Updated June 2022
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Buying guide for Best TENS units

Painkillers, and our dependence upon them, are in the national spotlight. Many who suffer from chronic pain are seeking alternatives to traditional medicine. One method many individuals are trying is TENS treatment.

The term “TENS” is short for transcutaneous electrical nerve stimulation. It’s a type of therapy that treats pain using a low-voltage electrical current. TENS treatments usually focus on joint and nerve pain in the back, neck, elbow, wrist, ankle, and other high-impact areas. While most users turn to TENS for chronic pain, many use it for pain relief after a traumatic injury, after surgery, or to combat arthritis. The TENS unit delivers a current to the body using electrode pads placed on the skin in the area where pain is felt.

Research on TENS treatment, both how it works and if it works, is relatively slim, but the treatment method dates back to the 1960s. It was then that the “gate control” theory of pain gained popularity. This is the theory upon which TENS technology was developed. Gate control is based on the idea that stimulating nerves closes a “gate” response in the spinal cord that can block the pain sensation. In short, the brain can’t process the pain because it’s busy processing the sensation created by the TENS unit. Pain relief to the area typically begins right away. It may stop shortly after the treatment ends, or it may last longer.

A second theory on why TENS treatment helps some is based on the idea that stimulating nerves in an affected area might help your body produce endorphins. Endorphins are chemicals that create pleasurable feelings, and they can diminish your brain’s perception of pain.

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Some believe that TENS therapy activates the spots in the brainstem and spinal cord that use serotonin and opioid receptors.

Key considerations

Power supply

Since electrical current is a key factor in TENS units, the power source is a big consideration. Most TENS units come with USB ports so they can be recharged when the battery runs low. Some plug into the wall, which may limit where you can use them. A few TENS units still run on removable batteries. If you go this route, consider whether disposable or rechargeable batteries would work better for you.

Treatment modes

It can be hard to predict what kind of impulse would provide the most relief, so units come pre-programmed with a variety of treatment modes. The modes deliver different results depending upon the body part being treated and the therapy needed. Some examples include kneading, cupping, acupuncture, shiatsu, and programs intended to help the abdomen, feet, and ears. If you haven’t used a TENS unit before, it’s a good idea to purchase one with a wide variety of modes.

Intensity levels

It can be hard to predict the strength of the impulse that would be most effective in treating your pain. For this reason, you may want to look for a TENS unit with multiple intensity levels. Good machines usually offer around 20 levels.  Machines with push-button digital adjustment allow more control over intensity than units with dials. Furthermore, a push-button configuration might help prevent you from accidentally jolting an area that’s already sensitive.


There are no concrete time limits for TENS machine use. However, experts say that it usually takes about 30 minutes to reach full efficacy. But they also advise not to use the machine for long periods of time without checking the skin around the electrodes. Furthermore, you should not sleep while using a TENS unit. Most TENS units have timers and auto shut-off protection to help prevent this from happening. The majority shut off after one hour of use.


Most TENS units display their information on an LCD screen. Look for machines with screens that have high visual contrast and letters that are large enough to read. If you have a unit with a smaller or hazier screen, it may be difficult to find the right setting. In turn, your treatment might not be as effective.

Consider the unit’s electrode pads, too. Electrode pads are made of self-adhesive gel and are reusable, but different brands stick better and last longer than others. Be sure to follow care instructions to get the most out of your pads. If you have sensitive skin, look for pads with blue gel, as these are known to be better for your skin type. Individuals with body hair in the area of treatment may want to look for blue pads as well, as they have more sticking power.

If your unit’s pads don’t work well on your skin, you could always try another kind, as long as they are compatible with the unit.

Some TENS units offer dual channels. This feature lets you treat different areas of your body with different impulses at the same time. If you decide to use both channels at once, be sure to use at least two electrodes on each channel for the most effective treatment.

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For your safety
Placing pads in the correct place can be a challenge, but this is essential for proper treatment. Be sure to consult the specifications of your unit — or a doctor, if your machine comes with incomplete instructions.

TENS unit prices


The least-expensive TENS units on the market cost between $20 and $25. These machines offer a number of treatment modes and intensity levels, but they can only be used to treat one body area with one impulse type at a time. They may be controlled with dials, which offer less precision. These products usually come with a handful of electrode pads.


Mid-grade TENS units cost between $25 and $40. They have digital controls and more treatment modes than cheaper units. They should also come with more electrode pads. Some offer dual channels so you can use different treatments to combat pain in more than one area of your body at the same time.


TENS units that cost more than $40 should offer high levels of digital control with high-contrast screens. They should also offer a wide variety of treatment modes and many electrode pad options. Some may even offer other electrotherapy treatment options.

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Did you know?
Some people try to use TENS units to increase muscle tone rather than for pain relief. This technically could be done, but not at the impulse level TENS units provide. The best way to build muscle is through a strength training program.


  • Before applying the electrodes, be certain that the area you plan to treat is dry, clean, and free from oil and lotion.

  • Don’t clean your skin with alcohol. Alcohol-based cleaners tend to dry the skin, which could lead to skin irritation and even burns from the electrode pads.

  • Individuals with sensitive skin should consider using electrode pads with skin-friendly blue gel. These same pads can also help keep electrodes in place in areas with thick body hair.

  • At least two pads must be applied to the skin at all times in order for the treatment to be effective.

  • You can change the direction of the sensation by moving the pads closer together or further apart, as well as by placing them horizontally, vertically, or diagonally.

  • Make sure you turn your TENS unit off before repositioning the electrode patches. Failing to do so could lead to a pinching sensation when you remove them from your skin.

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A few pricey units provide a full impulse circuit with only one electrode pad. If you have sensitive skin, this may be an option that’s worth your money, so check carefully. Since TENS therapy uses electrical impulses, two pads are usually required to complete the circuit.

Who shouldn’t use a TENS unit

Pregnant women and individuals with pacemakers should not use TENS units. In addition, experts advise against using them if you have abnormal skin conditions or conditions that reduce skin sensitivity, such as diabetic neuropathy. Those with tumors, infectious diseases, heart disease, and abnormal blood pressure should consult a doctor before use.

Temporary skin discoloration may occur during treatment. If a burn or rash appears under an electrode and lasts more than six hours, discontinue use and call your doctor.

Doctors also warn against the following, as these actions could be harmful or fatal:

  • Placing electrodes on skin that’s irritated or broken

  • Using a TENS unit while driving

  • Using heating pads or cold packs in conjunction with a TENS unit

  • Using a TENS machine while bathing

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Many physical therapists use TENS technology in their clinics. The TENS machines there are higher-powered versions of what’s available commercially.


Q. How fast can I expect pain relief using TENS therapy?

A. Unlike some therapies, if TENS will help relieve your pain, you should feel a difference relatively quickly. TENS is based on the theory that one electrical impulse blocks another, so the impulse from the unit should start blocking the pain impulse right away. Experts say that a TENS treatment takes about 30 minutes to reach full effectiveness, and the results should last about 30 minutes after treatment.

Q. How many times per day can I use my TENS unit?

A. Most experts recommend no more than three TENS treatments per day. This prevents your body from getting used to the impulses, which could reduce the therapy’s effectiveness. Each treatment should last no more than the maximum time limit allowed by your machine timer.

Q. Can I use TENS treatments for muscle pain, too?

A. Some people try, and you technically can make a muscle contract by placing the pads correctly, but there’s another choice. An electrotherapy device known as an Electric Muscle Stimulation, or EMS unit, would likely give you better results. EMS machines use electrical impulses to make your muscles contract. They help reduce muscle inflammation, spasms, and edema, the most common causes of muscle pain. EMS units stimulate the muscle themselves, while a TENS unit stimulates nerves. If you’re unsure whether your pain is caused by a problem with a muscle or a joint, be sure to talk to your doctor.

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