TENS Therapy

Starting from

€10

About

Transcutaneous electrical nerve stimulation (TENS) is a non-invasive pain management modality that uses low-voltage electrical currents delivered through surface electrodes placed on the skin. The goal of TENS therapy is to reduce pain perception and improve function in musculoskeletal and certain neuropathic pain conditions. It is commonly used in physical therapy and rehabilitation settings as part of a conservative pain management strategy.

TENS does not treat the structural cause of pain on its own. Instead, it is designed to reduce symptoms and make movement, exercise therapy, and daily activities more tolerable. This is why it is often integrated into broader rehabilitation plans for spine and joint conditions.

TENS therapy is commonly used for:

Lower back pain
Sciatica and radicular pain patterns
Neck pain and cervical tension syndromes
Osteoarthritis-related pain
Post-injury pain during rehabilitation
Certain types of neuropathic pain, depending on clinical assessment

How TENS works

TENS is primarily explained through two complementary mechanisms. The first is the gate control theory of pain, where stimulation of non-painful sensory fibers can reduce transmission of pain signals in the spinal cord. The second is modulation of endogenous pain inhibition, where specific stimulation parameters may support the release of endorphins and influence central pain processing.

Clinical response varies between individuals. Some patients experience immediate relief during the session, while others notice a gradual reduction in pain intensity over repeated treatments. The effect can be short-term, longer-lasting, or limited depending on pain type, chronicity, and underlying pathology.

What happens during a TENS session

TENS therapy is delivered through adhesive electrodes placed over the painful area or along relevant nerve pathways. The device generates electrical pulses defined by frequency, pulse width, and intensity. Treatment settings are selected based on symptom pattern and patient tolerance.

During treatment, patients typically report:

A tingling or buzzing sensation under the electrodes
Mild rhythmic pulsing that should remain comfortable
No burning, sharp pain, or skin irritation when properly applied

A clinical session typically lasts 15 to 30 minutes, although protocols vary. TENS can be applied as a stand-alone symptom relief session or combined with other modalities within the same visit.

When TENS is clinically most useful

TENS is most useful when pain is limiting mobility, sleep, or participation in rehabilitation. For example, in patients with radicular pain patterns consistent with sciatica, TENS may help reduce symptom intensity enough to allow progression into stabilization exercises and functional training. In spine-related cases where mechanical loading is part of the symptom driver, TENS may be combined with spinal decompression therapy when clinically indicated.

In chronic muscular overload and soft-tissue pain patterns, TECAR therapy may be considered as a complementary modality when the clinical goal includes circulation support and tissue recovery.

Advantages of TENS therapy

Non-invasive and does not require medication
Generally well tolerated with minimal downtime
Can be integrated into rehabilitation programs
May reduce pain intensity and improve tolerance to movement
Adjustable parameters for individualized symptom management

Candidate

TENS therapy is suitable for patients with acute or chronic pain where symptom control is needed to improve comfort and functional participation in rehabilitation. It is commonly used for musculoskeletal pain such as lower back pain, neck pain, and osteoarthritis-related discomfort, as well as selected neuropathic pain patterns after clinical evaluation. It may be considered for patients with sciatica-like symptoms or radicular pain where nerve irritation contributes to pain perception, especially when pain limits walking, sitting tolerance, or therapeutic exercise. TENS is often used as part of a broader plan rather than as a standalone solution, particularly in chronic conditions.

Preparation

No specific preparation is required. The treatment area should be clean and accessible, and the clinician may ask about skin sensitivity or previous reactions to adhesive electrodes. Patients should inform the clinician if they have implanted electronic devices, a history of seizures, cardiac rhythm disorders, pregnancy, or any medical condition where electrical stimulation may require additional caution. If there are recent imaging findings or a confirmed diagnosis guiding the rehabilitation plan, sharing that information may help optimize treatment selection and placement.

Treatment

The clinician places adhesive electrodes on the skin based on the pain location and symptom distribution. The device parameters are adjusted gradually to achieve a strong but comfortable sensory stimulation, without sharp discomfort. A typical session lasts 15 to 30 minutes. TENS may be used as a symptom relief intervention before exercise therapy, during rehabilitation for painful movement patterns, or after manual or physical modalities to help reduce residual discomfort. Treatment frequency and total number of sessions depend on symptom severity, chronicity, and response.

Result

TENS therapy is generally safe when applied correctly. It is not recommended for patients with pacemakers or active implanted electronic devices unless specifically cleared by the treating specialist. Electrodes should not be placed over the front of the neck, across the chest in a way that could affect cardiac rhythm, or on areas of broken skin or active infection. Additional caution is advised in pregnancy, epilepsy, and in patients with reduced sensation in the treatment area, where intensity feedback may be unreliable.

F.A.Q.

What does TENS therapy feel like?

Most patients feel a comfortable tingling or buzzing sensation under the electrodes. The intensity should be strong but not painful, and it should never feel like burning or sharp discomfort.

How long does pain relief last after a session?

Relief can last from minutes to several hours, and response varies by pain type and chronicity. Repeated sessions may help improve symptom control, especially when combined with rehabilitation exercises.

Is TENS therapy the same as electrical muscle stimulation (EMS)?

No. TENS is primarily used for pain modulation through sensory stimulation, while EMS is designed to produce muscle contractions for strengthening or neuromuscular re-education.

Can TENS help with sciatica?

TENS may reduce pain intensity in sciatica-like symptom patterns by modulating pain signaling. It does not correct disc pathology or nerve compression, so it is typically used as part of a broader conservative treatment plan.

Who should not receive TENS therapy?

Patients with pacemakers or active implanted electronic devices generally should not receive TENS unless medically cleared. It may also require caution in pregnancy, epilepsy, and in areas with impaired skin integrity or reduced sensation.

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Ivana, ZagrebMed patient coordinator