TENS Therapy

What Is TENS?

Transcutaneous electrical nerve stimulation (TENS) is a therapy that uses low-voltage electrical currents delivered through electrodes placed on the skin. TENS units are portable devices that can be used at home for pain management. While evidence is mixed, many people find TENS helpful as part of their pain management toolkit.¹

How It Works²

Gate Control Theory

Stimulates sensory nerves
May "close the gate" on pain signals
Competes with pain transmission

Endorphin Release

Low-frequency TENS may trigger endorphins
Natural pain-relieving chemicals
Can provide longer-lasting relief

Using TENS

Electrode Placement

Usually around or near painful area
Various placement patterns
Follow instructions or PT guidance
Clean, dry skin

Settings

High frequency (80-120 Hz): gate control
Low frequency (1-10 Hz): endorphins
Intensity: strong but comfortable
May need to experiment

What to Expect

Tingling or buzzing sensation
Should not be painful
Effect often during or shortly after use
Sessions typically 15-60 minutes
Can use multiple times daily

Research Evidence³

Mixed results in studies
Some evidence for chronic pain
May help osteoarthritis
Low back pain evidence limited
Generally considered safe
Individual response varies

Conditions Often Tried

Low back pain
Osteoarthritis
Fibromyalgia
Neuropathic pain
Neck pain
Labor pain

Safety Precautions

Not over pacemakers
Not on front of neck
Not over pregnant uterus
Avoid broken skin
Not while driving or in water
Not near metallic implants

Getting a TENS Unit

Available without prescription
Pharmacies, online retailers
Some insurance covers with prescription
Physical therapists can instruct
Range of prices

Tips for Success

Try different electrode placements
Experiment with settings
Give it adequate trial
Replace electrodes regularly
Use as part of overall plan

References

Johnson MI, Paley CA, Howe TE, Sluka KA. Transcutaneous electrical nerve stimulation for acute pain. Cochrane Database Syst Rev. 2015;(6):CD006142.
Sluka KA, Walsh D. Transcutaneous electrical nerve stimulation: basic science mechanisms and clinical effectiveness. J Pain. 2003;4(3):109-121.
Vance CG, Dailey DL, Rakel BA, Sluka KA. Using TENS for pain control: the state of the evidence. Pain Manag. 2014;4(3):197-209.