How Does TENS Work? - Will TENS Help? - A Physical Therapist Explains

A TENS machine is a noninvasive approach commonly used to address pain and injuries. They are commonly prescribed and used across healthcare settings. I'd like to take some time to clear up a few misconceptions and then discuss some potential benefits.

Transcutaneous Electrical Nerve Stimulation (TENS)

Commonly, TENS units are “those pads with the tingly sensation” that people put on injuries. Yes, this is a traditional use of TENS or also referred to as simply “stim” or “e-stim.” These low-level electrical impulses can be felt as a light or strong “tingling” sensation. It is very common in physical therapy clinics and is typically used for every patient regardless of injury. If you've been to PT before, you're probably familiar with TENS or stim.

From anecdotal experience polling my audience, I can say most people assume a benefit from TENS because they can “feel” something happening and it’s a fancy piece of equipment. Unfortunately I have to divulge that not much is being accomplished from a long-term point of view. TENS happens to be a very temporary alteration to your nervous system that provides fleeting relief.

Put very simply, TENS units temporarily trick your nervous system into not feeling pain. They do this in the same way that you feel better when you rub your elbow after you hit your “funny bone.” Or when you rub your shin after you whack it on the coffee table. In addition to a creative string of expletives, you feel better because you're exciting other sensory receptors that send a nerve impulse to your brain faster than the pain can travel. The nerves that carry “pain” signals transmit slower than the nerves that carry other sensory signals. Voila, pain loses that race up to the brain and we temporarily don't “feel” the pain. Ain't it magical!?

This is called the “gate theory” of pain where one gate closes (to pain) and another gate opens (to other sensory signals) to provide short term “distraction” or relief from the pain. There have been some studies to show some lasting effects of 30+ minutes but on the whole the lion's share of research is inconclusive due to a lack of reliable high-quality studies or clinical trials. In fact, there is some evidence to show that people who use it frequently may even develop a tolerance for it and the pain relief won't be as consistent.

What is the take away? Well the main point I'd like to hit home is that TENS machines are purely for subjective pain relief and for addressing the nervous system. There is no effect on the physiology or injury so it won't actually “help” heal an acute or chronic issue by itself. However, there are few contraindications to using it and when used safely (which is most of the time) it can be a low-risk option for pain relief for some people. Pain is public enemy #1 so it can be a useful tool when used appropriately and so long as we are not using it in lieu of a more beneficial treatment option.

In the clinic I can use it mostly for people with post operative pain and mobility restrictions. It can help provide pain relief during joint mobility and allow the clients to tolerate movements that would otherwise be painful. But I have to be honest, the only reason I have the machine is because it was given to me for free by a company rep and they've since gone out of business. We generally try and steer clients away from passive approaches to their healthcare and instead choose more active means of enacting change, especially if the choices are temporary vs lasting results.

TENS machines are by no means the devil, but they certainly aren't the magical end all that they are often touted to be. Be sure to ask questions, but don't shoot the messenger.

Feldman Physical Therapy & Performance is the premier provider of physical therapy services in the Hudson Valley. With locations in Poughkeepsie, Fishkill, and Pawling New York.
Each patient receives a full hour of personalized one-on-one treatment with a Doctor of Physical Therapy. This means you will save time and money with fewer visits over a shorter period of time, resulting in faster healing and recovery.

#PhysicalTherapy #TENS #Pain

[Cae]

I am literally using one right now. And I can say it is definitely not a placebo effect. I suffer from neck shoulder and lower back pain from a car accident and past jobs. & lately my shoulders have been extremely tight and painful. I'm unable to fully look to the left, but after 30 minutes of using the tens unit omron I'm able to fully turn my head to the left with minimum to no pain. As well as the pain within my shoulders has diminished almost completely while using it❤

[englishwithtroy]

Fantastic explanation. Thanks for posting this.

[TheMassif]

Fascinating! thanks for the explanation

[bohumilkolouch]

Thank you very much for the excellent explanation. I was thinking about buying one for my lower back morning pain and stiffness. As it is not healing, it is not the way I should go. Thanks again.

[carolynh]

I have chronic pain. I crank my tens all the way up and it feels like a good massage. Sometimes tricking my nervous system is whay I need to break out of a bad pain loop.

[armengraham]

TENS devices are fun, it's nice to know they are mainly pain relief, so I'll continue training.

[trpk]

Recovering from GBS and the use a TENS unit 2x day on a moderate setting has been a tremendous help to my recovery. It helps alleviate muscle tightness/chronic pain in my left foot and ankle which have allowed increased mobility, strength building, and healing the neuropathy instead of “learning to live with it” as I’d been advised by medical professionals.

[madman]

thanks for such a great review. it was really funny too! I had really horrible back pain and i couldnt sleep and my coworker recommended this to me. Im not sure what hype is around it but it does help reduce my pain so i can fall asleep, so thats a win! interesting stuff but kind of dangerous too, i thought about slapping them on my temples like clockwork orange lol.

[ANNACECILIASEBASTIAN-gi]

➕️ that was an eye opener for sure. I couldn't understand how the pain intensity came back. Now i know and accept the gadget for what it can do.
Thank you

[claraz]

Thanks the for the video. I have a question - how do I know which TENS machine is more suitable for me?

[Achala]

Just wondering if the pain receptor is disrupted like that with the TENS, if that is the correct terminology, if the brain isnt registering pain to a specific area does that change the body's chemical response, like inflamation etc if the brain isnt perceiving pain and help healing in that way?

[nabilmoussa]

I find it useful for muscle mind connection in areas I feel Week

[ΝΕΟΚερατσίνι]

when i am using it at my wrist(tfcc injury), my wrist becomes red after a while. Doesn't that means increaced blood flow?

[periklisgiannopoulos]

So, in my case, which is back pain from the usual L4-5 disk problem wouldn't be better to work with tecar and hypersound in terms of healing the muscles which cause the muscle spasm which caused the immobilisation?

Very useful video.
Thanx

[ChrisBakerNY]

oh... so if it's not actually going to heal my shoulder, I won't bother with it. Guess I'll keep with PT exercises. Thanks for the heads up.

[Ghosthead]

I heard it does increase blood and and healing nerves.