What is TENS?

Transcutaneous electrical nerve stimulation is a pain control treatment. It is often called TENS for short. 

A TENS unit is a portable, pocket-sized, battery-powered device.

The TENS unit uses mild, safe electrical signals to help control pain and delivers the electrical signal to the body through a connection of a lead wire and self adhesive conductive electrode.


The most common TENS programs use high-frequency stimulation, which is the first choice for both acute and chronic pain. High-frequency stimulation sends impulses to the nervous system’s own pain-inhibiting mechanisms, which block the pain.
You can use it as often and as long as you like, but each treatment should last at least 45 minutes.

Another type of TENS is low-frequency stimulation. Low-frequency TENS treatment can alleviate pain by stimulating muscles to release the body’s own morphine-like substances, endorphins. Place the electrodes on a muscle in the painful area so that a visible contraction occurs. You can use low-frequency TENS for 20–45 minutes, three times a day. Low-frequency stimulation can lead to sore muscles.

It is useful for you to have a pain assessment before you start TENS. This will identify what kind of pain you have and exactly where it is. If you have numb areas on your skin for example, these will need to be avoided as TENS needs an intact nerve pathway to work.

Two channel (four electrode) machines are more
flexible especially if the pain is large or widespread.

Start with conventional TENS with a continuous pulse settings.

  • Use middle pulse frequency(approx 80-100 per second) and pulse duration (100-200 microseconds).
  • Increase the intensity until the sensation is strong and a little uncomfortable, then turn it down slightly, until comfortable.
  • You may need to experiment with the settings as there is no sure way of telling which combination will suit you without trial and error.
  • Put the electrodes on normal healthy skin. Check to make sure you don’t have any cuts or other breaks in the skin which could be very uncomfortable and react badly.
  • Take time to find the best electrodes placements - this may be tricky.

Conventional or high frequency settings is performed when the Pulse Rate is set to 60 pulses per second or more.  The sensation produced will be a steady buzzing or tingling feeling between the electrodes.  Because the TENS signal is perceived as stronger than the pain signal being produced by the body, it effectively blocks the pain signal from travelling along nerves to the brain. Most clients find that high-frequency treatments produce the quickest relief from pain, as well as providing several hours of relief after the treatment.

Treatment duration - 45 - 60 minutes, or continuous if required.  Most modern units are portable and can be clipped to the belt while going about normal activities.

Low-frequency or burst type of treatment is produced when the Pulse Rate setting on the TENS unitis set manually below 10 pulses per second (or as with some units, at automatic burst mode). Low-frequency treatments produce visible muscle twitching often described as a tapping or pulsating sensation.

In reaction to this type of stimulation the body releases endorphins (pain-killing chemicals produced naturally in the body). These endorphins act as a chemical nerve block to reduce pain by interrupting the pain signals along the nerves to the brain.  Often this type of treatment can take longer to be effective but the results last longer.

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