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Transcutaneous Nerve Stimulation TENS: How It Works and Usage Guide

A man experiencing body pain

Transcutaneous Nerve Stimulation TENS is a pain relief technique that works by stimulating the nerves through the skin. It utilises the pain gate mechanism. This means electrical impulses from the TENS device can block the pain signals from reaching the brain. Additionally, TENS can stimulate the release of endorphins, which are natural painkillers produced by the body. Overall, TENS is an effective and non-invasive method for relieving pain.

It is important to understand that TENS is not a permanent solution for pain but rather offers temporary relief. The effectiveness of a TENS machine in providing pain relief can vary from person to person. Just like with oral medications, individuals may have different reactions to TENS treatment. Generally, the duration of pain relief can range from five minutes to 24 hours. This article will present the functioning of TENS, including its correct usage, frequency, and modes.

How Transcutaneous Nerve Stimulation TENS Works

Transcutaneous nerve stimulation TENS works well for various painful conditions. TENS follows the Pain Gate Theory. This theory suggests that when nerves get mild electric currents from TENS, they can close the “gate”, blocking pain signals from reaching the brain. As a result, the perception of pain is reduced or blocked.

Moreover, TENS make the body release endorphins. Endorphins are like natural painkillers that the central nervous system makes. When someone feels pain, their body makes endorphins to stop the pain signals. TENS works by copying this natural way the body deals with pain. This can make the person hurt less and feel more comfortable.

Furthermore, TENS can also help boost blood circulation. The electrical stimulation causes the blood vessels to dilate, allowing for better blood flow to the affected area. This improved circulation encourages the delivery of oxygen and essential nutrients to the tissues, aiding in the healing process. Additionally, the increased blood flow can help remove waste products and toxins from the area, reducing inflammation and swelling.

Conditions it can Treat

  • Phantom pain: experienced by amputees.
  • Postoperative pain: pain after surgical procedures.
  • Grip pain: a discomfort experienced in the hands when gripping.
  • Joint pain: pain conditions like arthritis or joint injuries.
  • Labour pain: pain during childbirth.
  • Period pain: menstrual cramps or primary dysmenorrhea.
  • Neuropathic pain: a pain experienced in conditions like diabetic neuropathy.
  • Cancer pain: a pain from the cancer itself or as a side effect of the treatment.
  • Musculoskeletal pain: pain in muscles, tendons, ligaments, or bones.
  • Rheumatoid arthritis: joint pain and inflammation in the hands, wrists, and knees.
  • Facial pain: can be due to anything from an infection to nerve damage in the face.

Operating a TENS machine through a smartphone app

How to Operate Transcutaneous Nerve Stimulation TENS Devices

To operate a standard wired TENS device, the person should clean and thoroughly dry that area to ensure good contact with the skin. Next, they have to connect the electrode pads to the device using the provided wires. Afterwards, the user can place the pads in the designated area and adjust the settings according to their comfort level.

Wireless TENS devices like iTENS provide added convenience. To use iTENS, individuals should position the electrodes on clean, dry skin near or on either side of the pain. The electrical device should be turned on, and the desired treatment can be selected through the app. The iTENS app offers eleven preset settings for various body parts and thirteen programs for specific ailments. Additionally, a treatment mode can be chosen from the menu to initiate pain relief.

Operating transcutaneous nerve stimulation TENS devices for pain relief is quite simple. Whether a person is using a regular wired TENS or a wireless electronic device such as iTENS, it is crucial to follow the manufacturer’s instructions. TENS can be a valuable tool for individuals in managing chronic conditions and enhancing their quality of life.

Types of TENS

A variety of Transcutaneous Electrical Nerve Stimulation (TENS) types offer different pain relief methods. Firstly, conventional TENS uses low-frequency current to activate specific nerves, creating a tingling sensation for pain relief. Secondly, acupuncture-like TENS aims to mimic the effects of acupuncture by using electrical currents to stimulate specific body points.

Thirdly, brief intense TENS uses high-frequency current to activate sensitive nerves, reducing pain sensation in body areas, called segmental analgesia. A wide range of healthcare professionals use these TENS techniques, as supported by systematic reviews, to control pain through electrical impulses on nerve fibres, including peripheral nerves and the spinal cord.


A woman using iTENS on her lower back.

Transcutaneous Nerve Stimulation TENS Frequency and Modes

The TENS frequency indicates how many electrical pulses it delivers each second. People often use high-frequency TENS to quickly relieve acute pain. In contrast, low-frequency TENS are typical for chronic pain. Both pulse frequencies mainly activate motor nerves, which trigger the body to release its natural painkillers, called endorphins.

Electrical stimulation devices also offer different modes of operation, allowing users to customise their relief of pain. The most common modes include constant mode, burst mode, and modulation mode. Firstly, the constant mode delivers a continuous stream of electrical pulses. Secondly, burst mode delivers a series of rapid pulses followed by periods of no electric stimulation. Thirdly, the modulation mode automatically adjusts the intensity and frequency of the pulses.

The frequency and modes of transcutaneous nerve stimulation TENS play a crucial role in providing pain relief. The frequency determines how electrical current interacts with nerves, while the modes allow for customisation of the pain relief experience. By understanding and utilising these features, individuals can effectively manage their pain and improve their quality of life.

Safety Guidelines

Electric nerve stimulation devices are a safe and effective method of pain control. However, users should follow certain safety guidelines when using these devices. Firstly, users should ensure that the electrode pads are clean and in good condition. This helps to prevent any skin irritation or discomfort during use.

Secondly, the TENS device should be used according to the instructions provided by the manufacturer. It is important to not exceed the recommended duration and intensity of the treatment. Thirdly, TENS devices should not be used on broken or damaged skin. Overall, these safety measures should be followed to ensure an effective treatment of pain.


Transcutaneous nerve stimulation TENS effectively relieves different types of pain in adults. This therapy follows the Pain Gate Theory and stimulates the release of natural pain-relieving substances. Additionally, TENS improves blood flow, which helps heal tissues and reduces inflammation. Using TENS devices, whether they are wired or wireless, is easy and should be done following the manufacturer’s instructions. Understanding the frequencies and modes of TENS empowers individuals to personalise their pain management.

Knowing the different types of TENS can help individuals find the most effective pain relief method for their specific needs. Conventional TENS, acupuncture-like TENS, and brief intense TENS all offer unique approaches to managing pain through electrical impulses. Additionally, users should follow safety guidelines. These include keeping electrode pads clean, following manufacturer instructions, and avoiding use on broken skin. Overall, TENS is a safe and beneficial method for managing pain and improving quality of life.

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