulator:

http://www.cerbomed.com/

It is not cheap though (£2500 from here: https://www.nemos.uk.com/, though you can do a 6 month trial for £400).
Using a tens machine sounds like a much more affordable alternative.

 

[Jonathan Edwards]

The Ceromed NEMOS is a medically approved commercially available in-ear Vagus nerve stimulator:

http://www.cerbomed.com/

It is not cheap though (£2500 from here: https://www.nemos.uk.com/, though you can do a 6 month trial for £400).
Using a tens machine sounds like a much more affordable alternative.

Cotton buds would seem even more affordable!

 

[voner]

Cotton buds would seem even more affordable!

@Jonathan Edwards, Why such seeming flippant prejudice against this device? it's been approved for use in Germany for refractory epileptic seizures.

their website lists the current clinical trial that is double-blind, randomized, controlled.....

A randomized, controlled, double-blind, two-arm clinical trial to assess safety and efficacy of transcutaneous vagus nerve stimulation (t-VNS®) in patients with drug-resistant epilepsy

 

[Lou]

@Jonathan Edwards, Why such seeming flippant prejudice against this device? it's been approved for use in Germany for refractory epileptic seizures.

their website lists the current clinical trial that is double-blind, randomized, controlled.....

A randomized, controlled, double-blind, two-arm clinical trial to assess safety and efficacy of transcutaneous vagus nerve stimulation (t-VNS®) in patients with drug-resistant epilepsy

Good question, it would seem fair, too, he retract his claim this is nonsense because he doesn't think the vagus nerve goes to the ear, as apparently it does go to the ear.

 

[Jonathan Edwards]

@Jonathan Edwards, Why such seeming flippant prejudice against this device? it's been approved for use in Germany for refractory epileptic seizures.

their website lists the current clinical trial that is double-blind, randomized, controlled.....

A randomized, controlled, double-blind, two-arm clinical trial to assess safety and efficacy of transcutaneous vagus nerve stimulation (t-VNS®) in patients with drug-resistant epilepsy

Yes, but it does not give any indication as to whether it actually worked. It seems like that from the text but they give no indication of what the control treatment was or the results of it.

But it might well work for epilepsy. I am not disputing that. I am merely pointing out that what the treatment does is stimulate nerve endings in the ear canal and it likely to be just as effective to stimulate them the normal physiological way (I assume they are touch receptors since they are in the skin) as with electricity. It may in fact be more convenient to do it electrically, I admit, but I am suspicious of a 'black magic' element here. The company is obviously out to make a lot of money out of their devices. To sell them for a high price they need to make them sound hi-tech. But from the physiological point of view it seems to me likely that something much simpler would do.

Simple physical procedures can be extraordinarily effective. If you injure yourself or get a nasty insect sting putting an ice cube on the painful part is far more effective than taking drugs.

And I remain sceptical about the description of 'vagal nerve stimulation'. What this is is stimulation of skin sensory nerves that happen to run in the auricular branch of the vagus. It may do interesting things but I am not sure they have anything specifically to do with the fibres running in the vagal trunk.

I am sceptical because rheumatologists got very excited about TENS systems thirty years ago and then it became clear that after a few weeks all the TENS machines ended up in the bedroom cupboard for eternity. The NHS had forked out thousands for these approved machines and nobody used them.

 

[Jonathan Edwards]

I am also unsure why anyone with ME/CFS would want to stimulate their vagus nerve since stimulation of the vagus tends to cause fainting.

 

[lansbergen]

And I remain sceptical about the description of 'vagal nerve stimulation'. What this is is stimulation of skin sensory nerves that happen to run in the auricular branch of the vagus. It may do interesting things but I am not sure they have anything specifically to do with the fibres running in the vagal trunk.

Might it work by letting the brain concentrate on something else?