What Is Transcutaneous Electrical Nerve Stimulation (TENS)?

Transcutaneous electrical nerve stimulation (TENS) is a noninvasive, drug-free technique to relieve acute and chronic pain. A device is used to send low-voltage electrical currents through the skin to stimulate nerves in the area where you’re experiencing pain. Electrical pulses are delivered through sticky pads called electrodes, which are placed on or near the site of pain.

There are a few variations of TENS therapy that may be used. Your provider will likely recommend a type that’s been shown to help your specific type of pain.

Types are categorized according to their levels of frequency, intensity, and pulse duration. Frequency (measured in hertz [Hz]) is the number of electrical pulses delivered per second, intensity is the strength of the electrical current, and pulse duration is the length of time each electrical pulse lasts, which is measured in microseconds.

Conventional TENS Also called high-frequency TENS, it delivers short-duration pulses at a high frequency and is often used for acute pain relief. The sensation is typically a light tingling, and it can be used for extended periods throughout the day.

Acupuncture-Like TENS This mode uses low-frequency (1–4 Hz), high-intensity stimulation and is intended to mimic the effects of acupuncture. It’s often used for chronic pain that doesn’t respond to conventional TENS and may produce stronger, rhythmic muscle contractions.

Intense TENS This is both high-intensity and high-frequency, and is most often used for pain related to cancer treatment.

Burst Mode TENS Burst mode delivers short bursts of high-frequency stimulation at low frequencies, combining features of conventional and acupuncture-like TENS. It’s thought to be effective for both acute and chronic pain.

Modulated TENS In modulated mode, the frequency, pulse width, or intensity is automatically varied to prevent nerve adaptation. This maintains the effectiveness of the treatment over longer sessions.

TENS can help manage a wide variety of conditions in a noninvasive and drug-free way, making it a safe and effective method to manage acute (short-term) and chronic (long-term) pain.

TENS therapy is often used as one part of a broader pain management program. Physical therapists, pain specialists, and other healthcare providers may recommend TENS to treat a range of pain-related conditions, including:

• Chronic musculoskeletal pain (such as back or joint pain)
• Osteoarthritis
• Fibromyalgia
• Tendinitis
• Bursitis
• Labor pain (under a doctor’s supervision)
• Sports injuries
• Neuropathic pain, including sciatica or diabetic neuropathy
• Peripheral artery disease

The TENS system is a small portable electrical device with two main wires that branch off into more wires that connect to adhesive pads (electrodes) that are placed on the skin near the area of pain. The procedure is straightforward and often performed in:

• Physical therapy clinics
• Pain management centers
• Chiropractic or sports medicine practices
• At home (with proper guidance)

TENS therapy doesn’t require much preparation. There are a few best practices:

• Avoid applying lotion or oil on the areas where the electrodes will be placed, as this can affect adhesion and conductivity.
• Wear loose clothing if you're going to a clinic, so the therapist can easily access the treatment area.

You’ll likely feel a mild tingling, buzzing, or pulsing sensation under the electrodes. The intensity should be strong but not painful. You won’t be sedated, and you can usually talk, read, or even move gently during the session.

Although there’s evidence that TENS can be an effective way to treat pain, it doesn’t work for everyone or for every type of acute or chronic pain.

TENS is generally considered safe for most people when used as directed. But there are a few risks, including:

• Skin irritation or redness at the site of electrode placement
• Muscle twitching or soreness from overly high intensity settings

TENS should not be used on damaged skin, varicose veins, eyes, mouth, neck, head, or genitals.

• Allergic reactions to electrode pads
• Uncomfortable sensations
• Burns from the electrodes (rare)

Depending on your condition and how you respond, your provider may recommend using TENS as part of a long-term pain management plan. If your provider prescribes a home unit, you’ll receive training on how to operate it, adjust the settings, and care for the electrodes. If you buy an over-the-counter device, check in with your provider for recommendations on how to use it.

• Transcutaneous electrical nerve stimulation (TENS) is a safe, noninvasive method to help manage both acute and chronic pain.
• It uses low-voltage electrical currents delivered through the skin to help stimulate nerves and block pain signals.
• Most people can receive TENS therapy or use a device at home with minimal side effects.
• Although it’s not likely to leave you pain-free, TENS can be a helpful part of a comprehensive pain management plan, especially for those seeking drug-free relief.