Transcutaneous Electrical Nerve Stimulation (TENS): Everything You Need to Know

Transcutaneous Electrical Nerve Stimulation (TENS)

What is Transcutaneous Electrical Nerve Stimulation (TENS)?

Transcutaneous Electrical Nerve Stimulation (TENS) is a type of therapy that uses low voltage electrical currents to provide pain relief. TENS therapy is often used in rehabilitation to manage pain caused by a variety of conditions, such as chronic pain, back pain, arthritis, and fibromyalgia.

During TENS therapy, small electrodes are placed on the skin over the affected area. The electrodes are connected to a small battery-operated device that delivers electrical currents to the nerves. The electrical stimulation is believed to reduce the sensation of pain by blocking pain signals from reaching the brain.

How does TENS work?

TENS works by delivering low voltage electrical impulses to the nerves through electrodes placed on the skin. The electrical impulses are thought to stimulate the nerves and activate the body’s natural pain control mechanisms, which can help reduce pain and improve rehabilitation outcomes.

There are several ways in which TENS is believed to work:

  • Gate Control Theory: This theory suggests that the electrical impulses from the TENS unit stimulate the large sensory nerve fibers in the area of pain, which can help to close the “gates” that allow pain signals to reach the brain. This can reduce the perception of pain.
  • Endorphin Release: TENS may also stimulate the release of endorphins, which are natural pain-relieving chemicals produced by the body.
  • Central Modulation: TENS may also affect the way pain signals are processed in the brain, leading to a reduction in pain perception.

Which conditions can be treated with TENS?

TENS therapy can be used to manage a variety of acute and chronic pain conditions, as well as for rehabilitation purposes. Some of the common conditions that can be treated with TENS therapy include:

  • Musculoskeletal pain: TENS therapy can be effective for managing pain associated with musculoskeletal conditions such as arthritis, low back pain, neck pain, and fibromyalgia.
  • Postoperative pain: TENS therapy can be used to manage pain after surgery and reduce the need for opioid pain medications.
  • Neuropathic pain: TENS therapy may be effective for managing neuropathic pain, which is caused by damage to the nerves and can cause symptoms such as tingling, burning, and shooting pain.
  • Headaches: TENS therapy can be used to manage headaches, including tension headaches and migraines.
  • Sports injuries: TENS therapy can be used as part of rehabilitation programs for sports injuries, such as sprains, strains, and tendonitis.

What can I expect during the procedure?

During a TENS procedure, you can expect the following:

  1. Preparation: You will be asked to remove any clothing or jewelry that may interfere with the placement of the electrodes. The skin will be cleaned and dried to ensure good contact with the electrodes.
  2. Placement of electrodes: Small electrodes will be placed on the skin near the area of pain or on specific acupuncture points. The electrodes will be connected to the TENS unit.
  3. Treatment: The TENS unit will be turned on and the healthcare professional will adjust the settings to the appropriate level of intensity and frequency for your specific condition and needs. You may feel a tingling or buzzing sensation in the area of the electrodes.

TENS therapy is usually applied for about 20 to 30 minutes per session.

Does TENS hurt?

TENS therapy is generally considered to be a non-invasive and painless procedure. However, some people may experience mild discomfort or a tingling or buzzing sensation during the treatment, which can take some time to get used to.

How long does TENS therapy take to start working?

Some people may experience immediate pain relief during the treatment, while others may need several treatment sessions before they begin to notice a significant improvement.

In general, it is recommended to undergo TENS therapy for several sessions over the course of a few weeks to achieve the maximum benefit. The duration and frequency of treatment can vary depending on the individual and the specific condition being treated.

Are there any risks associated with TENS?

While TENS therapy is generally considered to be safe and well-tolerated, there are some risks that should be considered. 

The most common side effect is skin irritation at the site of electrode attachment. This minor side effect can be treated by adjusting the position of the electrodes or by using a different type of electrode.

However, there are certain populations of patients who should only use TENS after consultation with their doctor:

  • Pacemakers or other implanted electrical devices: TENS therapy can theoretically interfere with the functioning of pacemakers or other implanted electrical devices. Therefore, people with these devices should not undergo TENS therapy without first consulting with their healthcare professional.
  • Epilepsy or seizure disorders: There is small possibility that TENS therapy may trigger seizures in people with epilepsy or seizure disorders. Therefore, they should use it with caution under the guidance of a qualified healthcare professional.

What are the benefits of TENS over other treatment options?

TENS therapy has several benefits over other treatments for pain management and rehabilitation, including:

  • Non-invasive: TENS therapy is a non-invasive procedure, meaning it does not require any injections or incisions. This can be beneficial for people who are hesitant to undergo more invasive treatments.
  • Minimal side effects: TENS therapy has minimal side effects compared to other pain management treatments like medications such as opioids
  • Targeted pain relief: TENS therapy allows for targeted pain relief, as the electrodes can be placed directly over the affected area to provide relief. This is in contrast to systemic pain management treatments, which may affect the entire body and can lead to unwanted side effects.

Is TENS right for me?

In general, TENS therapy can be a good treatment option for people who are looking for a non-invasive, drug-free, and targeted approach to managing pain and improving rehabilitation outcomes. However, it is important to consult with a healthcare professional to determine if TENS therapy is a good option for you.

About the Author

Dave Harrison, MD

Dr. Harrison is a board certified Emergency Physician with a part time appointment at San Francisco General Medical Center and is an Assistant Clinical Professor-Volunteer at the UCSF School of Medicine. Dr. Harrison attended medical school at Tufts University and completed his Emergency Medicine residency at the University of Southern California. Dr. Harrison manages the editorial process for