TENS: Transcutaneous Electrical Nerve Stimulation For Pain Relief

This therapy can help relieve pain in a variety of different problem areas, including pain in the muscles and joints, as well as chronic pain. Those suffering from sudden, acute pain can also benefit from TENS, often in combination with exercise or other treatments.

For pain relief, TENS (an acronym that stands for Transcutaneous Electrical Nerve Stimulation) is effective and safe.

How Does it Work?
TENS is administered through electrical stimuli sent to specific nerves in the skin. The electrical currents used in the process are painless, and carry no side effects that have been recorded.

The currents stimulate nerve fibers in the skin’s nerve endings (transcutaneous means through the skin) and warm the skin. This warmth eases stiffness and increases mobility for lower amounts of pain, and also promotes the production of hormones called endorphins. These endorphins act as natural pain killers as well.

What Equipment is Needed for TENS?
To deliver the current to the skin, the patients uses various skin patches that direct the current to a specific area of the skin. A current-generating pack called the stimulator creates the currents and then the patches direct the currents to the soft tissue in the body.

These units are portable and battery powered. A patient is able to direct his or her own pain relief with the use a stimulator by turning it on when pain relief is needed. Patients rent or purchase the units for long term use.

A physical therapist applies the patches and coordinates the strength of the receptors and currents. The therapist may also choose to deliver some kinds of surface, or topical, medications. Through a technique called iontophoresis, the electrical current assures that the medication moves into the tissue for lower levels of pain and inflammation.

What Pain Is Alleviated by Using TENS?
The technique is commonly prescribed by physicians to reduce lower back pain, arthritis pain, myofascial pain, bladder incontinence, and pain resulting from surgery.

The system is not always effective for every pain, so a trial usage is a great idea.

What Intensity of Electrical Stimulation is Effective?
The default settings for the stimulators is a comfortable amplitude, just below the threshold of pain, with the pulse width or duration between 10 and 1000 microseconds, and the pulse rate, or frequency, at 80 to 100 impulses per second when the machine is set on high.

The ideal setting for each patient has to be determined by trial and error over time. In addition to the settings on the stimulator, the patient also experiments with the location of the electrodes.

While they are often placed directly over the areas that are in pain, sometimes they are positioned over trigger points or the primary nerves in the body, and patients report pain relief that is as great or even greater relief than placing them on the painful area.

How Long Does the Pain Relief Last?
While it varies with each patient, the pain relief begins immediately upon use of the device, and lasts after it is turned off.

The average patient uses the machine for thirty minutes at a time throughout the day.

Transcutaneous Electrical Nerve Stimulation

Transcutaneous electrical nerve stimulation is a technique in which mild electric currents are applied to areas of the skin by a small power pack connected to two electrodes. It is also known as TENS and sometimes denoted as TNS. A passive, non-invasive, non-addictive modality with few side effects, TENS works to improve mobility, decrease pain perception and may be used to control acute and chronic pain.

The method involves passage of a low-voltage electric current to electrodes pasted on the skin. The current may be delivered intermittently. The mild electric current generates heat that serves to relieve stiffness, improve mobility and relieve pain. The treatment stimulates the body’s production of endorphins or natural painkillers. Transcutaneous electrical nerve stimulation can be of three types namely Conventional TENS, acupuncture-like TENS and auricular TENS.

Frequency, intensity and site of application depend on the specific condition and treatment goals. TENS can be used to treat a number of disorders like acute and chronic pain associated with cancer, joint disorders, Alzheimer’s disease, heart disease, autoimmune disorders, back pain, dysmenorrhea, nerve disorders, labor pain, nausea, diabetic peripheral neuropathy, postoperative recovery, gastroparesis, cognitive impairment and much more.

Transcutaneous electrical nerve stimulation is used in a variety of different clinical settings and has become popular with both patients and health professionals. It may be prescribed in combination with other treatments, primarily to provide relief from acute forms of nerve pain. TENS should not be used in people with implanted medical devices such as cardiac defibrillators, pacemakers, intravenous infusion pumps or hepatic artery infusion pumps. Portable TENS equipments are available for use which can be worn around the waist. 

TENS, might in some cases, have side effects such as skin irritation and redness, hives, welts, allergic skin reactions, and burns. A number of isolated side effects such as nausea, muscle ache, headache, increased hair growth, dizziness, and loss of sensation have also been reported. So this technique should be used only under the strict supervision of an experienced licensed healthcare practitioner. 

EMS Devices and Sports Injury Rehabilitation

Electrical muscle stimulation (EMS), also known as neuromuscular electrical stimulation (NMES), Transcutaneous Electrical Nerve Stimulation (TENS) or electromyostimulation uses an electrical current to stimulate your muscles. The impulses are produced by a device and delivered through electrodes that are placed on the skin near the muscles that require stimulation. The impulses mimic the impulses generated by the brain to stimulate muscle tissue. The result of stimulation is the toning and strengthening of muscles.

How EMS Works

EMS devices have become quite popular in sports injury rehabilitation. When a person has a muscle injury, the electrical current produced by the EMS machine stimulates the muscles. This stimulation triggers repairing of the muscle tissue.

Electronic Muscle Stimulation Devices produce electrical signals that stimulate the nerves. The devices are normally connected to the patient through electrodes that are held in place with adhesive. By placing the pads on a certain set of muscles, and then sending the impulses via the EMS unit, the muscles will react by contracting and relaxing. The resulting contractions are much like the contractions that take place during regular exercise.

Depending on the area that requires treatment, a practitioner can switch the voltage for different pressure points on the muscle. The low voltage reduces pain and stimulates the muscle tissue. EMS devices help stimulate muscle tissue that may not be affected by regular exercise routines. They will stimulate damaged muscle tissues resulting in repairing, toning, and strengthening of the damaged tissue. Wherever the tissues are damaged, EMA devices will stimulate the fibers to various degrees and patterns. These patterns will create a different response from the contraction. Programs are designed to improve exhaustion resistance, endurance, and promote muscle healing. The purpose of using EMS on athletes is to shorten recovery time so they can return to the sport.

Benefits of using EMS Devices

When using EMS devices, the repair process is much quicker because nerve and muscle tissue are able to recover faster after an injury. The rehabilitation process is reduced so the athlete is able to return to the sport much sooner. The treatment is much less painful so the athlete is motivated to concentrate on the healing process. If treatment takes place right away, an athlete has a better chance of avoiding a long term injury. This will keep the athlete positive during the rehabilitation process. Because the devices are very light and battery-operated, they can be taken almost any place. As well, it is an effective tool for people who have a long term injury. If someone spends a great deal of time in bed, a condition known as muscle atrophy will take place. This condition occurs when the muscles begin to waste. Electrical muscle stimulation is an excellent and efficient way of maintaining muscle integrity and strength.

The electrical muscle stimulation device is normally used by a professional medical practitioner. They know exactly where to place the electrodes in order stimulate the correct muscle fiber. An untrained individual may use the device improperly which could add further trauma to the injury. As well, the FDA states that EMS devices should not be used on children and should be used in accordance with their intended use.

People who use the EMS devices for purposes other than a sports injury do so for stress and relief from minor pain such as muscle and joint aches, to enhance their fitness program, strengthen muscles, and improve their appearance.

Most people who have received EMS treatment find the process helpful and relaxing. Electronic muscle stimulators are a great way to promote muscle healing, control pain, and tone and strengthen your muscles.

The Use of Combined TENS/ EMS Machines for Muscular Pain

If you have suffered from muscular pain from surgery or a sports injury you will know how excruciating and long lasting it can be. There are a number of options you can consider that are drug free including the use of a TENS machine for pain or for muscle stimulation. Using a TENS machine to stimulate the nerves can lessen the immediate pain and restoring muscle tone by stimulation will help to decrease long term pain and heal the damaged muscle. Although TENS (Transcutaneous Electrical Nerve Stimulators) and EMS (Electronic Muscle Stimulators) are similar and can be used with the same piece of equipment they differ in how they work.

Electronic Muscle Stimulators (EMS)

When you use EMS a low voltage current is passed from the electrodes attached to the skin into the nerves that stimulate the affected muscle. This causes the muscle to contract and relax continuously, effectively working the muscle. The muscle’s tone is increased and blood flow to the muscle is also stimulated. This helps to heal the damaged tissue. It is best to use EMS in combination with physical therapy. Improvement in circulation of the combined treatments helps to heal the muscles and remove any accumulated toxins.

Transcutaneous Electrical Nerve Stimulators (TENS)

TENS works in a different way to EMS. A small electric current is used to stimulate the nerves that transmit pain messages to the brain. This has the effect of blocking the pain messages so the brain does not perceive any pain. In addition TENS units can also be used to stimulate the production of the body’s natural painkillers, endorphins, so the pain relief continues after the TENS machine is turned off.

TENS/EMS Combined Machines

If you are suffering from muscular pain a combined machine that can be used as a TENS unit and an EMS unit would be the best choice. EMS is also a good choice for anyone who has to spend a long time immobile after surgery or an accident to keep the muscles toned and healthy.

Safety Considerations

Before using either a TENS or an EMS machine make sure you check with your doctor to ensure it is suitable for you and the pain that you are experiencing. These types of units shouldn’t be used by everyone. Please see

TENS Unit 3000 3 Mode Dual Channel TENS Unit for Pain

The TENS Unit 3000 is a professional effective TENS unit which can be used for the relief of back pain, sports injuries, phantom limb pain, peripheral nerve injuries, muscular pain etc. It is an easy to use machine that is dual channel with four electrode pads which can be placed near to the area of the pain. You can use all four electrodes or only two. The intensity, pulse rate and pulse width can be easily adjusted and the recommended time of twenty minutes should be long enough for pain relief. The three modes include constant, modulation and burst modes. The TENS Unit 3000 is less than $40.00

Buy Now from Amazon

The unit includes the LG-3000 Dual Channel Analog TENS Unit, a carrying case, four electrodes, 9v battery and an instruction manual. There is a 5 Year Warranty.

The TENS Unit 3000 has received excellent customer reviews and many people have reported that is is effective at relieving pain including pain from sciatica, muscular pain, pain from lumbar surgery and more. You can see some of the reviews from Amazon customers below.

Customer Reviews

Love my Tens3000

Review Date: March 18, 2009

Reviewer: Techie Lady, California–United States

This is a great product! It is very easy to use. The different adjustments make it easy to fine tune it to suit your need. Be sure to read the instructions before you use it so you know where you shouldn’t put the pads. And you might want to pickup some extra pads too; because the unit only comes with 4. I use my Tens at least 3 times a week for muscle pain relief. No sports person should be without one! Tech Lady, Spokane,WA

TENS Unit 3000 – 3 Modes

Review Date: October 26, 2009

Reviewer: Elaine, Kansas

I ordered this Tens unit after my physical therapist told my doctor I was a candidate for chronic lower and upper back pain.The unit works great and does help keep the pain to a tolerable level.I let my sister use it as she has a bad sciatic nerve and she liked it so well that she ordered herself one. The TENS Unit 3000 – 3 Modes, 3 Year Warranty is a very good product.

Great product

Review Date: December 1, 2009

Reviewer: Christina M. Deluhery,

This is a great product, it has many different adjustable features. You can change the type of current -fast pulse or slow, how strong and long the pulse lasts. It also has a timer feature, 15 min, 30 min or constant. It is small and discrete but it works just like the TENS units at physical therapy. I would highly recommend it to any one with chronic back pain or athletic injuries.

TENS Unit

Review Date: May 5, 2009

Reviewer: Jacqueline M. Wick, Denver, CO

I received the package torn open and the spray and rechargable battery used with the unit missing. I contacted LG Med Supply with no response from them. I guess they don’t care about customer service. The unit itself works great and I’ve had no trouble with it all. I would recommend the unit but not LG Med Supply.

Pain relief without medications

Review Date: November 18, 2009

Reviewer: T. Ancona, Seattle, WA

I bought this for my boyfriend who was in a motorcycle accident 8 months ago. He has had nerve pain since breaking several ribs and having surgery for a T9 burst fracture with internal fixation. I recommended he get a TENS unit. He uses this daily and finds it helps relieve his pain to where he can avoid his medications. It is a good use for breakthrough pain or as an alternative for pain meds. I plan on using it as well for tension/pain in my upper trap muscles from driving too much. The machine is an incredible deal. If we went through is MD and medical supply store it would have billed the insurance for over 500 dollars. Renting one per month is what this cost in full. So far, it is a good machine, goes through about one 9V battery every 2 weeks with him using it an hour a day most days. I got 9V batteries on sale for 3 dollars a piece. It’s worth the minimal cost to help his pain.

The Use of TENS During Labour

TENS (Transcutaneous Electrical Nerve Stimulation) machine can be used as a drug free method of pain control during labor. TENS uses electrical stimulation of the nerves to block pain signals from reaching the brain. It can also stimulate the production of endorphins, the bodies natural pain killing hormone.

TENS can be used during labor to help control the pain. The electrodes, usually four, are placed on the back and connected to the battery operated TENS machine. The intensity of the electrical stimulation can be controlled by the user and can be increased as the pain level increases. the labouring woman is thus in complete control of the device.

During labour the TENS machine is used in two ways. A high pulse rate is used during contractions to block the pain and a lower pulse rate between contractions which stimulates the release of endorphins by the body. This in turn also helps to block the pain of the contractions. It is most effective if the TENS machine is used from the very beginnings of labor to encourage the early stimulation of endorphins. Once the contractions become more intense application of the electrical current is then more effective than waiting to use the machine some time after the start of labor.

Advantages of Using TENS During Labor

• TENS is drug free
• TENS is under the laboring womans complete controlled
• TENS units are portable so the woman can move around during labour
• TENS has no side effects

Safety Issues

• TENS should not be used before the 37th week of pregnancy
• TENS cannot be used in water so cannot be used in a birthing pool or when showering
• TENS cannot be used if you have a heart pacemaker or heart condition
• TENS should not be used if you suffer from epilepsy
• TENS should be used for about forty five minutes before induction of labour

Conclusion

If the hospital does not have a TENS machine, or one is not available they can be hired from a reputable company prior to labour.  Your physician or midwife may be able to recommend one.  During use of  the TENS machine you will feel a tingling or pins and needles sensation that is not unpleasant. As a natural method of pain relief during labor TENS is becoming more widely known and used.

TENS/EMS Machines for Muscle Stimulation

TENS EMS or Electrical muscle stimulation machines use electrical impulses to stimulate muscular contractions through electrodes placed on the skin. EMS machines can be purchased that only stimulate the muscles or as combination units that can also be used for the relief of pain by stimulating the nerves.  See Introduction to the Use of TENS Machines

By applying a small electrical current to the muscles are induced to contract int he same way as when they receive an impulse through the central nervous system. EMS can be used as both therapy and for muscle training. The impulses are delivered from the machine to the muscles through electrodes in the form of pads that are placed on the skin.

Use of EMS in Therapy

EMS can be used for rehabilitation after damage to bones, muscles, joints and tendons by providing stimulation to the muscles and preventing muscular atrophy from lack of use. It can also be used after surgery to stimulate calf muscles to prevent thrombosis and to relieve painful muscular spasms. It should not be confused with the use of electrical stimulation for the relief of pain (TENS).

EMS for Aesthetic Use

Toned and strengthened muscles have an effect on the appearance so toning the muscles through electrical stimulation is often seen as an easier way to improve the appearance that working out at the gym. However you should be wary of claims made by some advertisers that EMS can be used for weight loss or reduction of body fat. The use of EMS burns very few calories and cannot be effectively used for these purposes. To burnt a significant number of calories you would need to exercise vigorously using more muscles and with a raised heart rate not by stimulating a few targeted muscles.

Use of EMS in Sports Training

The use of EMS for sports training is controversial with some professional coaches using it for supplemental training. It cannot taloe the place of conventional training methods but may have its place as an additional training method.

FDA Certification

EMS devices are classified into prescription devices for therapy or over the counter (OTC) devices for muscle toning. Professional devices should only be used while being supervised by a medical practitioner and can be used for the prevention of muscular atrophy, relaxation of muscular spasms, re-education of muscles, stimulation of the muscles in the calf after surgery for the prevention of thrombosis etc. There are also FDA regulations for manuals to display warnings and safety issues including contraindications. See TENS Machines Safety Precautions

TENS Machines Safety Precautions

Transcutaneous Electrical Nerve Stimulation (TENS) machines can be used for chronic pain including the relief of pain after surgery. Always use under the supervision of a physician.

Who Should Not Use a TENS Machines?

There are some people who should never use a TENS machine.

• If you have a pacemaker TENS could interfere with its operations.
• TENS is also not recommended for anyone with heart disease unless your physician has evaluated the risk and recommends it.
• TENS should not be used if you have pain that has not been diagnosed by a physician.
• If you have pain that occurs from issues such as appendicitis, hepatitis etc do not use TENS.
• Do not use if you suffer from epilepsy
• TENS has not been evaluated for the use pregnant women before the 37th week of pregnancy so should not be used except under the supervision of a physician or midwife

Safety Issues

Never use TENS electrodes:

• On the head or close to the eyes
• Near to the trigeminal nerve
• In the mouth
• On the front of the neck
• On the groin
• On each temple
• On any wounds or broken skin
• On any areas that have decreased sensitivity or are numb
• If you have carotid sinus as it could cause bradycardia or slow heart rate

TENS does not have any affect on the underlying cause of your pain but only provides relief. Always make sure that pain is diagnosed by a physician before you use a TENS machine.

Introduction to the Use of TENS Machines

The basis for TENS machines has a long history as using electrical stimulation for the relief of pain has been known for a long time. Surprisingly it was used as long ago as 60 AD when pain relief was achieved by standing on electrical fish! Through the sixteenth, seventeenth and eighteenth centuries it was used for the relief of headaches and other pain and was advocated by Benjamin Franklin as a good method.

Modern TENS machines derive from the first machine patented and manufactured in 1974 in the United States. It was used as a testing device for patients who were having electrodes implanted into their spinal columns as a means of pain relief. However many patients found that the stimulation gave them enough pain relief that they did not need the electrodes implanted. Medtronic began producing TENS machines which were later then produced by Empi.inc after purchasing the TENS line in the 1980’s.

The Difference Between TENS and EMS

TENS is a device for blocking pain by applying a small electrical current to the skin. EMS ont he other hand is used to stimulate muscles and is often sold as a device to tone muscles and to lose inches!

What Types of Pain is TENS Recommended for?

TENS is not suitable for all types of pain and is not recommended for headaches, chest or abdominal pain. In addition you should always consult a physician before using a TENS unit to diagnose the cause of your pain. It is effective for chronic joint, muscle and nerve pain. It should not be used by anyone with a pacemaker or epilepsy and only for those who are pregnant under a doctors guidance.