TENS Therapy for Pain Relief: Everything You Need to Know!

Geoffrey Lions
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What is TENS therapy?

TENS “ transcutaneous electrical nerve stimulation ” is a non-invasive therapy, now widely used to treat pain. TENS therapy applies a low level electrical current to the skin, producing a sensation like pins and needles. It works by blocking the transmission of pain signals from the nerve endings to higher centers in the brain.

Historically TENS therapy has been used to treat pain related to miscarriages, sports injuries, strains and sprains, PMS, and has also been helpful for helping people recover from injuries to muscles and ligaments. TENS therapy is used by many women who experience premenstrual cramping or pelvic discomfort.

Since it works differently for different people, there is no way to tell ahead of time if TENS therapy will be effective for you. However, it is a favorite among women who have found no relief from other forms of treatment, and have had little success with pain medication.

TENS therapy is painless and FDA-approved. It’s a self-administered method that can be as effective to use for pain relief as is spinal cord stimulation. The difference is that TENS therapy doesn’t require you have the surgery and you can get similar effects using a TENS unit.

Can TENS therapy provide pain relief?

The short answer is yes, TENS therapy (transcutaneous electrical nerve stimulation) can provide pain relief.

This answer, however, is a little bit incomplete. There are some guidelines and ideas to take into consideration before using TENS therapy for chronic pain.

TENS therapy can provide pain relief for a variety of different issues. These include post surgery pain, pain from back injuries, pain associated with rheumatoid arthritis, and pain from an abscess tooth.

Not only does TENS therapy provide pain relief, but it does so while reducing swelling and toning the surrounding muscles.

TENS Therapy Features

There are a few features of TENS therapy that determine how effective it can be. These features include:

Electrodes” – To use TENS therapy the electrodes are placed around the area where pain is present. These go on the skin in the area where the pain is occurring. Depending on the user and their goal, this can include nerve stimulation, muscle stimulation, both, or neither.

“Timer” – TENS is equipped with a timer to allow the user to preset how long it will be on. It is also equipped with an intensity setting.

What’s the cost of TENS therapy?

TENS therapy uses electricity to stimulate nerves and promote pain relief. The system is usually battery-operated, and can be used by anyone with a pulse. Most insurance plans cover TENS device in the home, but you may want to check with your insurance before you submit the claim. To increase the chances that your reimbursement will go through, keep your insurance company in the loop at every step of the way. Get a policy number and file your claim with them as the provider, rather than getting everything from the manufacturer. Putting this little effort into purchasing and submitting your claim can save you quite a bit of money.

What’s involved?

TENS treatments can be done in your own home or in a clinic, and usually take place over a number of consecutive treatments. While there is no requirement for you to have a partner, a friend or family member is usually present to provide the person receiving treatment with support.

Although they’re both well-meaning, your significant other and your mother-in-law are especially bad choices. You may want to get a friend or family member who’s less emotionally attached to help you out.

Before the procedure:

The patient should try to wear loose-fitting clothing.

The site being treated should be shaved and cleaned.

You will be asked to lie down or sit comfortably on a treatment table.

Do you need a prescription to try TENS therapy?

You typically don’t need a prescription for TENS devices. You may need one for add-on items, such as pads for a TENS unit, though.

Do you want to convince your insurance company to cover the cost of using a TENS unit? It’s probably a good idea to use a TENS unit for an injury or illness. If your doctor prescribes the device, then the chances of insurance companies covering the cost are better.

However, using a TENS unit for pain shouldn’t be a problem. The insurance company should cover the costs if you are seeing a specialist or physician.

Further reading:

TENS (Transcutaneous Electrical Nerve Stimulation) therapy involves applying electrical stimulation to your nerve endings. This electrical stimulation can be controlled by your physician to deliver strong electrical currents to road block pain signals in the body.

TENS is sometimes called EMS (electrical muscle stimulation). TENS may not be a treatment you have heard of but that’s just because not many physicians have heard of it either. It’s been around since the 1960’s but has been used by less than one percent of all physicians.

Doctors normally use TENS while treating patients in the hospital. This is because the equipment they use in hospital settings is extremely high quality and they have the necessary training to use it correctly.

This device is often used on their post operative patients so the patient has an easier time in recovery. These machines are specifically built to be safe for use in the hospital. A TENS unit is built to shut off automatically if it is accidentally left on.

This makes it far less dangerous than the hand-held TENS devices that are available on the market. It’s not that TENS is dangerous but that you can’t tell if the unit is on. A portable device is much less likely to give you the correct dosage of electrical current.

Does TENS therapy have any side effects?

You may feel a little queasy, and you should never use TENS therapy if you are pregnant, as there is a higher risk of miscarriage. TENS should also not be used by those with the heart condition known as tachycardia.

You should also avoid TENS if you suffer from secondary headaches. This condition is caused by the misuse of non-steroidal anti-inflammatory drugs. Although this condition is not life threatening, you should consult your doctor if you are suffering from pain that is not being treated. If you have had an organ transplant, your doctor will advise you against using TENS therapy. Secondary headaches will also be a problem for people who have had cardiac pacemakers, as they can also trigger the condition.

It is important to avoid any other pacemakers, in case that you trigger anything that can cause you harm. It is also important to hold TENS units at least six inches away from the heart. This is to ensure that you don’t feel any arrhythmia.

Frequently Asked Questions: TENS therapy FAQs

What is TENS therapy?

TENS therapy is one of the most common non-invasive alternative pain therapies. It sees use at home and in the treatment of pain in physical therapy clinics. A TENS unit is a small electronic device that sends currents through the nerves, this inhibits the pain signals and relaxes the muscles that may be spasms or wary.

TENS are not recommended for everyone experiencing pain. Those with pacemakers, hypoglycemia, and above all the pregnant, are not advised to use TENS. In addition, the device will not work if the muscles are too veiny or spasmed.

How can I distinguish a real TENS unit from a fake?

Using technology as old as the TENS unit is a popular and sometimes expensive hobby in the world of counterfeits. When you are about to buy a TENS unit from a seller you haven’t bought one from before, look for the box the device comes in. It should say authentic brand and have information about trademarks. Some counterfeit TENS unit sellers tend to put fake information like the package.

How do I use a TENS unit?

What does a TENS unit feel like?

TENS units are connected to electrodes, which are placed against the body, usually on or just under the skin. This is a safe, effective, and inexpensive way of relieving pain from most parts of the body. You can even use a TENS unit in the privacy of your own home!

Many people relate the tingling, itching and tumbling sensation they feel from a TENS unit to having their flesh crawled over by dozens of ants. This is caused by the electrical pulses stimulating the nerves, muscles and tissues of the body on contact. The feeling can be varied by changing the pulse stimulation rate and by applying the electrodes at different points.

The sensation is often uncomfortable for people but not painful. Prior to using a TENS unit it is highly recommended you test whether your threshold of pain is exceeded and the level of stimulation of the electrodes are painful to use on your skin. On this basis many patients change the frequency of the pulses to reduce the sensation during treatment.

What does a TENS unit feel like?

TENS units are connected to electrodes, which are placed against the body, usually on or just under the skin. This is a safe, effective, and inexpensive way of relieving pain from most parts of the body. You can even use a TENS unit in the privacy of your own home!

Many people relate the tingling, itching and tumbling sensation they feel from a TENS unit to having their flesh crawled over by dozens of ants. This is caused by the electrical pulses stimulating the nerves, muscles and tissues of the body on contact. The feeling can be varied by changing the pulse stimulation rate and by applying the electrodes at different points.

The sensation is often uncomfortable for people but not painful. Prior to using a TENS unit it is highly recommended you test whether your threshold of pain is exceeded and the level of stimulation of the electrodes are painful to use on your skin. On this basis many patients change the frequency of the pulses to reduce the sensation during treatment.

How many channels and pads do I need?

The number of channels in a TENS unit determines the number of different areas that can be stimulated, or caused to have nerve impulses that can block the pain signals. Most TENS units come with two channels, and can be paid in two areas at once. This means that you could stimulate the nerves that block the pain in both of your hips at the same time, without the use of a splitter.

The most common TENS unit comes with the standard two channel operation and two pads. It’s called the TENS 3000, and is manufactured by Healthmate. This TENS unit is great for beginners because it’s simple to use and affordable. You can purchase pre-made pads that fit the TENS unit you get, although some people opt to make their own pads.

In order to use two channels on the TENS unit, you simply use two different headsets. The only time you would need a splitter is if you wanted to stimulate the same channel on two different areas. TENS units that have three channels usually include the two channel headsets and a three channel headset. The third channel allows you to stimulate the same area on multiple parts of your body.

How many channels and pads do I need?

The number of channels in a TENS unit determines the number of different areas that can be stimulated, or caused to have nerve impulses that can block the pain signals. Most TENS units come with two channels, and can be paid in two areas at once. This means that you could stimulate the nerves that block the pain in both of your hips at the same time, without the use of a splitter.

The most common TENS unit comes with the standard two channel operation and two pads. It’s called the TENS 3000, and is manufactured by Healthmate. This TENS unit is great for beginners because it’s simple to use and affordable. You can purchase pre-made pads that fit the TENS unit you get, although some people opt to make their own pads.

In order to use two channels on the TENS unit, you simply use two different headsets. The only time you would need a splitter is if you wanted to stimulate the same channel on two different areas. TENS units that have three channels usually include the two channel headsets and a three channel headset. The third channel allows you to stimulate the same area on multiple parts of your body.

What is the difference between programs and modes?

Each program has a different short-burst pattern that uses a frequency or rotation of pulses with each burst.

Press the desired program button to choose between:

  • Burst mode – A continuous pain-reliving pulse and pause mode.
  • Interval mode – An increase in intensity mode by pulses, and a pause mode for relief.
  • Modulation mode – A pulsed mode which alternates the intensity of each tap.
  • Wave mode – A pulsed pattern of varying intensity.

Each mode has different applications on the body and uses different nerve-stimulating frequencies.

Press the desired mode button to choose between:

  • Normal – Provides pain relief through the stimulation of nerves for acute and chronic pain
  • Mixed – Combines modulation & burst modes by rotating between two separate pulsing patterns
  • Burst – Provides pain relief through the stimulation of nerves using a continuous burst, pause pattern
  • Pause – Provides short-term pain relief through the stimulation of nerves using a continuous pulse, pause pattern
  • Triphasic – Provides long-term pain relief by promoting the body’s own natural healing processes.
  • Modulation – Stimulates blood and lymph circulation, provides localized pain relief, and temporarily reduces nerve sensitivity.
  • Neural – Stimulates the body’s natural pain relieving mechanisms using small, short bursts of energy.

What is the difference between programs and modes?

Each program has a different short-burst pattern that uses a frequency or rotation of pulses with each burst.

Press the desired program button to choose between:

  • Burst mode – A continuous pain-reliving pulse and pause mode.
  • Interval mode – An increase in intensity mode by pulses, and a pause mode for relief.
  • Modulation mode – A pulsed mode which alternates the intensity of each tap.
  • Wave mode – A pulsed pattern of varying intensity.

Each mode has different applications on the body and uses different nerve-stimulating frequencies.

Press the desired mode button to choose between:

  • Normal – Provides pain relief through the stimulation of nerves for acute and chronic pain
  • Mixed – Combines modulation & burst modes by rotating between two separate pulsing patterns
  • Burst – Provides pain relief through the stimulation of nerves using a continuous burst, pause pattern
  • Pause – Provides short-term pain relief through the stimulation of nerves using a continuous pulse, pause pattern
  • Triphasic – Provides long-term pain relief by promoting the body’s own natural healing processes.
  • Modulation – Stimulates blood and lymph circulation, provides localized pain relief, and temporarily reduces nerve sensitivity.
  • Neural – Stimulates the body’s natural pain relieving mechanisms using small, short bursts of energy.

Should I buy a rechargeable device?

As you're looking at how to purchase a TENS unit, you'll notice that they come in both rechargeable and battery-operated varieties. While most doctors recommend going with rechargeable, battery-operated TENS units are usually a less expensive.

Unless you plan on using TENS all day every day, the cost of the rechargeable unit will pay for itself quickly. Rechargeable devices are perfect for traveling, as well, and you won't have to worry about needing to bring the cord or the batteries.

That said, if you think you’ll be using TENS just for minor aches and pains, then a battery-operated unit is certainly a reasonable choice.

Should I buy a rechargeable device?

As you're looking at how to purchase a TENS unit, you'll notice that they come in both rechargeable and battery-operated varieties. While most doctors recommend going with rechargeable, battery-operated TENS units are usually a less expensive.

Unless you plan on using TENS all day every day, the cost of the rechargeable unit will pay for itself quickly. Rechargeable devices are perfect for traveling, as well, and you won't have to worry about needing to bring the cord or the batteries.

That said, if you think you’ll be using TENS just for minor aches and pains, then a battery-operated unit is certainly a reasonable choice.

Do I need independent intensity controls for each channel?

Some manufacturers of TENS therapy units have independent intensity controls for each channel. But most of them have a single knob or dial that controls both channels. Can you still use this unit?

Yes. You will just need to turn the intensity knob counter-clockwise for channel 2.

The most popular model is a dual channel TENS, so most people can use the same unit without any filtering. There are a few exceptions, though.

You might want a dual channel unit if you have a small area of pain, like carpal tunnel syndrome in your wrist, and you want to independently control the intensity for each side. Alternatively, if you have options for different units, a dual channel unit may be easier to use if you want to dose your pain in time, say, every 3 hours. That’s because there are often two different settings for 1 hour and 3 hours, but no setting for 2 hours.

Typically, single channel units have the background pulses on the left channel and modulated (programming) pulses on the right channel. So you can focus on the background pulses while programming the modulation for the right channel. This may be a feature that you won’t use now but may use in the future.

Do I need independent intensity controls for each channel?

Some manufacturers of TENS therapy units have independent intensity controls for each channel. But most of them have a single knob or dial that controls both channels. Can you still use this unit?

Yes. You will just need to turn the intensity knob counter-clockwise for channel 2.

The most popular model is a dual channel TENS, so most people can use the same unit without any filtering. There are a few exceptions, though.

You might want a dual channel unit if you have a small area of pain, like carpal tunnel syndrome in your wrist, and you want to independently control the intensity for each side. Alternatively, if you have options for different units, a dual channel unit may be easier to use if you want to dose your pain in time, say, every 3 hours. That’s because there are often two different settings for 1 hour and 3 hours, but no setting for 2 hours.

Typically, single channel units have the background pulses on the left channel and modulated (programming) pulses on the right channel. So you can focus on the background pulses while programming the modulation for the right channel. This may be a feature that you won’t use now but may use in the future.

What are fully isolated channels?

There are four channels of stimulation to choose from with a TENS but the question is “what’s the difference between them?” Most TENS units utilize only two channels: one for the left side of the body and one for the right. Two channel TENS units are great but if you suffer from panic attacks and need both channels working more often than not, there’s fully isolated channel TENS”they’re four channel! Likewise, your two channel TENS unit will likely be able to provide a better boost in pain relief than one that can’t.

These units can also be more complicated and a bit pricier. Most units can be switched over to four channel but not all are built for it. If you’re up for the extra controls, it’s worth checking out the manual to see what you’ll be in for. Lower, higher, more focused stimulation, it’s all there.

What are fully isolated channels?

There are four channels of stimulation to choose from with a TENS but the question is “what’s the difference between them?” Most TENS units utilize only two channels: one for the left side of the body and one for the right. Two channel TENS units are great but if you suffer from panic attacks and need both channels working more often than not, there’s fully isolated channel TENS”they’re four channel! Likewise, your two channel TENS unit will likely be able to provide a better boost in pain relief than one that can’t.

These units can also be more complicated and a bit pricier. Most units can be switched over to four channel but not all are built for it. If you’re up for the extra controls, it’s worth checking out the manual to see what you’ll be in for. Lower, higher, more focused stimulation, it’s all there.

Do more intensity levels mean more power?

When you go to the pharmacy to buy a TENS unit, you’ll quickly realize that there are a lot of options. This can make it hard for you to pick the right one for your needs.

Some units are for very basic pain relief and don’t offer any preset intensity levels, but instead, an on/off button. The theory is that you can maintain the level of intensity by pressing and holding the button.

However, that being said, the ones that offer preset intensity levels can offer more convenience because you won’t have to worry about monitoring the intensity appropriately.

If you want to use the TENS unit for home health, then it’s best if you get one with a few different intensity levels, so it will be useful for a broader range of needs as your pain improves.

Do more intensity levels mean more power?

When you go to the pharmacy to buy a TENS unit, you’ll quickly realize that there are a lot of options. This can make it hard for you to pick the right one for your needs.

Some units are for very basic pain relief and don’t offer any preset intensity levels, but instead, an on/off button. The theory is that you can maintain the level of intensity by pressing and holding the button.

However, that being said, the ones that offer preset intensity levels can offer more convenience because you won’t have to worry about monitoring the intensity appropriately.

If you want to use the TENS unit for home health, then it’s best if you get one with a few different intensity levels, so it will be useful for a broader range of needs as your pain improves.

Is it better to have more intensity levels?

Based on the World Health Organization’s comparative effectiveness review of TENS devices, it concluded that there was not a significant difference in their effectiveness. However, the number of different intensity pre-sets can make it easier for you to find a setting that is most restful and comfortable.

The report explained that those with less intensity levels tended to be more comfortable to have around the neck, while those with more intensity settings may be convenient for the body, especially if you want to use it to stimulate or control muscle contractions.

Is it better to have more intensity levels?

Based on the World Health Organization’s comparative effectiveness review of TENS devices, it concluded that there was not a significant difference in their effectiveness. However, the number of different intensity pre-sets can make it easier for you to find a setting that is most restful and comfortable.

The report explained that those with less intensity levels tended to be more comfortable to have around the neck, while those with more intensity settings may be convenient for the body, especially if you want to use it to stimulate or control muscle contractions.

What conditions can a TENS machine be used for?

A TENS unit can be used on numerous conditions. The TENS unit is usually applied directly on the area to make it stings but can also be used over the entire body. Although it's unproven and some medical professionals think that using it is not effective, a TENS unit has been used in hospitals in combination with other types of medical treatments.

How to Use a Tens Machine for Pain Relief

Apply a conductive gel on the sticky pads that fit on the back of the machine to make contact with the skin. You can buy special gels for this purpose, or a better option is a gel made for sanitary protection. Apply the electrodes to the area where you experience the most pain and then adjust the knobs to secure them. The TENS unit will beep or flash to indicate that it is working. If it's placed on the body, you should feel a gentle vibration.

Who should not use a TENS machine?

The American Heart Association called the use of TENS machines in people with pacemakers dangerous and they should not use it. People with epilepsy should not use a TENS unit without a doctor's permission. People with a history of seizure should be monitored by their doctor.

What conditions can a TENS machine be used for?

A TENS unit can be used on numerous conditions. The TENS unit is usually applied directly on the area to make it stings but can also be used over the entire body. Although it's unproven and some medical professionals think that using it is not effective, a TENS unit has been used in hospitals in combination with other types of medical treatments.

How to Use a Tens Machine for Pain Relief

Apply a conductive gel on the sticky pads that fit on the back of the machine to make contact with the skin. You can buy special gels for this purpose, or a better option is a gel made for sanitary protection. Apply the electrodes to the area where you experience the most pain and then adjust the knobs to secure them. The TENS unit will beep or flash to indicate that it is working. If it's placed on the body, you should feel a gentle vibration.

Who should not use a TENS machine?

The American Heart Association called the use of TENS machines in people with pacemakers dangerous and they should not use it. People with epilepsy should not use a TENS unit without a doctor's permission. People with a history of seizure should be monitored by their doctor.

How do I find out more about TENS units?

You can find out more about TENS units by going to a medical supply store. Ask for information from the staff about the machines that they have available and what they cost. They will have plenty of literature that you can take home, too.

Or, you can search for TENS units online. Many websites sell them and many offer a selection of the best TENS units. You can also buy cheap TENS units from various retailers on Amazon.

There are many websites where you can go to learn about different TENS units. If you want one that comes with features that are especially useful to you, it is a good idea to research it online.

How do I find out more about TENS units?

You can find out more about TENS units by going to a medical supply store. Ask for information from the staff about the machines that they have available and what they cost. They will have plenty of literature that you can take home, too.

Or, you can search for TENS units online. Many websites sell them and many offer a selection of the best TENS units. You can also buy cheap TENS units from various retailers on Amazon.

There are many websites where you can go to learn about different TENS units. If you want one that comes with features that are especially useful to you, it is a good idea to research it online.

References