The Ultimate Guide to Tens Units
No one likes to live with chronic pain, and many people will try numerous treatments to manage their pain. One of the most popular treatments for constant pain currently available is the TENS unit.
Before you try a new treatment, it's essential to learn everything you can about how it works and the potential outcomes. In this guide, we will cover everything you could need to know about TENS units.
What is a TENS Unit?
Transcutaneous electrical nerve stimulation (TENS) is a device that can be used to manage both acute and chronic pain. The small device is battery operated and is one of the most common forms of electrotherapy. By placing electrodes on the skin, the TENs unit will administer small electric shocks to the areas of the body that are experiencing pain.
How Do TENS Units Relieve Pain?
TENs units relieve pain by administering mild electric shocks that will stimulate your body's nerves. When the unit releases these shockwaves, it helps your body release endorphins and promotes the process of pain gating.
Endorphin Release
Endorphins are neurotransmitters that help deliver messages between cells. These brain chemicals signal our brain and body to function as we perceive our environment. By stimulating endorphin release, the TENS unit can help us manage pain and stress.
Endorphins are commonly known to help reduce pain and make us feel happier. Additionally, endorphins can help improve our immune responses, thus helping with pain relief. Many prescription drugs target endorphin release. So, it makes sense that TENS units can also help with pain management.
Pain Gating
Pain gating refers to the idea that our spinal cord acts as a gate for all pain signals. In some cases, pain signals can pass easily through the gate, and we will feel more intense pain, but in other situations, you can manage or stop the pain signals from entering the gate in the first place.
To experience pain, our brain and body have to send messages to each other. While this process is done with nearly every sensation felt by the body, the messages that translate pain to our brain rely on signals between our nervous system and brain.
Every time we touch something or feel the pressure of outside stimulation, large nerve fibers communicate these signals to our brain. The same is done when we experience pain signals. So, the TENS system works to activate these nerve fibers and block the signals that tell our brain we are in pain. When that happens, the perception of pain subsides, and chronic and acute pain symptoms are lessened.
How Long Does the Relief Last?
By using a TENS unit, the user can manage pain for various periods. Mostly, the pain relief will last from anywhere between 5 minutes and 24 hours. Typically, the level of pain relief will vary depending on the type of pain and the intensity of that pain.
For example, those who experience acute pain may have longer periods of relief than an individual who experiences constant, chronic pain. This is because acute pain only happens in bursts, while chronic pain is always there in the background.
Additionally, if a user regularly uses a TENS unit, they may experience longer periods of relief. This result is generally the goal of pain management treatment. Alternatively, as they use their unit more often, another phenomenon may occur when the individual builds up a tolerance to the electrotherapy treatment, resulting in less favorable circumstances.
The Difference Between TENS and EMS
TENS units and EMS units are not the same devices. While both of these devices rely on small electric shocks, TENS units are meant to stimulate nerves, and EMS units are designed to stimulate muscles. So, EMS units are primarily used to help strengthen and tone muscles, but TENS units are solely used to manage pain.
History of TENS Therapy
While TNeS therapy may seem like a brand-new pain relief mechanism, it is used for thousands of years. Ancient people have used electric eels or electric fish to help stimulate nerves to manage pain.
Throughout history, many people used forms of electrotherapy to treat various ailments. While it has been known that electrical stimulation can be used for pain management, the discovery of narcotic drugs mostly rendered the need for electrotherapy mechanisms useless. Yet, with devices such as the TENS system, electrotherapy is making a comeback.
To understand just how this pain management therapy made a comeback, read the summary of TENS history below.
1964: the gate control theory was released add showed medical professionals that electrotherapy could be used to relieve pain.
1974: the first version of the TENS unit was invented and patented.
1987: the TENS device for labor was developed and released to help laboring women manage the pain of childbirth.
1987 to today: studies have shown that TNS units can effectively treat chronic, acute pain.
The Benefits of Using a TENS Unit
Whether you have tried numerous different ways to manage your pain or you are first researching potential pain relief options, the TENS unit may be the right one for you. There are many reasons why that TENS unit is superior to any other form of pain relief.
Drug-free pain relief. If you use a TENS unit, you will not need to use any pain relief drugs. Because the primary mechanism is electrotherapy, there is no need to take prescription drugs and experience numerous adverse side effects.
Long-term use. A few risks are associated with using a TENS unit, so you are safe to use this system for as long as you need to.
Solution for many types of pain. Unlike many other treatments, the TENS unit can manage a wide variety of different chronic and acute pains. For example, the TENS unit could be used to relieve headache pain or carpal tunnel. Additionally, it can be used to manage all sorts of pain.
Small and portable. The TENS unit is small enough to fit inside your pocket or purse. So, you can bring it along with you anywhere you go without anyone knowing that you have it.
Simple to use. While it may sound complicated, the TENS unit is incredibly user-friendly. There is a simple control panel and self-adhesive electrodes that you can use to manage your pain with little effort on your part.
Affordable. Contrary to popular belief, TENS units are incredibly affordable to buy upfront as well as manage. The typical TENS unit costs between $20 and $200, and it only costs about $10 to $15 to replace electrodes.
Over-the-counter options. While it is best to see a medical professional before you start using TENS, there are options for you to buy a TNS system without seeing a doctor.
Control. When you go to a doctor and get a prescription, you have very little say over the amount and dosage of treatment that you will get. But with a TENS system, you can take your treatment into your own hands and choose your treatment session and intensity.
The Difference Between Over the Counter and Prescription
While there are over-the-counter and prescription TENS systems available, there are a few differences. However, the main difference between the two types of devices is mainly the intensity and treatment modes.
For example, prescription TENS systems will generally offer more intense settings and have a wider variety of treatment modes, such as customizable frequencies and different types of waves. In general, these differences allow prescription devices to relieve pain in any more targeted manner.
However, prescription TENS units are generally more expensive than over-the-counter devices. In addition, the less costly over-the-counter units are usually sufficient for most people’s use. So, if you are thinking about trying a TENS system, you might also purchase an over-the-counter device before you go to your doctor for a prescription.
What Are TENS Units Used for?
Because TENS systems can be used for nearly every type of pain, they have been shown by researchers to be able to manage some of the most common types of pain. For example, TENS units can handle the following types of pain:
Abdominal pain
Cancer pain
Carpal tunnel syndrome
Cervical spondylosis
Complex regional pain syndrome (CRPS)
Elbow pain
Foot pain
Hip pain
IT band pain
Joint pain
Knee pain
Lower and upper back pain
Menstrual pain
Migraines and headaches
Muscle atrophy
Muscle pain
Neck pain
Nerve pain
Osteoarthritis
Pelvic pain
Pregnancy and labor
Sciatica
Shoulder pain (frozen shoulder)
Stroke recovery
Temporomandibular Joint Syndrome (TMJ)
Trigeminal neuralgia (TN)
While TENS has been shown to help relieve the symptoms of the above ailments, you should always consult your doctor before trying TENS to manage your pain.
Are TENS Units Safe to Use?
TENS units are entirely safe to use. While it may seem dangerous to use electrical shocks to stimulate your body, significantly few side effects are associated with using this device. No one has ever recorded TENS systems resulting in any severe injuries. This is because the shocks that are delivered are too weak to do any significant damage.
The only thing you have to worry about is accidentally turning your device on when you were least expecting it. If that happens, you may simply experience a small, unexpected shock. Further, if you overuse your TENS device, you may experience side effects more than those who stick to a typical 30-minute session.
There are also very few side effects associated with TENS. However, some patients do report the following side effects:
Tingling or buzzing sensation
Irritated skin
Red or itchy skin
Soreness and burning due to overuse
Who Should Not Use a TENS Unit?
Even though TENS systems provide low risk, it's always advised to consult your regular physician before using this system for the first time. This is because some individuals may have an adverse reaction to using TENS. For example, if you experience any of the following, you should most definitely consult your doctor before using TENS.
Pregnancy
Epilepsy
Heart problems
Pacemaker or metal implant
Numb, irritated, and fragile skin
Additionally, you should only ever use the TENS unit if you are in a safe environment. For example, you should never use TENS if you were driving, operating machinery, sleeping, or in the bath or shower.
Which TENS Unit is Best?
With so many units on the market, it can be challenging to find the one that works best for you. Additionally, numerous different modes and features are offered by various TENS units.
It could be challenging to find a suitable unit with so many different brands available on the market. But to find the right TENS unit, use the following guidelines to help you choose the unit with the features and capabilities you require.
Electrodes
The electrodes that come with the TENS unit are generally wired or wireless. These are the pads that will administer the electric shock to your body through the unit. Most of the time, these electrodes are reusable but do need to be replaced eventually.
Unsurprisingly, wired electrodes are generally connected to the TENS unit and use lead wires to deliver the shock. If you are using a wired unit, longer lead wires may be more comfortable and easier to use because they will give you more room.
However, wireless electrodes may be the most convenient because you don't have to worry about these electrodes getting tugged or accidentally disconnecting. Yet, because there are no wires attached to them, wireless electrodes are generally heavier and bulkier.
The final aspect that you should consider when purchasing electrodes is what they're made of. Many electrodes are made with latex, so if you have a latex allergy, you will want to look for TENS units that use latex-free pads.
Channel Systems
TENS systems will deliver electric shocks via lead wire channels. While some TENS units have just one lead wire channel, others will have up to four working at once. Typically, the more channels the TENS system has, the more electrodes will be running at once. For example, a single lead wire channel will have two electrodes running simultaneously, while a quad lead wire channel but have up to 8 electrodes running at the same time.
Generally, TENS systems will use a dual channel system that runs up to four electrodes simultaneously. This is usually the best and most suitable for nearly every user.
Pulse Duration
The pulse duration refers two how long the pulse will last. Generally, the longer the pulse duration, the stronger the stimulation. Many people who use TENS systems well start adding lower duration and work their way up because most systems come with an adjustable range of pulses.
Pulse Rate
Most units come with a range of pulse rates. The pulse rate determines the intensity of the electrodes being sent to the body. These are generally measured in Hertz or pulses per second, and you can choose the intensity in which you want to receive electrical stimulation. Typically, a lower pulse rate is best for chronic pain, while a higher pulse rate may be best for acute pain.
Timer
The typical TENS unit comes with a timer that will automatically shut off so that the machine does not run continuously. Some devices may not have adjustable timers that will need to be restarted if you engage in prolonged treatments.
Intensity Level
The level of intensity refers to the strength of the treatment. Typically, the higher the intensity, the stronger the electrical current and vice versa. The average TNS unit goes up to 80 mA, but some will reach 100 mA.
Modes
Many TENS units come with preset settings that you can choose from to make treatments much easier. These modes will have a set pulse duration, pulse rate, timers, and intensity to make it easier for you to use your device. Typically, more expensive TENS units have more preset modes.
Portability
Not all TENS systems are small and compact. So if you want to carry your TENS device everywhere you go, look for smaller and more compact ones.
Accessories
Some TENS systems come with carrying cases, extra electrodes, equipment, and more. For the most part, the more you spend, the more likely it that you will get these additional accessories. So if you want to stick with a less expensive TENS unit, you may not get as many accessories.
TENS with EMS Capability
Some TENS units will come with the ability to use EMS technology. So if you are looking for a machine that can not only relieve pain but also help tone muscles, you can buy a machine that does both. However, these machines are typically more expensive.
Battery
While many TNS systems simply use AAA or 9 Volt batteries, some machines can use rechargeable batteries that can save you money in the long run.
How Do You Use a TENS Unit?
Luckily, it is straightforward to use a TENS unit. However, if you want to get the most out of your unit, you should know how to use it. When first using your TENS unit, follow these steps:
Connect the lead wires to the electrodes.
Connect the lead wires to the TNS unit device.
Clean your skin, but you plan to treat using soap and water or an anti-bacterial wipe.
Dry the area.
Place the electrodes flat on the area you plan to treat.
Make sure your machine is at the lowest intensity level, or make sure your devices at the preset mode you want.
Turn on the machine.
Set the timer if available.
Monitor your pain relief and change settings as needed.
Run your machine for no more than 30 minutes.
How to Place TENS Unit Electrodes
For the best pain relief, you want to make sure that you placed your electrodes in the proper position. If you are trying to target a specific area for pain relief, you should put the electrodes on either side of the intended area.
This will also depend on the number of electrodes that your machine can use. While most TENS units have dual electrodes, some of them will have four. For the best results, place all electrodes around the targeted area.
However, there are some areas that you should avoid placing TENS unless authorized by your doctor. These areas include:
Throat
Neck
Face
Head
Eyes
In your mouth
Sore or infected skin
Broken skin
Numb skin
On top of a joint (elbow or knee, for example)
Directly over your heart
If any of the above areas are the spots you want to target with the TENS unit, you should try to place the electrodes around the area instead of on top. That way, you can still experience pain relief men enjoy no side effects.
Reminders for Using TENS Units
When you use your TENS unit, you should keep the following factors in mind:
If you're using higher intensity, you may notice your muscles twitch.
If the electrodes are on your back and you lean back in your chair, the intensity may increase due to more contact with the skin.
If your skin becomes irritated, stop treatment and call your doctor.
You may not feel pain relief immediately, but you should still start with lower intensity and increase as needed.
TENS units are not a cure for pain. Instead, they are a pain relief tool and should be used alongside other forms of treatment, such as physical therapy.
How to Maintain Your TENS Unit
Because you want to keep your TENS unit in top condition for optimal pain relief, you should make sure you maintain it and clean it well. Before you use your unit, make sure there is no damage to the device or electrode cords.
When you clean your TENS unit, make sure the device is turned off and use a damp cloth to wipe the surface without getting water inside the device gently. Once storing your device, keep it out of direct sunlight, high humidity, or any areas that may have high voltage. For extended storage, it's best to remove your battery so that the battery does not leak.
Typically, electrodes will last between five and six months. However, there are ways for you to make your electrodes sticky and last longer. To do this, you can use some of the following tips:
Always clean your skin with soap and water before you use them.
Clean electrode pads with a moist towel after each use.
Use a conductive gel or spray to help preserve the moisture of the pad.
Always store the pads in their original packaging so they won't dry out.
Frequently Asked Questions
Does Medicare cover TENS Units?
In some cases, TENS units may be covered by Medicare or other health insurance. Further, these devices are generally approved by Medicare and covered if different types of pain management have been tried and failed. Instead of outright buying the device, it is more likely that Medicare will cover the cost of renting for at least 30 days at first. If the device shows that it works, Medicare may help cover the cost of purchase. However, Medicare will not cover every type of chronic pain.
Are TENS Units FSA Eligible?
Over the counter, TNS units may be eligible for purchase or reimbursement if you're using a flexible spending account (FSA), health savings account (HAS), or health reimbursement arrangement (HRA). Yet, they may not be eligible for reimbursement if you use a limited care flexible spending account or a dependent care flexible spending account.
