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Physio TENS: A Comprehensive Guide to Physical Therapy Using TENS

A female new anchor reporting on TENS therapy for pain relief

Transcutaneous Electrical Nerve Stimulation, or TENS, is a modality in physiotherapy used for relieving pain. It applies mild electrical currents through an electrode machine to the aching area of the body to alleviate its symptoms. Physio TENS provides drug-free pain relief for various conditions like acute and chronic pain. In addition, users can customise their treatment by adjusting the pulse rates and intensity based on their comfort level. Hence, it enables them to manage their pain conditions optimally.

TENS therapy is a popular pain management method in physical therapy and rehabilitation centres. A healthcare professional supervises the treatment and guides the patient on how to use the device effectively. Conveniently, more portable units are available for personal or home use. Nevertheless, understanding the proper use of a TENS machine is crucial to ensure its effectiveness and safety. In this comprehensive guide, we will explore TENS for physiotherapy, how it works, and how to operate the unit.

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What Is Physio TENS Therapy?

Physio TENS therapy is a non-invasive treatment method that uses low-voltage electrical currents to relieve pain. It uses a handheld device with adhesive electrode pads to deliver these currents to the body. When the unit is turned on, the stimulation produces tingling sensations, which are gentle and relaxing. It is commonly used in physical therapy and rehabilitation programs to help patients cope with chronic pain or recover from injuries or surgeries.

Through a portable device, people can manage their pain without going to clinics or hospitals. They can use it at home or on the go whenever necessary. Hence, it allows them to receive pain relief without interrupting their daily activities. Additionally, the unit is applicable to various areas of the body, making them versatile.

TENS therapy is best for treating nerve pain, muscle and joint pain, and sports injuries. It is also beneficial for postoperative pain, menstrual cramps, and even labour pain. Aside from pain relief, it also has muscle relaxation benefits through massage modes. However, it is best to consult a health professional before using the device for proper guidance.

Benefits of TENS in Physical Therapy

  • Drug-free pain relief: TENS can help reduce the intensity of pain without medications.
  • Improved circulation: TENS machines can help increase blood flow in the affected areas. This can help reduce inflammation and alleviate discomfort.
  • Increased range of motion: It helps relax tense muscles and relieve soreness. Thus, releasing muscle tension can help improve joint flexibility.
  • Rehabilitation aid: TENS can help manage pain during the recovery period. The increase in blood circulation can speed up the healing process of injuries or postoperative pain.
  • Improved sleep patterns: TENS therapy can help reduce stress levels, helping people to relax more at night.

A person wearing an iTENS electrode placing another one on a man's back

How Does a Physio TENS Machine Work?

A Physio TENS machine works by delivering small electrical impulses to the body to activate the natural pain relief mechanisms. The impulses target sensory nerves, primarily responsible for sending pain signals to the brain. By stimulating these nerves, the TENS unit can effectively block or interfere with the transmission of pain signals.

Apart from blocking pain signals, TENS therapy also stimulates the production of endorphins, the natural painkillers. Endorphins can help alleviate pain and promote a sense of well-being. Moreover, the electrical pulses from the TENS machine can vary in frequency, intensity, and duration. Users can adjust the settings according to their type of pain or tolerance.

Furthermore, each TENS unit offers different modes, such as continuous, burst, or modulation. These built-in settings allow individuals to manage their pain at a few touch of a button. While TENS therapy can provide temporary relief from pain, it is important to note that it does not address the underlying cause of the pain. Therefore, it is often used as part of a comprehensive pain management plan that may include other treatments such as physical therapy, medications, or lifestyle modifications.

How Does It Relieve Pain?

When the electric currents reach the body, they stimulate the sensory nerves to block pain signals. This process is based on the Gate Control Theory of Pain. It suggests that non-painful input can close the “gates” to painful input. As a result, it blocks the pain signals to the brain, reducing the pain sensation.

Another mechanism is stimulating the motor nerves to help release more endorphins. Endorphins bind to opioid receptors and block the nerve cells from sending pain messages to the brain. Additionally, they have similar analgesic effects to morphine but without the potential for overdose or addiction.

A woman adjusting the settings on her wireless electrodes

Different Types of Physio TENS Devices

There are different types of Physio TENS devices according to their uses or features. Firstly, there is the traditional unit that comprises a push-button remote and adhesive pads attached through wires. Secondly, the wireless TENS machine is a more compact device that utilises Bluetooth technology instead of cords. Thus, users can control the electrical stimulation from a smartphone or tablet.

Additionally, there are combination TENS/EMS (Electrical Muscle Stimulation) units. These devices offer both pain relief and muscle stimulation functionalities. EMS therapy uses stronger electrical signals to contract muscles. It can be beneficial for those recovering from injuries or post-operation. Combo devices allow users to switch between TENS and EMS modes, providing versatile treatment options.

TENS machines come in single-, dual-, or quad-channels. A single-channel unit connects two electrodes and delivers one type of stimulation at a time. On the other hand, dual-channel units connect to four electrodes. A quad-channel TENS device uses four leads and connects to eight electrode pads. It is suitable for individuals experiencing pain in various areas of the body.

Wireless TENS Machines

A wireless TENS machine offers discreet pain relief. It is an ideal treatment option for those with active lifestyles. The device is more lightweight, making it easy to carry around. In addition, it eliminates the inconvenience of tangled wires. They are also barely noticeable when worn underneath the clothes.

The settings of the wireless TENS devices are accessible via a smartphone app. Users can personalise the treatment or select from several pre-set modes. Most units have more automatic therapy programs than their traditional counterparts. Hence, it provides more convenience and efficiency in pain management. Likewise, individuals can use the device without restrictions on movements.

The charging cable for the iTENS electrode

Components of a Physio TENS Device

Physio TENS devices consist of several key components that work together to deliver electrical nerve stimulation effectively. One essential part is the control unit itself. It houses the circuitry responsible for generating electrical pulses and sends them to the pads. It typically features a display screen and buttons or knobs for the settings and modes. Some advanced devices may have touchscreen interfaces or Bluetooth transmitters.

Another crucial component is the electrodes. These are slim, adhesive pads that stick to the skin. Electrodes come in various shapes and sizes to accommodate different body parts or treatment areas. Moreover, most pads are reusable and can last for several weeks or months, depending on the frequency of use.

The power source is another important component of a TENS device. Most units are battery-operated for portability and convenience. They may use disposable batteries, such as AA batteries. Another type utilises rechargeable batteries. This type can be replenished using a power adapter or USB cable. It is vital to use new or fully charged batteries to ensure sufficient and uninterrupted treatments.

Adhesive Electrode Pads

  • Electrodes often come in square, rectangular, and circular shapes.
  • They are made of conductive materials, such as carbon or silver, which allow for efficient transmission of electrical signals.
  • Some electrode pads need a conductive gel, while others are pre-gelled or self-adhesive.
  • Reusable pads can be cleaned between uses to maintain their adhesive properties and longevity.
  • The adhesives from the electrodes may cause allergic reactions in some people.
  • Gel pads are suitable for people with sensitive skin as they have a lower risk of developing allergic reactions. The gel provides a layer of protection, preventing any kind of burning sensation.

A person removing the plastic film from the gel pad

Physio TENS Machine Set Up: Preparing the Skin for Electrode Pad Placement

Proper skin preparation is essential for the effective and comfortable placement of electrode pads. Before using the Physio TENS machine, clean the treatment area by removing any oil, lotion, sweat, or other residues with warm water and mild soap. Then, dry the skin thoroughly before applying the electrodes. This will allow the pads to stick firmly and prevent skin irritation.

It is recommended to remove hair if necessary. Excessive hair can hinder the contact between the electrodes and the skin, reducing the effectiveness of the TENS therapy. Shaving or trimming the hair can help ensure optimal conductivity. However, be cautious not to cut or damage the skin during hair removal, as this can lead to discomfort during the treatment.

After preparing the skin, it is now ready to apply the electrode pads. Peel off the protective backing of the pads and place them in the designated treatment area. Make sure to press down firmly to ensure good contact between the electrodes and the skin. It is essential to follow the instructions for proper pad placement, as incorrect positioning may result in ineffective or uncomfortable stimulation.

Advanced Tips & Tricks

For optimal adhesion, some people may apply a small amount of the conductive gel to the pads. It is also vital to apply the gel evenly and thinly, making sure to cover the entire surface of the electrodes. Additionally, avoid using harsh cleansers or alcohol-based products, as these can irritate the skin and affect electrode adherence.

Furthermore, applying a small amount of water can help restore the stickiness of the pads. Regular cleaning can help extend the lifespan of the electrodes. Lastly, when not in use, store the device in a cool, dry place away from direct sunlight.

A person placing an electrode on the back

Physio TENS Machine Set Up: Connecting and Placing the Electrode Pads on Your Skin

To set up the Physio TENS machine, first, attach the electrodes to the control unit through wires or a snap-on feature. Make sure the device is off before connecting the cables or putting them on the skin. Also, check for any loose connection or open wirings. Do not use the machine with exposed wires to prevent accidental shocks or burns.

Subsequently, position the pads on the side of the pain. Press down gently on each electrode to secure it in place and smoothen any air bubbles or wrinkles. Likewise, they should not be loose or move around while worn. Next, keep the distance of the pads two to three inches apart for an even distribution of electrical pulses.

The common treatment areas are the lower back, shoulders, legs, and joints. For back pain, position the electrodes on either side of the spinal cord. Meanwhile, position the pads around the joints for shoulder, knee, elbow, and ankle pains. Once the electrodes are in place, turn on the TENS unit to start the therapy.

Advanced Tips & Tricks

Generally, place the electrodes symmetrically around the area of pain. Refer to the provided pad placement chart of the device or the instructions of a healthcare professional. Another effective placement is to put the pads along the nerve pathways that innervate the painful area.

The most common mistake is to put the electrodes on top of the pain. However, positioning them on the side can provide the most effective pain relief. Moreover, always place the pads over the fleshy or muscly areas to ensure comfort. Finally, avoid sensitive areas, such as the head, chest, infected skin, and areas with blood clots or decreased sensation.

A woman manually adjusting the settings of her wireless iTENS electrode

Physio TENS Machine Set Up: Adjusting the Current for Pain Relief

Upon activating the Physio TENS machine, modify the frequency and pulse duration accordingly. Start with a low intensity and gradually increase it to a comfortable level. This allows the body to adjust to the electrical stimulation. The goal is to find a stimulation level that provides therapeutic relief without causing any discomfort or muscle contraction.

The frequency or pulse rate is the number of pulses delivered per second. Typically, low-frequency TENS (10 Hz or below) induces the production of endorphins, providing long-lasting relief for chronic pain conditions. In contrast, high-frequency TENS (50-120 Hz) stimulates the pain gate mechanism of the body. It is suitable for intense or acute pain conditions, such as labour, injuries, and period cramps.

Furthermore, pulse width refers to the duration of each electrical impulse and is measured in microseconds (μs). Adjusting the pulse width can affect the depth of penetration and the sensation during TENS therapy. Experimenting with different settings can help users find the most effective combination for their specific condition and pain management goals.

Advanced Tips & Tricks

  • Always start at the lowest intensity level and gradually to a comfortable sensation.
  • Avoid overstimulation by keeping the intensity below the threshold of muscle twitching or discomfort.
  • Identify the type of pain and use the appropriate frequency levels. Experimenting with different settings can help find the optimal treatment frequency.
  • Use pre-set modes to relieve pain for common conditions like osteoarthritis or sciatica quickly.
  • Use a variety of pulse patterns or alternating high and low currents, such as burst or modulation, to prevent adaptation or tolerance.
  • Take breaks between TENS sessions to avoid desensitisation to the electrical stimulation.

A man wearing an electrode on his arm

Implications for Use of Physio TENS in Physiotherapy

The use of TENS in physiotherapy has several implications for pain management and rehabilitation. Firstly, it provides non-invasive pain relief for a variety of conditions. Physiotherapists often incorporate TENS therapy into treatment plans to help alleviate discomfort from musculoskeletal injuries, postoperative recovery, and neuropathic pain. By targeting the sensory nerves, a Physio TENS machine can offer immediate and localised pain relief.

Secondly, TENS in physiotherapy has the potential to enhance the effectiveness of other treatment modalities. It can be used as a complementary intervention alongside exercises, manual therapy, and other techniques to optimise outcomes. For example, combining TENS with therapeutic exercises may help reduce muscle spasms, allowing patients a greater range of motion.

Thirdly, TENS can facilitate neuromuscular re-education and promote muscle relaxation. These are essentials of rehabilitation following injury or surgery. Furthermore, the versatility and accessibility of TENS devices make them valuable tools for empowering patients to participate actively in their convalescence. Finally, the use of electronic devices can help reduce reliance on medications, minimising the risk of adverse effects and dependency.

Studies in Postoperative Pain Relief Rehabilitation

Several studies cover the effects of TENS on postoperative pain management. One study has shown that TENS was useful in significantly reducing pain scores compared to pain before the treatment. Moreover, a multimodal approach can not only relieve pain but also shorten hospital stays and improve the overall quality of life after surgery.

A healthcare professional may suggest TENS for postoperative rehabilitation to reduce opioid consumption. It can aid in restoring neurological functions. By stimulating the nerves and relaxing the muscles, it may improve their strength and coordination. The effects are beneficial for those who wish to recover from physical impairments.

A female new anchor reporting on TENS therapy for pain relief

Can You Buy a Physio TENS Machine?

Physio TENS machines are readily available for purchase, both online and in-store, from various retailers. Many online platforms and specialised medical equipment websites offer a wide selection of TENS machines. Customers can browse through various models, read product descriptions and reviews, and compare prices. One reputable supplier is iTENS Australia. It offers the world’s first FDA-cleared wireless TENS machine for pain relief.

Additionally, brick-and-mortar stores such as pharmacies, medical supply stores, and specialty health and wellness retailers may also carry TENS devices. They can provide customers with the opportunity to see and try out different models in person before making a purchase. These portable machines are often smaller than the ones used in clinical settings.

Furthermore, individuals can choose from different types of devices, battery types, and features. Another essential aspect to look at is safety. Look for a device with FDA approval or clearance to guarantee it has undergone strict testing for quality assurance. The prices of TENS machines start from $50 for entry-level units with basic functions to $300 or above for advanced models.

Advantages of Owning a Device for Home Use

Owning a personal or home TENS unit offers many advantages, making it a valuable investment for long-term pain management. One significant advantage is the convenience and accessibility of on-demand pain management. With a TENS device readily available, individuals can alleviate acute or chronic pain without having to schedule appointments.

Another benefit is the potential cost savings and reduced reliance on medications and other pain management modalities. Having a personal TENS machine minimises healthcare expenses from ongoing treatments. It also enables flexibility and autonomy of use without the risk of adverse side effects. This is favourable for people who require frequent care.

An elderly woman wearing an iTENS on her wrist

Safety Precautions When Conducting Physio TENS Therapy

Ensuring safety during Physio TENS therapy is paramount to prevent adverse effects and maximise the effectiveness of treatment. One essential precaution is to consult a healthcare provider before using a medical device. They can assess the medical condition and history of the patient to determine the most appropriate settings. It will also help to identify any contraindications, such as heart problems, cancer, epilepsy, and people with pacemakers.

Another important safety guideline is the proper electrode placement and adjustment of settings. It is crucial to avoid sensitive areas to prevent further harm or discomfort. Similarly, adhere to the recommended usage parameters and avoid stimulation levels that cause rigorous muscle contractions. Moreover, do not exceed the advised treatment duration, as prolonged use may lead to skin irritation and muscle fatigue.

It is vital to monitor the response of the body during the TENS sessions. Individuals should be aware of the expected sensations they may experience during the therapy. If unusual symptoms or side effects occur, they must discontinue use and inform a professional. Finally, do not use the TENS device in water or while sleeping or driving.

Possible Risks & Side Effects

  • Allergic reactions: A common side effect of TENS is redness or rashes. This is due to the adhesives or placement of electrodes on sensitive skin.
  • Skin burns or irritation: Inappropriate intensity levels may lead to burning sensations or marks.
  • Muscle twitches: tingling sensations may cause slight spasms. However, they should not be painful.
  • Headaches or dizziness
  • Numbness: Reduced sensation beyond the treatment area.
  • Contractions: using TENS near or over the abdomen while pregnant may induce uterine contractions.
  • Electric shocks: open wires or the use of the device in the water causes electrocution.
  • Device malfunction: TENS may interfere with cardiac pacemakers and other metal implants.


Physio TENS is a non-invasive and drug-free method of pain relief. It can help relieve various pain symptoms using low-voltage electrical currents to the nerves. The electrical stimulation can block pain signals from reaching the brain and trigger the release of endorphins. As a result, it can help alleviate acute and chronic conditions, including neuropathic pain, muscle pain, and joint pain. Additionally, TENS machines have adjustable settings to control the delivery of impulses according to preferences.

There are various types of TENS machines available for purchase. They differ in their electrode connections, operation, and battery types. Moreover, proper usage and safety precautions are keys towards effective treatment and avoiding any potential risks. Users should avoid delicate areas that may cause further pain. For best results, consult a health professional for guidance and advice. TENS machines are available in stores and online, such as iTENS Australia. Always ensure to get a certified device for safety.

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