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A complete guide
to TENS therapy

For all TENS users

This guide will walk you through everything you need to know about TENS machines, including what they are, how to use them, and how to find the best unit for you.  

What is a TENS Machine?

TENS therapy is a safe, easy to use and drug free method of pain relief used by hospitals, pain clinics and by physiotherapists since the 1960's. TENS is an abbreviation of Transcutaneous Electrical Nerve Stimulation. A TENS Machine is a small battery operated machine which produces pain relieving electrical pulses. Up to 8 self adhesive electrodes are applied to the skin and attached to the TENS unit with lead wires. The tiny pulses are then passed from the TENS unit, via the lead wires and electrodes, so that they are applied to the nerves which lie underneath the skin surface. The electrodes are normally positioned over, or around, the area of pain but other more advanced applications may often prove better.

How does a TENS machine relieve pain?

A TENS Machine works through 3 different mechanisms to relieve pain.

First, electrical stimulation of the nerves can block a pain signal as they travel from the site of injury to the spine and

upwards to the brain. If these signals arrive at the brain we perceive pain - if they are blocked en-route to the brain we do not perceive pain - this is known as 'closing the pain gate'. In the early 1960s, Ronald Melzack and Patrick Wall proposed the idea of “pain gating,” or gate control theory. This is the idea that before your brain can receive pain signals, a “pain gate” at the end of the spine allows or blocks the signals from passing through to the brain. For some injuries, the signals pass easily, and we feel intense pain. In other cases, the signals may be inhibited or stopped entirely.

Activating the large nerve fibers with normal sensations can help inhibit the pain signals sent by the small nerve fibers and help relieve pain. This is why we often rub or shake an injured body part, and why TENS units work! TENS units activate the large nerve fibers by creating a tingling or massaging sensation on the injured area, which blocks pain signals and temporarily reduces our perception of pain.

Secondly, the body has its own built in mechanism for suppressing pain. It does this by releasing natural chemicals called endorphins in the brain and spinal cord and these chemicals act as very powerful analgesics.  Endorphins, specifically, are released when our bodies experience pain or stress. When released, they reduce pain and make us feel happier, and enhance our immune response. Endorphin release can be achieved with pain medication. But TENS machines have the same effect without the risk of addiction or side effects.  

Finally, muscles which are in spasm, or have become short and hard as a result of long term hypertension, can produce much of the pain associated with back related problems and arthritis. We can help these muscles to relax and soften by using the gentle massage effect of EMS Mode which exercises problematic muscles and helps to reduce musculoskeletal pain.

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How long does pain relief last?

After using a TENS machine, pain relief can last up to 24 hours. The amount of relief depends on the type, intensity of the pain and the duration of the treatment session. Someone with acute pain may experience more prolonged periods of relief than someone with chronic pain.

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In short, a TENS Machine is used to stimulate your nerves to achieve a reduction in perceived pain, EMS Machines stimulate the muscles and cause them to contract. Stimulating the muscles helps strengthen and tone, as well as relax and rehabilitate them. If you’re looking to build muscle as part of a training program, an EMS machine can be of great benefit to you But if you’re mainly looking to relieve acute or chronic pain, you will want to make sure you purchase a TENS unit.

Due to advances in technology, we are focusing on stocking Combo TENS Machines which combine both TENS & EMS functionality in one machine. Eventually, TENS or EMS only machines will be phased out.

How long has TENS therapy been used?

You may be surprised to learn that TENS therapy is not technically a new method of pain relief. In 2500 BC, records show people including Hippocrates (the father of western medicine) using electric eels or fish to help manage pain! 

As time went on, more discoveries were made that developed electrotherapy as a treatment method. In the 1600s, man-made electricity was discovered and studied. In 1747, Ben Franklin found that electricity could penetrate the body without damaging it. These discoveries paved the way for the development of dozens of first TENS machines in the 1800s. However, those devices (and electrotherapy as a whole) became largely irrelevant with the emergence of narcotic painkillers and big pharma profits!

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Why should you use a TENS Mahcine?

With so many pain relief options, you may still be wondering if a TENS Machine is the best choice for you. If that’s the case, consider the following benefits to using a TENS machine:

Drug Free Pain Relief

TENS therapy is all-natural and drug-free, helping you manage pain without the risk of dependence or dangerous side effects. 

Long or Short Term Solution

Because there are very few risks and a TENS Machine can last for many years, you can use it to treat yourself or someone else as short or long term as you like.


TENS Machines are effective in managing a wide variety of chronic and acute pain and could help relieve other unrelated pain, such as headaches or menstrual cramps.

Controlled Treatment

TENS Machines allow you to have more control over your treatment than other options. There are multiple modes, intensity levels and other adjustable parameters to choose from based on your specific condition.  


Some TENS Machines are small enough to fit in your pocket or have an included belt clip so that you can use them wherever you go. Noninvasive and small electrodes also make it easy to use in public discreetly.  

Easy to use

A TENS machine may sound complicated, but they’re actually very simple to use. With a simple to follow instruction manual and detailed pad placement and settings chart, you’ll get the relief you need without any hassle.

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Cost Effective

TENS Machines are one of the most affordable treatment methods available to us. With just a one-time purchase of $60 to $260 depending on its features and about $15 to $25 every few months to replace your pads.  

What can a TENS Machine be used for?

​Because TENS Machines offer customizable, targeted therapy, they can treat a wide variety of pain.

Below are some of the many ailments a TENS machine can help relieve.

 Back Pain

TENS Machines are widely used to treat upper and lower back pain. Although, more evidence is needed on its effectiveness for general back pain, the UK's NHS does recommend TENS therapy as one treatment option for a herniated disc. 

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Conductive Back Garment

Large TENS Pads

Neck Pain

Thousands of people are using TENS Machines to treat neck pain related to cervical spondylosis with great results. We recommend placing the electrodes right below the neck on the upper back as the neck is a sensitive area which may cause irritation if pads are placed incorrectly

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Conductive Neck Garment

Nerve Pain

Because a TENS Machine blocks nerves from sending pain signals to the brain, TENS therapy is an excellent option for nerve pain relief. This includes pain caused by nerve damage and pain associated with sciatica. TENS therapy is also recommended by the Brain and Spine Foundation and the Foundation of Peripheral Neuropathy to treat neuropathic pain.

Knee Pain

Studies have shown TENS therapy to help with various knee pain, including swelling, osteoarthritis, and post-surgery pain.

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Conductive Knee Garment

Migraines & Headaches

Studies conducted in 2014 and 2018 both found that TENS therapy can help relieve pain from migraines. Additionally, both the U.S. Library of Medicine and the National Headache Foundation found that TENS units can reduce headaches. 

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TENS Ear Clips

Shoulder Pain

Many users have found TENS therapy to be an effective method of treating shoulder pain. TENS therapy has been recommended by the Oxford Shoulder and Elbow Clinic to treat frozen shoulder. Many physical therapists will also recommend it to treat rotator cuff injury.

Muscle Pain

TENS therapy is very commonly used as a treatment for muscle pain. It's recommended to use EMS function and has been found to effectively treat sore muscles, muscle spasms, muscle knots, and muscle atrophy. 

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Menstrual Pain

Research shows that menstrual cramps and other period pain can be effectively treated using TENS therapy. Additionally, a study of 22 women found TENS therapy effective in treating pain related to endometriosis. 

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Pregnancy & Labour

Research shows that menstrual cramps and other period pain can be effectively treated using TENS therapy. Additionally, a study of 22 women found TENS therapy effective in treating pain related to endometriosis. 

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Hand & Wrist Pain

Although more research needs to be conducted, a major TENS study found positive results when considering hand pain treatment. Additionally, a study conducted in 2010 found TENS therapy to reduce pain related to Carpal Tunnel Syndrome significantly.

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Elbow Pain

Although more research needs to be conducted, a major TENS study found positive results when considering hand pain treatment. Additionally, a study conducted in 2010 found TENS therapy to reduce pain related to Carpal Tunnel Syndrome significantly.

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Stroke Recovery

TENS therapy can also be useful in aiding in stroke recovery. One study found that using a TENS unit after experiencing a stroke can improve walking capacity and reduce spasticity. Another study found that electrotherapy can help improve movement and relieve shoulder pain post-stroke. 

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Abdominal Pain

Research has shown that TENS therapy can effectively reduce abdominal pain. A 2006 study showed TENS to reduce pain during recovery from abdominal surgery. One study even found that TENS therapy can aid in digestion by increasing the salivary flow.

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Foot Pain

TENS therapy can be incredibly useful in treating the feet with several TENS products specifically made to target foot pain available. The British Orthopedic Foot and Ankle Society recommends TENS therapy for heel pain in particular. Additionally, TENS therapy can strengthen the foot muscle to help treat foot drop. 

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Are TENS Machines Safe?

Although sending electrical shocks to your body may seem dangerous, TENS units are much safer than they sound. There have been no recorded instances of anyone being severely injured while using the device. The electric shocks delivered by the device are too weak to cause electrocution or other significant damage. The most you have to worry about is a harmless, surprising shock if you accidentally set the intensity up too high for your needs.

Warnings & Precautions

Although TENS machines are generally low risk, you should always consult your doctor before using one to ensure that it is the right choice for you. In some instances, the device can be unsafe to use. It is recommended that you do not use a TENS machine if you:

  • Are pregnant. Pregnant women should avoid using a TENS machine on the abdominal and pelvic regions.

  • Have epilepsy. Using a TENS unit on the head or neck can cause seizures. 

  • Have heart problems. 

  • Have a pacemaker or any electrical or metal implant. 

  • Have skin that is numb, irritated, or fragile. 

  • Are driving, using machinery, sleeping, or in the bath/shower. 

Which TENS Machine is best for you?

The number of available options can be overwhelming, especially if you have no clue what the different features mean. In this section, we’ll go over what to consider (and what it all means) so that you can find a TENS machine that’s right for you.  


Electrodes or Pads are the adhesive sticky pad that administers the electric shocks to your body. They are usually reusable, and all TENS machines will come with a pack to get you started. Some pads use a higher quality sticky gel and are hypo-allergenic. The most significant difference will lie in whether they are wired or wireless. 

  • Wired: Electrodes are most often connected to the unit using lead wires, with two pads per wire. These electrodes are more lightweight, conductive and durable than wireless.

  • Wireless: Wireless electrodes may seem more convenient however the power output, durabilty and battery life are inferior to conventional pads. In addition, the replacement costs of wireless pads are much higher.


The number of channels refers to the number of lead wires that can be plugged in at a time. More lead wires means more electrodes, which allows you to target more, or larger, pain areas at a one time. Typically, there are three different channel types: single, dual, and quad.

  • Single: One lead wire channel; two electrodes running at once.

  • Dual: Two lead wire channels; four electrodes running at once.

  • Quad: Four lead wire channels; eight electrodes running at once.

The average TENS unit will feature dual channels, which is typically best for most users.


The pulse duration is the length of the pulse that the TENS unit administers. A longer duration means stronger stimulation. Most units will come with an adjustable range for maximum


The pulse rate is the rate at which the electric pulses are sent from the device, usually described in hertz or pulses per second. The pulse rate you choose will usually depend on the area of the body and the type of pain being treated. 2-10 Hz can help release endorphins to treat chronic pain, while 80-120 Hz can be best for acute pain. Like pulse duration, most units will come with an adjustable range for maximum customization.


Most TENS machines will come with a preset timer that automatically shuts off, so it doesn’t run continuously. Depending on the unit, the timer may not be adjustable. You may need to restart the device for longer treatments.


Intensity levels determine how strong the treatment is. The higher the intensity level, the stronger the electrical current sent from the unit. Most TENS units go up to 80 mA, while some go up to 100 mA. What you choose depends on the type and amount of pain you feel, but most users don’t need more than 80 mA. Those with intensities higher than 80 mA are often prescription units.


Most TENS machines will come with a certain amount of modes, or “presets” to choose from. These will have a predetermined pulse duration, pulse rate, timer, and intensity set for the treatment to make getting started easier. Some units might even allow you to choose different modes for different channels.

Usually, the more expensive TENS units will feature more modes. But if you’d rather customize your treatment yourself, fewer modes might not matter to you as much.  


Some machines have both TENS and EMS capabilities built into one machine. This is a great, convenient option if you want to relieve pain and strengthen muscles, but it can add more to the cost. If you’re only looking for pain relief, a simple TENS unit will work just fine.


Some TENS machines use high quality rechargeable lithium batteries while others use traditional, one-use batteries such as AA or 9V. Rechargeable batteries can be a convenient option and save you time and money in the long run. But if you’re not interested in rechargeable batteries, traditional ones will work just as well.

Points to Remember

  • Do not use your TENS machine while sleeping, driving, swimming, or in the bath/shower.

  • Your muscles may twitch when using a TENS machine at high-intensity levels.

  • The intensity felt may be increased if sitting back in a chair with electrodes on your back, as it increases the pads contact with the skin.

  • If irritation occurs and persists, cease treatment, and consult your doctor.

  • You may not immediately feel pain relief when the treatment begins. It’s best to start at a lower intensity and continue to increase and change modes as needed.

  • TENS machines are not a cure for any physical ailment. They are a tool for pain relief and can aid in rehabilitation.

Can I claim back my TENS Machine from Private Health Insurance?

Yes! Most private health insurance companies will reimburse the full or partial cost of your purchase. You can see more information here

Unanswered Questions?

Please don't hesitate to contact us if you have any other questions or need guidance before or after purchasing. Contact Us Now

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