TENS has been used to treat many types of pain but when does TENS therapy work best? This may be your first attempt at treating your pain or maybe you have already tried other treatment modalities with little or no success. Let me help you decide if TENS is right for you and show you how to get started.
If you are already familiar with TENS therapy then you can skip the next three sections and proceed directly to “Conditions That Respond Best To Treatment”.
What Is TENS Therapy?
TENS stands for transcutaneous electrical nerve stimulation. TENS therapy is also known as TENS unit therapy or TENS electrotherapy. It is used by physical therapists and other health care professionals to treat pain in specific areas of your body. TENS therapy can also be done at home.
A typical treatment can last about 15 to 30 minutes, and up to 60 minutes. It is done using a small battery-powered device called a TENS unit, which stimulates the muscles and nerves at key areas of the body through temporarily attached electrode pads on the skin.
The treatment time, frequency of the current, and other treatment parameters of TENS therapy machines can be adjusted up or down to obtain the desired effect. This therapy is generally painless but can produce muscle twitching or tingling sensation.
How A TENS Unit Relieves Pain
A TENS unit is a small battery-powered device that generates a low voltage electrical current in the form of an impulse. The impulse is delivered through the skin at key areas of pain or at trigger points on the body. This electrical impulse is theorized to relieve pain in two ways.
Gate control theory – During TENS therapy the electrical impulse stimulates the particular sensory nerves that are carrying pain signals to the brain. This stimulation causes a “gate to close” in these sensory nerves, which prevents them from sending the signal. This generally provides quick pain relief once the treatment has started.
Endorphin release theory – The electrical impulse can also stimulate motor nerves. These are the nerves that typically cause muscle contraction. The stimulated motor nerves cause small muscle twitches, which can cause the body to release endorphins after about 20 to 30 minutes. Endorphins are normally produced by the body and released in response to pain. They can typically reduce or eliminate pain for hours after a TENS treatment.
Here is a short video by Zynex Medical that discusses how a TENS unit controls pain.
Benefits Of TENS Therapy
In addition to the reduction or elimination of pain, there are other benefits to using a TENS unit. For additional information please watch the video above.
Decreased use or elimination of pain medications – Implementing TENS therapy after some surgical procedures or at the start of pain from certain types of medical conditions may allow patients to totally avoid or rapidly discontinue pain medications. Talk to your health care provider about the possible use of TENS therapy before you begin narcotic pain medications.
Reduction or elimination of pain – This is the number one reason that people begin TENS therapy. It is typically implemented by some health care professionals after other options have been tried unsuccessfully. Now that home TENS units can be purchased at more affordable prices in-store or on-line it is becoming more commonly used by patients as first-line therapy.
Pain medication dependence can be especially problematic in the treatment of chronic pain. Consistent use of TENS therapy can allow patients with chronic pain to progressively taper down and discontinue narcotic medications. It may also be associated with significant cost savings on the purchase of pain medications.
Improved rehabilitation – TENS therapy can be used in some cases to shorten the duration of physical and occupational therapy for some medical conditions and after certain injuries or surgical procedures. Pain control from TENS therapy can also improve patient participation, which can result in an improvement in overall clinical outcome after the completion of a rehabilitation program.
Increased physical endurance – In people with chronic pain TENS therapy can improve their ability to participate in normal activities of daily living (ADLs) if used regularly. This can often improve fatigue and lead to a significant increase in daily productivity. For more information on how to improve fatigue see Chronic Fatigue Causes – Find The Energy You’ve Been Missing!
Improved quality of life – TENS therapy can improve the quality of life in people that suffer from chronic pain by increasing physical endurance and improving mental outlook. Many people are able to return to work and live fuller lives by doing more of the things they enjoy. This can improve pre-performance anxiety and depression.
Conditions That Respond Best To Treatment
TENS therapy can be implemented for the following ailments by placing the TENS unit electrode pads in close proximity to or directly over the area of the ailment. Always check with your health care provider on how and where to use a TENS unit, especially if you have a history of medical problems.
Osteoarthritis – TENS therapy has been shown to effectively reduce the pain of osteoarthritis (age-related joint degeneration) as well as improve both swelling and inflammation. TENS therapy is commonly used to treat arthritis of the shoulders, hips, and knees.
Peripheral artery disease (PAD) – TENS therapy has been shown to be a good treatment option for PAD. The TENS-PAD Study showed that TENS therapy significantly delayed the time to onset of pain during walking (claudication) and increased the pain-free walking distance in mild (Class II) PAD. If you smoke cigarettes it is absolutely essential that you quit immediately. You also need to control high blood sugar and cholesterol.
Chronic pelvic pain – In a study from the Journal Of Mid-Life Health TENS therapy has been shown to be a useful clinical intervention for women with chronic pelvic pain without an underlying medical cause (idiopathic pain). If you have chronic pelvic pain be sure to have a complete gynecologic evaluation before beginning TENS therapy.
Labor Pain – TENS therapy that is administered at specific locations (acupoints) has been effectively used to control pain without narcotics or anesthetic during child labor. TENS therapy should not be used during pregnancy, except under the guidance of your health care provider.
Conditions That May Respond To Treatment
The following conditions have been treated with TENS therapy but are less likely to achieve substantial pain relief. Some people have had better results by combining TENS therapy with other treatment modalities such as acupuncture or yoga. Always check with your health care provider on how and where to use a TENS unit, especially if you have a history of medical problems.
Low back pain – So, does a TENS unit work for back pain? TENS therapy is frequently used for the relief of low back pain and many people claim to get positive results, especially if the pain is acute (not chronic) in nature and mild in intensity. Acute onset pain is typically seen in people who have lifted a heavy object or twisted their back without blunt force or trauma.
People with chronic low back pain report much less, if any, relief from TENS therapy. Despite the fact that quite a few people use TENS therapy for back pain there is no convincing evidence in the medical literature that TENS therapy plays a useful role in the treatment of low back pain. If you use TENS therapy for low back pain never put the electrodes directly over the spine.
Fibromyalgia – According to the Mayo Clinic Fibromyalgia (chronic musculoskeletal pain in a particular distribution of the body) may be relieved by TENS therapy, especially when combined with exercise. Pain relief is typically temporary and varies in effectiveness from person to person.
Diabetic Neuropathy – TENS therapy may be an effective treatment for the discomfort associated with diabetic neuropathy, especially in the early stages of the disease. The best way to control the advancement of neuropathic symptoms is to achieve good control of blood sugar levels.
When And How Long To Use A Tens Unit At Home
Home-use TENS therapy use is individualized according to your particular situation and medical history. If you are using a TENS unit as a participant in a rehabilitation program, like physical therapy, then you will receive professional guidance from your therapist. You may be given the option of buying the TENS unit at the conclusion of your therapy sessions. You can check with your insurance provider to see if they will pay for some or the entire cost of the device.
If you are initiating TENS therapy on your own then follow the instructions for use that came with the TENS unit. Start with one treatment a day, preferably in the morning, and see how things go. You can progressively increase it to 2 or 3 treatments, either spread throughout the day or as the pain begins to return. Generally speaking, a single TENS therapy session can last about 15 to 60 minutes. Stop the therapy immediately if it causes any pain or abnormal symptoms and check with your health care provider before beginning another treatment.
Here is a video from the University of Vermont Medical Center that shows how to use a TENS unit. Each TENS unit looks and functions a little differently but this video will give you an excellent idea of how a typical device operates.
When And Where Not To Use A Tens Unit
TENS therapy is not recommended for use in certain situations and the application of TENS electrodes to particular areas and acupuncture points on the body should be avoided. Here are some of the situations that can cause problems and possible serious harm, but this list is by no means exhaustive. For additional information see the TENS article by Clevland Clinic.
Therapy should always be individualized according to your particular medical history or situation by your health care provider. Health care professionals may use TENS therapy to treat medical conditions that you should not attempt on your own without proper training.
History of heart disease – Generally speaking, you should not use TENS therapy on the chest. Applying TENS electrode pads to the chest can cause a potentially serious problem if you have any type of heart disease, especially an electrical conduction problem with your heart like an abnormal heart rhythm (arrhythmia).
During pregnancy – If you are pregnant it is best not to use TENS therapy. Never place electrodes on the abdominal, pelvic, or low back area. Always check with your obstetrics provider beforehand. TENS therapy can be used by your obstetrician as analgesia during labor.
Epilepsy – If you have seizures or a seizure disorder (epilepsy) do not apply TENS unit electrodes to any area of the shoulders, neck, or head. The electrical impulses could bring on a seizure. Check with a neurologist before beginning TENS therapy and stop immediately if you develop any type of neurologic symptoms during use.
Generally speaking, avoid using a TENS unit on the face, neck, or spine without specific guidance and clinical supervision from a health care professional.
Blood clot (deep venous thrombosis or thrombophlebitis) – Avoid using TENS therapy during the treatment of a blood clot. TENS therapy can increase the speed of blood circulating through your body and dislodge the blood clot, which can travel to your lung and cause a pulmonary embolism (PE). If you have a blood clot in your heart, it could also travel to your brain and cause a stroke (cerebrovascular accident or CVA).
Bleeding disorders and tissue trauma – People with a history of bleeding disorders, like hemophilia; and with recently traumatized tissue, open wounds, or active bleeding should not use TENS therapy. Treatment could cause bleeding or make active bleeding worse by increasing blood circulation. In some cases, health care professionals can use TENS therapy to accelerate the healing of open skin and other tissue wounds.
Infected tissues – TENS therapy can increase the blood flow through infected skin and other tissues. This can spread the infection to nearby or distant areas of the body.
Cancer – Do not place TENS electrodes over or near areas of the body where there is known, suspected, or previous cancer. Increased blood circulation in this are could spread cancer to local or distant areas of the body.
Implantable Devices – Do not place TENS electrodes near or over implantable devices. Examples include pacemakers, implantable cardioverters-defibrillators, cone growth stimulators, and neurostimulators. The electrical impulse from a TENS unit could cause a malfunction or failure in the implantable device, with resultant harm or death.
Commercial Versus Retail (Home) TENS Units
Different TENS unit models are available for commercial and home-use. Commercial models are typically used by physical therapists, orthopedic providers, and chiropractors. Some commercial machines may contain TENS unit electronics that are part of a larger “electrotherapy device” that can include various electro-stimulation protocols such as TENS, EMS, IF, and Russian.
These commercial units can have additional settings to control things such as power output and electrical impulse frequency. They may also have advanced preset and customizable user-defined protocols. Commerical TENS units are usually best for treating acute or chronic pain that is moderate to severe in intensity. They typically have multiple channels, which allow for simultaneous areas of body stimulation.
TENS units that are prescribed by a health care provider for home use can often be bought or leased directly through their office for long-term use. If you are initiating your own home TENS therapy program then you can purchase a TENS unit online or at your local pharmacy. Home units typically have more basic settings with lower power output than the commercial units. Home TENS units are best for treating low-trauma acute injuries or chronic pain of mild intensity.
If you are looking for a dual-channel home TENS unit that is reasonably priced and can also do up to 20 modes of muscle stimulation (EMS) then the number one machine that I recommend is the AUVON Dual Channel TENS Unit Muscle Stimulator Machine. It has independent mode control for each channel and industry-leading TENS pads.
TENS therapy is a useful therapeutic treatment modality that works well for particular situations and medical conditions. It can have a number of benefits, in addition to pain relief. TENS therapy can permanently cure acute pain that is mild but chronic pain that is more severe in nature may require ongoing treatments.
It is important to have an evaluation for severe pain or chronic pain before beginning TENS therapy to be sure there is not a serious underlying medical cause that needs to be treated. TENS therapy is not for everyone and there are many situations in which TENS therapy cannot be used (is contraindicated). If you have a history of medical problems then always check with your health care provider before initiating TENS therapy.
Tell Us What You Think
Please let us know what’s on your mind in the comment section, or if I can help you with anything.
- Do you have any additional tips or suggestions for using a TENS unit?
- Are you currently doing or thinking of doing TENS therapy?
- How has TENS therapy helped you?