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TENS Pain Therapy: Definition & the Mechanisms of Action

iTENS small wing kit with written features

Transcutaneous Electrical Nerve Stimulation (TENS) is a non-invasive and drug-free method of pain relief. It involves using a small device to send electrical pulses to nerve endings through the skin. These pulses block pain signals from reaching the brain to reduce pain sensations. Also, TENS pain therapy can prompt the body to release more natural pain-relieving chemicals called endorphins. Moreover, it enhances blood circulation to the affected area, aiding tissue repair and reducing inflammation.

Pain is a common issue that impacts millions of people globally, whether it is acute or chronic. Traditional pain management techniques commonly include pain medications, physical therapy, heat therapy, and exercises. However, it is important to note that they may not consistently deliver the intended amount of pain relief. Therefore, many people explore alternative remedies to address conditions effectively. This article will present TENS therapy, including its mechanism of action and various applications.

What is TENS Pain Therapy?

TENS pain therapy is a treatment of pain that uses a device to deliver electrical currents to the body. It streams the electrical impulses through electrode pads placed on the skin. Accordingly, this technique is widely embraced by people suffering from various pain characteristics. Pain clinics and medical professionals often recommend TENS therapy.

There are two primary types of TENS devices: traditional and wireless. The traditional TENS units are connected to the electrodes via lead cables. Conversely, wireless TENS units offer more flexibility and convenience. It eliminates the need for physical wires. Additionally, users can manually control the electrical pulses directly on the electrodes or through a smartphone app via Bluetooth connectivity.

TENS therapy can help with different types of pain in adults. These include acute pain, chronic pain, sore muscles, musculoskeletal pain, neuropathic pain, osteoarthritis pain, postoperative pain, primary dysmenorrhea, and more. It is worth noting that TENS is not a cure for pain but only provides short-term relief and the effects vary from person to person.

Brief History of TENS Treatment

  • Using electricity for pain relief dates back to ancient times when Egyptians and Greeks used electric fish to alleviate pain.
  • The modern use of TENS therapy began in the 1960s when researchers discovered they could control the electrical currents to manage pain.
  • The first modern wearable TENS machine was made available in the 1970s.
  • TENS machines were initially used to test the tolerance of patients with chronic pain conditions to electrical stimulation before implanting electrodes in the spinal cord.
  • Over the years, healthcare providers saw the emergence of modern designs, including wireless TENS machines and specialised devices like labour TENS.

A woman operating the iTENS attached to her wrist

Mechanisms of Action in TENS Pain Therapy

TENS pain therapy works by sending electrical impulses through electrode patches that people place on the skin. These impulses produce two general responses from the body, particularly the central nervous system. The first method is based on the Gate Control Theory of Pain. During TENS treatment, the pain gate mechanism in the spinal cord closes. Therefore, it inhibits the transmission of pain signals to the brain.

The second method involves stimulating endorphin production. TENS devices let the body produce more endorphins. These are hormones that can reduce pain and enhance overall well-being. Endorphins attach to opioid receptors and prevent them from transmitting pain messages. They are also known as natural painkillers as they have similar effects to morphine.

Furthermore, electric nerve stimulation has a positive impact on the circulatory system. The electrical pulses or mild vibrations boost blood circulation in the affected area. This mechanism helps to reduce inflammation, relax the muscles, and promote faster recovery of damaged tissues and nerve regeneration.

Understanding the Settings of TENS Units

A TENS unit often comes with three main controls. Firstly, pulse rate measures how frequently the pulses travel through the skin. Secondly, pulse duration indicates the width of each electrical pulse. Lastly, pulse amplitude refers to the strength or intensity of these electrical pulses.

People often adjust these settings gradually, increasing them until they find the level that offers the best therapeutic or pain-relieving effect. This process helps with pain management, allowing users to tailor the intensity to their tolerable level. Physical therapists commonly guide patients through this adjustment process to achieve optimal pain control and analgesic effects.

An elderly woman using iTENS on her arm while reading a book

Applications of TENS Pain Therapy in Different Populations

In the general population, TENS pain therapy finds its application as a non-pharmacological intervention for managing pain. Clinical trials and systematic reviews have shown its effectiveness in providing analgesia by targeting sensory nerves. People suffering from various medical conditions, such as chronic back pain or arthritis, often benefit from TENS therapy, reducing reliance on medication and enhancing overall well-being.

In addition, athletes frequently utilise TENS therapy to alleviate pain because of sports injuries or muscle strains. Its ability to provide effective analgesia makes it a popular choice among athletes seeking quick recovery and pain relief. TENS also aids in reducing inflammation and promoting muscle recovery, allowing athletes to resume their training and competitions sooner.

Moreover, women in labour can use TENS therapy as a valuable non-pharmacological intervention for managing the intense pain associated with childbirth. Clinical evidence and studies have demonstrated its effectiveness in providing relief during labour, offering women a sense of control over their pain. TENS units are often used in maternity wards as part of the comprehensive management of pain.

Is It Safe and Effective?

TENS is generally safe. However, there are some safety precautions to consider to avoid negative outcomes. Firstly, avoid electrode placement on sensitive areas. These may involve various body parts, such as the temples, neck, chest, and spinal column. Secondly, it is essential to familiarise the functions of the device. Always ensure to use tolerable intensity levels to minimise skin irritation.

Thirdly, do not use the TENS machine while sleeping, driving, or operating heavy machinery. It is essential to remain alert and focused during the treatment. Lastly, since they are electrical devices, do not use the unit in water to avoid shocks.


In conclusion, TENS pain therapy offers a non-invasive and drug-free approach to managing various types of pain. Traditional and wireless TENS devices offer flexibility, with wireless units providing added convenience. By sending electrical impulses through electrode pads, TENS can effectively block pain signals from reaching the brain. Additionally, it can stimulate the production of endorphins. Moreover, it improves blood circulation, which aids in reducing inflammation and promoting tissue healing.

Furthermore, TENS therapy can help manage pain across various populations. Whether it is chronic conditions like back pain, sports injuries for athletes, or the intense pains of childbirth for women in labour, TENS provides relief. However, caution is necessary to avoid adverse effects. Proper electrode placement, understanding the device, and using it in appropriate settings are crucial for safety. TENS therapy is a valuable non-pharmacological option, empowering individuals to alleviate pain and improve their well-being.

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