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Electric TENS Machine: Mechanisms of Action & the Treatable Conditions

An elderly lady using a TENS machine on the elbow

Electric TENS (Transcutaneous Electrical Nerve Stimulation) machines are devices that deliver electrical impulses to the body through electrodes placed on the skin. There are two main mechanisms in which these machines work. One stimulates the nerves to block pain signals, and the other is to trigger endorphin release. The electric TENS machine has adjustable settings to achieve different therapeutic effects. Hence, it allows for personalised treatment. This treatment method is suitable for both acute and chronic pain.

In pain management, TENS has provided individuals with innovative solutions. It is a natural and non-invasive method that can help relieve pain symptoms without the need for medication. It offers many other benefits, such as portability and convenience, allowing individuals to use it in the comfort of their own homes or on the go. This article will present the functions and mechanisms of action of TENS machines and the various conditions that can be treated using this technology.

What is an Electric TENS Machine?

One popular tool in pain relief is the electric TENS machine. It is a small, portable unit that delivers low-voltage electrical currents through the electrodes placed on the skin. The device has adjustable settings to give different pulsating effects for various types of pain. This ability allows users to use the device with the appropriate amount of stimulation for their pain level. 

TENS machines are commonly used in physical therapy and rehabilitation centres to help patients with chronic pain or injuries manage their conditions. Fortunately, these portable devices are also available for home use. The machine is easy to use and is suitable for various body aches, making it a comprehensive pain relief system.

Moreover, there are two types of TENS devices: wired and wireless. Standard (or wired) devices require lead cables to connect the electrodes to the unit. Also, the handheld unit has buttons or dials to control the settings. Meanwhile, wireless TENS units integrate Bluetooth technology instead of cables, making them more convenient and discreet to use.

Components of the Device

  • Pulse generator: This is the control unit that emits electrical pulses. The frequency and intensity of these pulses can be adjusted here.
  • Electrode pads: Slim and flat adhesive patches that stick to the skin. They come in various shapes and sizes to accommodate different body areas and provide targeted pain relief.
  • Connections: Traditional devices use thin cables to connect the pulse generator to the electrodes. Meanwhile, most wireless TENS units have a snap-on feature. They also use Bluetooth to operate the machine from a smartphone app. 
  • Battery: TENS machines either use single-use or rechargeable batteries.

iTENS wireless TENS machine in small wings and spare long wings

Mechanisms of Action Behind Electric TENS Machine

Electric TENS machines use several mechanisms of action to relieve pain. The primary mechanism is nerve stimulation. The electrical pulses target the sensory nerves. These nerves are responsible for carrying information from the body to the brain and vice versa. During TENS therapy, it interferes with the transmission of pain signals to the brain, reducing the perception of pain in that specific region. This process is called the pain gate mechanism.

The second mechanism of action is endogenous opioid release. The brain releases endorphins, natural chemicals, in response to the electrical stimulation from the TENS machine. Endorphins act as natural painkillers and can help reduce pain sensations. This dual mechanism of action makes TENS machines an effective tool for managing chronic and acute pain conditions.

Furthermore, TENS machines can help boost blood circulation. It increases the blood flow, delivering more oxygen and nutrients to the affected area. This helps promote healing and reduce inflammation and swelling that contributes to pain. Some devices also have massage modes, providing muscle relaxation.

Understanding Pain Signals

Pain signals are chemical messages the nerves send to the brain. It communicates that something is wrong in a specific area of the body. Various factors trigger the release of these signals, such as injury, inflammation, or nerve damage. When pain messages reach the brain, they are interpreted as discomfort or pain sensations.

In the case of chronic pain, these signals can become persistent and overwhelming, leading to ongoing discomfort. TENS machines work by using electrical signals to interrupt or block pain. In particular, it overrides the nerve fibres that transmit these messages, providing temporary relief from the pain.

A man sitting on a sofa while holding his lower back

Types of Conditions Relieved by an Electric TENS Machine

An electric TENS machine is a versatile device used to manage a wide range of pain conditions. One of the most common uses is managing chronic pain such as arthritis, fibromyalgia, sciatica, bursitis, and tendonitis. Arthritis is a type of inflammatory disorder. It affects the joints, causing pain and stiffness.

Fibromyalgia is a condition that causes widespread musculoskeletal pain, fatigue, and tenderness. It is one of the common reasons for chronic low-back pain and leg pain. Meanwhile, sciatica is a type of nerve pain that radiates from the lower back down the leg. Bursitis and tendonitis are also inflammatory conditions that affect the joints and tendons, causing pain and swelling.

In addition, a TENS machine can also help alleviate acute pain like muscle soreness, headaches, period pain, postoperative pain, and labour pain. In particular, the impulses help combat the muscle cramps or contractions from menstrual periods and labour. Likewise, it relaxes tense muscles and overexcited nerves. This eases redness and swelling, increasing the range of motion and accelerating recovery.

Are There Potential Side Effects?

While TENS electrical devices are generally safe and well-tolerated, there are some potential side effects to be aware of. They are usually mild and temporary, but following guidelines is essential for safe use. One common side effect is skin irritation or redness. This reaction may be due to the adhesives of the electrode pads.

Another potential side effect is muscle twitching or tingling sensations. This event is a normal response to the electrical stimulation and should not be painful. Some users may also experience headaches or dizziness, especially if the intensity of the electrical pulses is too high.


An electric TENS machine is a convenient tool for managing various kinds of pain. It utilises electrical currents to block pain signals and release natural painkillers. Hence, many people use it as a drug-free alternative to pain relief. Additionally, the device has programmable settings that users can adjust to control their level of pain relief. It is crucial to understand the role of pain signals and electrical stimulation to maximise the benefits of TENS therapy.

TENS therapy is beneficial for treating acute and chronic pain. These may include neuropathic pain, joint pain, and musculoskeletal disorders. It is also valuable in lessening discomfort during rehabilitation of injuries and providing relief during labour. While a TENS machine is versatile, it is vital to consult a health professional before using one. The reason is that individuals with significant medical conditions may require specific instructions or precautions.

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