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TENS Therapy Unit: What It Is, How It Works, and How to Use

A large and small wing iTENS electrode and refill gel pads

Transcutaneous Electrical Nerve Stimulation (TENS) is a popular form of electrotherapy many people use for pain management. It uses TENS therapy units, which are small, battery-operated devices that deliver low-voltage electric currents using electrode pads. This stimulation can trigger the pain gate mechanism and endorphin release, providing immediate short-term relief. To use it, the individual must apply the electrode pads to the pain source and adjust the settings according to their comfort levels.

Many people suffer from chronic conditions that cause mild to debilitating pain. It can severely impact the quality of life and cause stress and anxiety. For relief, many use the traditional approach and take medicine or undergo surgery. TENS is an alternative method that is non-invasive and drug-free, making it ideal for many. This article will present information on TENS machines, how they work, and how to operate them.

What is a TENS Therapy Unit?

A TENS therapy unit is a medical device that uses low-voltage electrical currents to alleviate pain from various acute and chronic pain conditions. Doctors and physical therapists often use these in medical settings, like hospitals and pain clinics. However, people can also buy personal units. These small, battery-operated devices are easy to carry around for effective pain relief.

People can buy TENS machines from online retailers and pharmacies without prescriptions. Several models from various brands are available, but generally, there are two types of TENS units. The wired or traditional unit utilises cables to connect the control unit and the electrode pads. Some products offer quad-channels, which enable users to link up to eight pads simultaneously.

Meanwhile, wireless units use Bluetooth to link the pads with the control unit. They usually offer advanced features like pre-set modes along with manually adjustable settings. These are ideal for individuals who lead active lifestyles since movements remain unrestricted during sessions. This enables them to do simple activities at home or during work.

Treatable Conditions

  • Acute pain conditions: sudden or sharp aches that do not last for more than six months. This includes various body aches and sports injuries, such as muscle strains, sprains, and fractures. TENS can also be safe for relief during labour pains.
  • Chronic pain conditions: aches that last more than six months, often due to underlying conditions. Some also persist even after the injury heals. One example is fibromyalgia, which causes widespread musculoskeletal pain, fatigue, and tenderness.
  • Neuropathic pain: nerve pain from injuries, damage, or pressure to the nerves. Conditions include diabetic neuropathy and sciatica.
  • Musculoskeletal conditions: ailments affecting the muscles, bones, and joints like arthritis.

A woman with an electrode on her arm placing an electrode on another person

How a TENS Therapy Unit Works

A TENS therapy unit works by using electrical impulses to stimulate the sensory nerves. It has adjustable settings that enable users to modify them depending on their comfort level and the condition they wish to treat. Some also offer preset modes, which enhance the convenience of TENS by reducing the need for experimentation.

Different settings can bring about various effects. High-frequency stimulation (50-120 Hz) is ideal for immediate relief from sudden and severe pains. It triggers spinal nerve cells to block the transmission of pain signals to the brain. It also has a massage-like effect that can help relieve sore muscles and increase blood flow to the target area. This aids in healing, improving recovery speed.

On the other hand, low-frequency stimulation (2-10 Hz) works well for chronic pain conditions. Although temporary, its effects can last longer since it triggers the production of endorphins. They can improve moods and promote a sense of well-being. Furthermore, they can help reduce inflammation, increasing the range of motion.

Main Theories at Work

Two main theories explain how TENS therapy alleviates pain. The first of which is the Gate Control Theory of Pain. This suggests that the electrical stimulation from TENS can close the gates in the spinal cord to limit the pain messages that reach the brain. It is also known as the pain gate mechanism.

The second theory is the Endorphin Release Theory. This suggests that low-frequency electric nerve stimulation can affect the motor nerves and trigger the production of endorphins. These are natural painkilling hormones that bind to opioid receptors and reduce the overall pain intensity.

A guide on how to use the iTENS smartphone app

How to Use a TENS Therapy Unit

Using a TENS therapy unit is a straightforward process. It is easy to self-administer due to its intuitive controls and does not require medical supervision. Nevertheless, taking safety precautions is ideal when using any electrotherapy device. Hence, preparing for the session by washing the target and area and reading the instruction manual is recommended for effective pain relief therapy.

To start, the individual must apply the electrode pads on muscles near or on the source of discomfort. Then, they may turn the machine on and adjust the settings accordingly. However, it is best to start with low settings to avoid sudden shocks, muscle twitching, or unsettling tingling sensations. Hence, they should gradually increase the intensity settings.

Users may set a timer to keep track of the session duration. TENS therapy usually lasts between 15 to 30 minutes, depending on the settings and the health issues they are addressing. Once the time elapses, the user should turn the machine unit off and remove the electrodes.

Safety Precautions

Although TENS therapy is safe for most people, taking safety precautions is necessary to prevent adverse events. Foremost, individuals should consult a medical professional before using any electrotherapy devices. They can diagnose the medical condition and ensure they do not have underlying conditions that disallow them from using TENS. This includes having heart disease, seizures, and epilepsy.

Furthermore, users must practice proper pad placement. They should avoid sensitive areas like the spinal cord and damaged skin. Individuals must also refrain from using TENS while driving, operating heavy machinery, or in water. Lastly, they must refrain from overusing the machine.


A TENS therapy unit is a medical device people use for pain relief. It uses electrical pulses to trigger the spinal nerve cells to block pain messages. It also induces endorphin release and increases blood circulation. TENS therapy is effective for conditions like fibromyalgia, sciatica, arthritis, and sports injuries. It provides non-invasive and drug-free pain that people can easily access using personal units. However, consulting a healthcare professional is recommended before using it.

People can buy TENS machines without prescriptions and self-administer them easily. Most devices offer adjustable settings for customised relief. To use it, they must place the electrode pads on the pain source and then alter the settings based on their condition. Sessions may last between 15 to 30 minutes. People can use it multiple times daily, but they must take at least a 20-minute break to avoid overstimulation or skin irritation at the electrode site.

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