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Transcutaneous: Definition, Mechanisms Of Action, And The Applications Of TENS

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Transcutaneous Electrical Nerve Stimulation (TENS) is a method of pain relief that involves the use of low-voltage electrical currents. The device works by sending electrical impulses through the skin to nerves to block or modify pain signals. TENS is commonly used to treat various conditions such as arthritis, back pain, and sports injuries. In addition, the therapy is non-invasive and can provide relief for many individuals experiencing discomfort.

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 individuals explore alternative remedies to effectively address conditions. This article will present TENS therapy, including its mechanism of action and various applications.

What is Transcutaneous TENS?

Transcutaneous TENS is a method of pain relief that uses a portable electronic device. It typically consists of a control unit and sets of electrodes. The adhesive electrode pads send electrical currents to stimulate the nearby sensory nerves to reduce pain in adults. Moreover, there are two types of TENS devices that individuals can use: standard and wireless.

A standard TENS machine has a handheld push-button remote and wires connecting to the electrode pads. On the other hand, a wireless TENS machine utilises Bluetooth technology to connect to a smartphone app. It is popular among individuals who prefer convenient and on-the-go pain management. Nevertheless, both types deliver adequate electrical stimulation.

The TENS electrodes are interchangeable in different sizes and shapes. This can help fit different areas of the body and deliver appropriate stimulation levels. Additionally, the pads stick firmly to the skin but do not penetrate or leave permanent marks. It is worth noting that TENS is not a cure for pain but only provides temporary relief.


  • TENS relieves various acute and chronic pain conditions, including neuropathic pain and musculoskeletal pain, for quality of life improvement.
  • It offers an analgesic mechanism without the need for surgical intervention or medication.
  • Most TENS devices are small and easy to carry, allowing users to manage pain on the go.
  • Users can adjust pulse rate, pulse duration, and pulse amplitude to suit their needs.
  • Electrotherapy does not carry the risk of side effects associated with pain medications.
  • People can use TENS as a complementary therapy alongside conventional treatments, including heat therapy, physical therapy, or medication.
  • Electric nerve stimulation may improve blood flow, aiding in healing.

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Mechanisms of Action of Transcutaneous TENS

Transcutaneous nerve stimulator machines work 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. The electric devices let the body produce more endorphins, which 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, the use of TENS machines has a positive impact on the circulatory system. The electrical pulses or mild vibrations boost blood circulation in the affected area. This helps to reduce inflammation, relax the muscles, and promote faster recovery of damaged tissues and nerve regeneration.

Understanding Frequencies and Intensities

Frequency refers to the number of pulses or cycles of electric current per second. The typical frequencies in TENS therapy range from 1 to 150 Hz. Lower frequencies, such as 1-5 Hz, are suitable for chronic pain. Meanwhile, higher frequencies, such as 80-150 Hz, are for acute pain.

Intensity is the strength or power of the electrical currents, measured in milliamps (mA). It influences how deeply the electrical signals penetrate the body. Generally, TENS therapy starts with a low intensity and gradually increases to a comfortable level. Finding the right intensity is essential for maximising the benefits of the therapy.



Man with neck and back pain

Applications of Transcutaneous TENS in Pain Management

Transcutaneous TENS finds applications in managing various types of pain in adults. In cases of acute pain, such as primary dysmenorrhoea, postoperative pain, labour pain, or muscle sprains, these devices prove beneficial. By emitting controlled and continuous pulse patterns, they help alleviate pain and promote faster recovery. For instance, after surgery, people can strategically place these devices to target the affected area, providing relief and supporting the healing process.

For chronic pain lasting for more than three months, TENS medical devices play a crucial role. Conditions like diabetic neuropathy, chronic low-back pain, sciatica, fibromyalgia, or knee osteoarthritis pain often involve persistent discomfort. Electric stimulation provides a means of managing this enduring pain without relying solely on medications. By modulating nerve signals, these medical devices contribute to pain relief over extended periods.

Beyond specific conditions, electric stimulation devices address the more general concern of body aches. Whether it is localised pain in joints like wrists, elbows, and knees or a pervasive sense of soreness, these devices offer targeted relief. Users can place electrodes on specific areas of discomfort, tailoring the effective treatment to their needs.

Is It Safe?

TENS is generally safe. However, there are some safety precautions to consider. Firstly, avoid electrode placement on sensitive areas. This may involve various parts of the body, such as the temples, neck, chest, and spinal column. Secondly, it is important to familiarise the functions of the device. Avoid extreme intensity levels to minimise skin irritation or allergic reactions.

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, transcutaneous TENS offers effective pain relief through electrical stimulation. It works by closing the pain gate in the spinal cord, reducing pain signals to the brain, and stimulating the production of endorphins, natural painkillers. Additionally, it enhances blood circulation, aiding in muscle relaxation, inflammation reduction, and tissue repair. TENS is a convenient and non-invasive option for temporary pain management, providing relief and promoting overall well-being.

TENS finds application for various types of pain, both acute and chronic. It is generally safe when used properly, but precautions like avoiding sensitive areas, moderating intensity levels, and not using it during certain activities are necessary. TENS devices provide targeted pain management without heavy reliance on medications, making them valuable tools for individuals seeking alternative methods. With proper use and understanding of safety guidelines, TENS can be a beneficial addition to pain management strategies.

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