TENS device: which one among so many?

You can buy a TENS device everywhere today, even in grocery stores. However, just because something is called a TENS device doesn’t mean it will help your problem! There can be a significant difference in effectiveness between devices. Don’t hope that a couple-thousand-forint TENS device will permanently eliminate pain from osteoarthritis or rheumatism. I will explain the differences between devices and what to consider before buying one.
You can read more about the TENS method itself in this article of mine: TENS treatment – pain relief without drugs

How do TENS devices differ?

• quality
• number of treatment channels
• types of TENS programs
• impulse quality
• other programs (EMS-muscle stimulation, iontophoresis, microcurrent, etc.)
• additional features, e.g. wireless, special accessories

The importance of device quality

If you search for the phrase “tens device,” the results will show the cheapest devices. Right now the cheapest thing called a TENS is 2,690 forints. You can tell by its appearance that it’s low quality, yet many people think that for two thousand forints they get a device that will really eliminate their problems. To borrow Hofi’s words: “How old are you, child? 40. And you still believe in fairy tales?”

Far-eastern manufacturers churn out these junky units by the millions (pardon the expression, but there isn’t a better one). I’ll show you what they can cause.

Product recommendation: our selection of TENS devices

TENS device | Pain relief device, drug and side-effect free

A TENS device is a tool for drug- and side-effect-free pain relief. It is especially effective for reducing joint and muscle pain.

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A TENS device provides pain relief treatments without drugs or side effects. It can reduce pain caused by musculoskeletal diseases. There are simple devices that provide only TENS programs, while the more capable units include TENS programs as just one treatment mode among others.

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I have a TENS device — which program should I use?

A TENS device usually contains several programs. The impulse settings differ in each program, so they work differently. It matters when and which one you use.

Traditional (high-frequency) TENS program

It blocks the transmission of the pain signal to the brain.
Its effect develops quickly but lasts only 30–120 minutes.
After 3–4 treatments its effect decreases or disappears because the brain gets used to it. After a 1–2 week break it becomes effective again for a few sessions.

Endorphin (low-frequency) TENS program

It triggers the production of pain-relieving substances (endorphins) in your body.
The effect develops more slowly but can last 2–8 hours.
After a few treatments its effect diminishes or disappears because the brain adapts. After a 1–2 week break it becomes effective again for a few sessions.

Burst (or alternating frequency) TENS program

The program emits a high frequency for a few seconds, then switches to low frequency repeatedly.
Therefore it provides the advantages of both the Traditional and Endorphin programs.
Originally created to avoid habituation, even this treatment loses effectiveness after 1–2 weeks. After a short treatment break it becomes effective again.

Modulated (continuously varying impulse) TENS program

The program continuously varies the impulse frequency, duration, and intensity, so habituation is minimal or absent.
It combines the benefits of the Traditional and Endorphin programs.

Pain relief treatment can be applied anywhere on your body (except over the skull, across the heart, over the thyroid, or above the carotid arteries in the neck).

Simply place the electrodes around the painful area, select one of the above programs and enjoy the effect. Try them all and observe which is most effective for you.

During the first days TENS reduced my pain, but then the good effect disappeared — what happened?

This is a common phenomenon! I am often asked about this by disappointed TENS owners. I must emphasize, however, that the problem is not the TENS method but habituation.

All the cheap, couple-thousand-forint TENS devices provide only constant-frequency treatment programs (Traditional and Endorphin TENS). These regularly repeating impulses are “recognized” by our brain and after a few days it “gets used to it.”

The excellent effect of the first treatments begins to decline after a few days and then stops. This is why buyers of cheap devices eventually consider the device ineffective.

If you don’t find the term “modulated TENS” in your device description, you can expect pain relief from that device for only a few days. Don’t be surprised if its effect begins to fade on the 3rd–4th day. The loss of effect is not permanent. After 1–2 weeks it will be effective again for a few treatments. Use such a device for a stiff neck, toothache, sprain, bruise, hematoma, etc. In these cases the initially strong pain subsides in 2–3 days and the device remains effective for that long.

Modern TENS devices — to eliminate habituation — offer MODULATED TENS programs. Modulation means the device continuously modifies the impulse parameters (frequency, pulse width, amplitude), so the brain cannot filter it out and habituation does not develop. Therefore modulated TENS programs do not lose their effectiveness. They are excellent for pains that have been present for a long time and require sustained treatment.

So if your device provides a modulated TENS program, you own a modern and versatile device. You can use it for any pain, including chronic pain (e.g. caused by osteoarthritis, arthritis, rheumatism, etc.), and expect lasting effects.

More precise impulses reduce discomfort during treatment

The “soul” of TENS and every other electrotherapy treatment is the regular impulse. This is produced by the impulse generator. Numerous medical studies confirm that one of the most important elements of an effective TENS treatment is an as-perfect-as-possible square impulse. The impulse shape produced by cheap devices does not even approach a square wave (see the figure for the right-hand impulse).

The more imperfect the waveform, the more painful the stimulation feels. Cheap devices sting, cause nettle-like sensations, and burn. The stinging is so strong that you cannot raise the intensity to the level needed for effective treatment. That is, the cheap device’s treatment is burning, painful, but ineffective or of low efficacy (more noise than flame), and as mentioned earlier it can even cause skin injuries.

In higher-quality devices the impulse generator is much more precise, so treatments are painless and even people with sensitive skin can use them completely free of discomfort.

Multifunctionality: EMS-muscle stimulation, iontophoresis, microcurrent

There are now few devices that truly offer only TENS programs.

Most devices called “TENS” are actually multifunctional units. In other words, beyond pain relief treatments they also provide other electrotherapy treatments.

These can include muscle stimulation, denervated treatment, iontophoresis, microcurrent treatment, interferential, Kotz or other currents.

Although all of these are electrotherapy, they are intended for different things and act differently. It’s like a spoon, fork and knife. They are all eating utensils, but their functions and advantages are completely different.

But it doesn’t end here, because more advanced devices also provide skin-tightening, cellulite treatment and body-shaping programs suitable for beauty care, not just therapy.

When you buy a device, think carefully about what you need it for.