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How Does a TENS Machine Work: The Need to Know

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Individuals new to electrotherapy may ask how does a TENS machine work. A Transcutaneous Electrical Nerve Stimulation (TENS) machine is a tool that can provide relief from pain by sending electrical impulses through electrode patches. The electrical impulses help to block pain signals from reaching the brain, which can reduce the sensation of pain. TENS machines come in both wired and wireless versions, and they offer features such as flexible electrode pads and various adjustable programs.

Pain management options include oral medications, physical exercise, and TENS therapy. Many people use analgesics due to their accessibility and affordability. However, medications may not always be sufficient. Long-term use of oral painkillers can also lead to adverse effects. On the other hand, using a TENS machine is a natural and non-toxic method for managing pain. This article will provide information on the functionality, types, features, and proper usage of a TENS device.

How Does a TENS Machine Work – Overview

Many people looking for alternative methods of pain relief may wonder how does a TENS machine work. A TENS machine can help alleviate the pain by delivering electrical impulses through the electrode patches. The pulses stimulate the underlying nerves to reduce pain and discomfort. Mainly, high-frequency electric current induces the pain gate mechanism of the body to block pain signals from reaching the brain.

Additionally, low-frequency electrical stimulation triggers the release of endorphins. These natural pain relievers inhibit the nerve cells from transmitting pain messages. Moreover, endorphins have a long-lasting therapeutic effect. A health professional may recommend alternating or trying different stimulation levels to find the most effective relief.

Furthermore, the gentle tingling sensations from the electrical device can produce acupuncture or massage benefits. The effects of acupuncture-like TENS help to boost blood circulation, reduce swelling, and relieve sore muscles. As a result, it creates a soothing feeling in the inflamed area. It enables people with pain to have restful nights and better physical functioning.

The Ailments It Can Treat

  • Primary dysmenorrhea or period pain – refers to the common menstrual cramps experienced by women during their menstrual period.
  • Sciatica: a condition caused by injury to the sciatic nerve. It causes lower back and leg pain.
  • Arthritis pain: the inflammation of one or more joints. It causes joint pain, swelling, and stiffness and affects mobility.
  • Fibromyalgia: causes widespread musculoskeletal pain, general fatigue, and tenderness.
  • Postoperative pain: refers to severe pain after undergoing a surgical procedure.
  • Cancer pain: discomfort or distress as a result of cancer or its treatment.
  • Various body aches: neck pain, hip pain, knee pain, foot pain, and others.

A woman using iTENS on her arm and lower back

How Does a TENS Machine Work – Device Types and Features

In addition to understanding how does a TENS machine work, people should know the electronic device types and features. Firstly, the machines come in standard and wireless units. A standard TENS machine has a handheld remote control connected to wired electrode pads. The devices use single, dual, or multi-channel, allowing multiple adjustments and settings. Multi-channel TENS machines can connect up to eight pads at a time.

Meanwhile, wireless TENS machines come with flexible electrode pads and various adjustable programs. It eliminates the need for lead cables and connects remotely to a smartphone app. This makes wireless TENS machines more lightweight and comfortable to use. Its compact design is more discreet than traditional TENS machines when worn under the clothes.

The features include adjustable electrical pulse rates, pulse duration, and pulse amplitude. This customisation feature allows individuals to find optimal effects for pain control. Lastly, TENS may combine other functions, such as heat therapy or Electric Muscle Stimulation (EMS), for more comprehensive pain management. TENS with heat can help reduce inflammation, while EMS can address muscle issues.

Understanding Low and High Frequencies

Pulse rate or frequency of the electrical current is adjustable to suit different needs or preferences. Low-frequency TENS (10 Hz and below) cause the nerves to become less sensitive. It is also the ideal setting to trigger the release of endorphins. Furthermore, low vibrations give massaging effects. This setting is particularly advisable for acute pain conditions.

High-frequency TENS (50-120 Hz) stimulate the sensory nerves to block pain. This has short pulses and intensity, often characterised by strong but comfortable sensations. It is a suitable setting for people with acute pain. It also has an analgesic effect on activity-induced musculoskeletal pain and fatigue and increases mobility.

Workflow on how to operate the iTENS app

How Does a TENS Machine Work – How to Operate the Device

Knowing how does a TENS machine work and its features can provide valuable insights on how to use the unit. To begin, people should clean and dry the area of the skin where they will apply the electrodes. It is crucial to ensure that the skin is free from any lotions, oils, or creams. These substances may interfere with the effectiveness of the treatment.

After ensuring the correct placement of electrodes, turn on the unit and set the appropriate pulse rate and duration. Then, start the intensity at the lowest level and gradually increase until the sensations are strong but comfortable. The average treatment duration is 30 to 45 minutes for chronic conditions. However, this may depend on the intensity of stimulation.

It is crucial to avoid sensitive areas like the head, eyes, throat, spine, and near varicose veins. The electric nerve stimulation in these locations may worsen the condition or cause complications. Furthermore, prolonged use may cause overstimulation. For continuous treatment, allow a 20-minute break between sessions.

Proper Pad Placement

The electrode placement guide for using a TENS unit is essential for safety and effectiveness. People should position the electrode pads directly over or on either side of the painful area. They have to make sure that the currents are directed toward the centre of the most painful part.

An essential consideration of pad placement is to avoid areas with broken skin, open wounds, and infection. Individuals may refer to the placement chart provided by the TENS unit or consult a medical professional or physical therapist. Also, use appropriate-sized electrode pads. For small or joint areas, smaller pads will do.


In summary, how does a TENS machine work is a common question for people new to electrotherapy. TENS machines offer a drug-free option for pain relief. By sending electrical pulses through electrode patches, they activate the pain gate mechanism of the body and release endorphins, providing relief. With different types, like standard and wireless models, individuals can find the best TENS unit for their needs. Some models even integrate heat therapy or EMS for a holistic approach.

Using a TENS machine involves cleaning the skin, placing electrodes correctly, and avoiding sensitive areas. Users should start with low intensity, gradually increasing for comfort. Sessions typically last 30-45 minutes with breaks. Moreover, proper pad placement is crucial, avoiding broken skin or wounds. People can refer to the placement chart or consult a professional for guidance. Following these steps ensures safe and effective TENS therapy, promoting relief from pain and discomfort.


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