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TENS Analgesia: Definition, Mechanisms of Action, and Its Clinical Applications

A newscaster reporting about TENS as a new pain relief

Acute pain is sudden and usually lasts for a short period. Meanwhile, chronic pain persists for a long duration. Despite the difference, Transcutaneous Electrical Nerve Stimulation or TENS analgesia can help manage them. TENS is an electrical stimulation type that sends mild electric currents to the body. This stimulates the nerves, leading to pain gating and endorphin release. These mechanisms are utilised in physiotherapy to alleviate conditions like primary dysmenorrhea, spinal cord injury, diabetic neuropathy, and musculoskeletal pain.

Traditional pain control methods typically occur through clinical practices, such as medication, physical therapy, or surgery. While these pain reduction options can be effective, they may also come with potential adverse events. Thus, having alternative treatments, like electric nerve stimulation, is crucial. TENS therapy is 100% drug-free and non-invasive. Hence, people can rely on it with minimal to no concerns about potential side effects. The following sections will present the definition, mechanisms of action, and clinical applications of TENS.

What is a TENS Analgesia?

TENS analgesia is a method often used for pain relief. This approach involves using an electrical stimulation device and electrode pads. The unit delivers gentle electrical currents to the skin, targeting the nerves to help alleviate pain. Physical therapists and individuals can apply TENS to various areas of the body. Moreover, they commonly utilise it for acute and chronic pain conditions.

According to systematic reviews, TENS reduce analgesic tolerance by providing a non-pharmacological alternative for pain management. It is not intrusive and does not require pain medicines. People can acquire a traditional, handheld unit. This model uses wires to connect the device to the electrode pads. Alternatively, wireless TENS machines are available to provide more flexibility and convenience.

Most TENS devices have adjustable settings. Individuals can alter the pulse duration, frequency, and intensity of the electrical currents to personalise their pain relief experience. There are also preset modes that target pain sites or types. These include neuropathic pain, muscle pain, joint pain, and post-surgical pain.


  • Non-invasive pain relief: Instead of using needles or injections, TENS can utilise high-intensity levels to trigger the inhibitory pathways in the body.
  • Drug-free option: Electric nerve stimulation offers relief without taking medications. This is suitable for people who prefer to avoid pharmacological interventions.
  • Portable and convenient: TENS units are handy devices that users can operate at home or on the go.
  • Targeted pain relief: Clinical experience advises that TENS can target specific painful areas without affecting the rest of the body.
  • Adjustable intensity: Individuals can customise their pain relief based on their specific needs and comfort levels by modifying the settings.

A step-by-step process on how to operate the mobile app of iTENS

The Mechanisms of Action of TENS Analgesia

Electrical nerve stimulation sends gentle electrical currents to specific areas of the body. It targets nerve fibres that transmit pain signals. Then, the electrical impulses from the TENS unit stimulate the nerves. This helps disrupt or reduce the transmission of pain signals to the brain. This can result in a reduction of pain intensity, providing temporary relief from discomfort.

One of the mechanisms of action of TENS analgesia is activation of the pain-regulating systems of the body. Clinical practice suggests that electric nerve stimulation can trigger the release of endorphins. These are natural pain-killing chemicals the body produces. Endorphins can help to dampen the perception of pain and enhance a sense of well-being. Additionally, TENS may stimulate the release of other neurotransmitters, such as serotonin and norepinephrine, which can further modulate the pain response.

Furthermore, previous studies show that electrical stimulation from the TENS unit may stop the transmission of pain signals by altering the activity of nerve cells in the central nervous system. This interference with the pain pathways can alleviate pain for both unhealthy and healthy subjects, which suggests that TENS is effective for various pain conditions.

Low and High Frequencies

The low-frequency setting of TENS typically ranges from two to nine Hz. This setting provides a continuous, non-pulsating current that effectively targets chronic, deep pain. Low-frequency TENS stimulates the release of endorphins. These are natural pain relievers, and their production results in long-lasting pain relief.

On the other hand, the high-frequency setting of TENS ranges from 50 to 120 Hz. This setting delivers a pulsating current. This is effective for addressing acute, superficial pain. High-frequency TENS stops pain signals travelling from the spinal cord to the brain. It provides immediate relief without causing muscle fatigue or habituation.

A woman using TENS machines on her lower back and arm

Clinical Applications of TENS Analgesia

Physical therapists and other medical providers widely use electrical nerve stimulation in clinical applications for pain management. TENS analgesia is commonly used for various conditions. These include chronic pain conditions, such as arthritis and fibromyalgia. Moreover, electrotherapy can alleviate the analgesic requirements of postoperative pain. It can also help with primary dysmenorrhea.

In physiotherapy, TENS is often incorporated into treatment plans to relieve discomfort. Also, electric nerve stimulation improves functional outcomes in patients with musculoskeletal injuries and disorders. Physical therapists can recommend its use with other interventions to provide immediate relief during rehabilitation sessions. Patients can use multiple wireless pads at once for convenience.

Additionally, TENS manages pain effectively in some populations, such as older adults and individuals with neurological conditions. Clinical practice suggests that electrical stimulation reduces pain without the potential adverse effects of long-term medication use. Thus, it is a favourable option for these patient populations. With its ability to modulate pain perception and improve quality of life, TENS continues to be an essential therapeutic approach in various clinical settings.

Are There Potential Adverse Effects?

Potential adverse effects are a possibility when using electrical nerve stimulation. Some individuals may experience skin irritation or allergic reactions to the electrodes or adhesive used in TENS therapy. Additionally, there have been reports of muscle twitching or discomfort during TENS treatment, especially when the intensity is too high.

In rare cases, TENS therapy may lead to temporary changes in blood pressure, dizziness, or headaches. Hence, it is essential for people with certain medical conditions, like pacemakers, to consult a medical provider before using TENS therapy. Otherwise, there is a risk of interference with these devices. Nevertheless, TENS is generally safe when used correctly.


TENS analgesia is a non-invasive pain relief therapy. It uses electrical currents to target specific nerves and provide relief from discomfort. The mechanisms of action involve the stimulation of sensory nerves. This can help stop pain signals from reaching the brain and spinal cord. Moreover, electric nerve stimulation can promote the release of endorphins. Physical therapists and individuals can utilise low TENS for chronic pain conditions, while high TENS is for acute pain conditions.

Clinical applications of electrical nerve stimulation include using it in physiotherapy settings. Also, people use TENS in chronic and acute pain management. Some of the conditions it can help treat are arthritis, fibromyalgia, and musculoskeletal injuries. Overall, TENS offers a non-invasive and safe option for pain relief. This makes it a beneficial treatment for patients seeking to manage their discomfort without relying solely on medication. They can check iTENS from iTENS Australia for Bluetooth-enabled units.

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