A Transcutaneous Electrical Nerve Stimulation (TENS) unit is a very useful device when it comes to pain relief. And one of the main reasons it’s widely preferred is because it’s a non-invasive pain management tool.
But how exactly does this device work to relieve acute pain and chronic pain.
TENS units, or are small battery-operated devices that have sticky pads (tens electrodes) which are placed on the skin. These pads act by stimulating the underlying nerves through the use of mild electrical current and this creates a tingling sensation on your skin. This process can help suppress pain and also be used for muscle stimulation. Many users find them ideal for relieving neck pain.
The TENS machine, apart from being a non-invasive method of pain relief, offers another advantage which is that it can be used in the comfort of your home. But for best results, you need to find the right settings depending on your level of pain.
We’ve decided to outline the settings found on TENS units - and when you should use each one.
Different Settings for TENS unit:
Generally the device features three settings as we’ll briefly explain below:
- Normal/Continuous: If you’re new to TENS therapy, then we highly recommend the normal setting—only until you’re more comfortable with handling the device. But generally this setting is ideally suited for relieving short-term pain.
- Burst mode: Patients who suffer from chronic pain will find this setting ideal. This is because it’s designed to stimulate the peripheral nerve fibers through a burst of pain relieving power.
- Modulation mode: The modulation setting is designed for both acute and chronic pain relief. This is because this mode acts cyclically by varying between different settings.
How do the settings on the TENS unit work?
TENS units can be configured in several ways to treat different types of pain. The intensity, frequency, and duration of each pulse that a TENS unit produces can be modified directly via controls on the device itself. Furthermore, if you want a specific type of pain gone, then you must know the best settings for each one.
Thankfully, TENS unit adjustments can be made without worries.
TENS Unit Settings for Sciatica
Sciatica is a form of pain originating from the sciatic nerves, which are the longest nerves in the human body. A sciatic nerve stretches from the base of the spine down to either the left or right foot. Pain on either sciatic nerve can be debilitating, but TENS units can provide electrotherapy to mitigate or completely nullify the pain.
For the most part, the settings on a TENS unit for treating Sciatica depend on the user. First, place one sticky pad on either side of your lower back—just make sure to avoid contact with the spine itself. Then, place another pad on the underside of your thigh. Afterward, start your TENS unit on Normal/Continuous mode and adjust the device’s settings until you are relieved from pain.
If you’re suffering from chronic Sciatica, then start treating the affected areas with your TENS unit in Burst mode instead of Normal mode.
TENS Unit Settings for Building Muscle
Contrary to popular belief, TENS units do not build muscle by themselves. TENS units can only stimulate sensory nerves. On the other hand, Electrical Muscle Stimulation (EMS) devices are designed specifically for rehabilitating and training muscles via electrotherapy.
This does not mean that TENS units cannot help you build muscle at all. By using a combination of TENS and EMS, you can tone your muscles with little to no pain. Using these two techniques simultaneously can help you maximize your time and effort.
TENS units can be used to alleviate pain from muscle knots, soreness, tightness, and spasms. Simply attach TENS electrodes onto the affected areas of your body and set it to Normal mode. Make sure to adjust the intensity of your TENS unit accordingly.
TENS Unit Settings for Lower Back Pain
Treating lower back pain with a TENS unit follows the same procedure as the treatment for other areas. Start by attaching TENS electrodes to the affected areas, then start your device on Normal mode.
There’s no particular setting for back pain since it differs from situation to situation, so you must find the setting that works best for you. This also goes for addressing general pain with a TENS unit.
TENS Unit Settings for Period Pain
TENS units can also be used to help with menstrual pain. Place electrode pads on your back and around the area of the pain. This allows the electric pulses to cover every nerve in the entire region.
It is recommended that you start with your TENS unit in its lowest setting in Normal mode, then gradually increase its intensity if required.
TENS Pulse Rates:
When using the TENS unit, it’s important to note that pain relief from transcutaneous electrical nerve stimulation is felt at different frequencies. You must set the machine to a certain rate and width depending on your pain intensity:
The rate at which pulses are delivered is what‘s known as the pulse rate or frequency. Here we basically measure the number of electrical pulses felt in a second and this frequency is measured in hertz.
The pulse width settings refer to the periods during which the electrical current is sent. Note that you can either modify or control these periods. Generally low or mid periods are enough to relieve pain but for muscle contraction, you’ll need longer pulse duration. Pulse width is measured in milliseconds and the recommended settings are 175-200Us.
Different machines produce different pulses—both rates and widths—depending on the brand, which can affect the pain relief.
High and Low Frequencies:
TENS units have two types of settings; high and low frequency. Generally most people prefer the high frequency but we’ll discuss both of them below.
High Frequency Setting:
When set to high frequency, the machine works by creating what is known as the “gate theory”. A “gate” is formed between your nerves and brain. Here the TENS unit effectively blocks out the pain signals from reaching your brain. As a result you don’t feel the pain, higher frequency settings are recommended for acute pain.
A typical setting under high frequency would be:
- Pulse rate = 60
- Pulse width = 80
At this setting—or something close to that—your TENS unit will provide you with a “buzz” feeling that you’re likely to find comforting. This feeling will in turn stop the pain from reaching your brain.
If you pick this setting you’re likely to experience one of the following scenarios:
- The pain is likely to return as soon as you switch off the machine. If you fall in this group of people, then you have to keep the TENS unit on continuous mode.
- If you’re lucky, the pain may stop for a while after a 30 or 60 min session. In this case, you can repeat the session after 90 minutes to increase the treatment’s effectiveness.
If you experience severe pain, you can modify the settings to:
- Pulse rate = 80
- Pulse width = 150
Low Frequency Setting:
This setting is completely different from the high frequency. At low frequency, the massage functionality of the unit causes your body to release natural endorphins to help manage the pain. A typical low frequency setting would be:
- Pulse rate = 2
- Pulse Width = 200
In such cases, you don’t have to wear it in continuous mode because the pain free effect can last from minutes to hours depending on the individual.
How High Should I Set My TENS Unit?
All TENS units have a range of settings to deliver different ranges of transcutaneous electrical nerve stimulation from low to high. It is always advisable to start low and increase the power settings over time as you get used to using your TENS unit.
Why is it Important to Use Different Settings on Your TENS Unit?
The effectiveness of a TENS treatment (transcutaneous electrical nerve stimulation) depends on the dosage from the tens electrodes. This means that any benefits will depend on both the frequency & intensity used. Each condition requires certain stimulation levels for effective results. If you don’t find the right combination using the machine won’t yield any positive effects.
We’ll outline a few examples of different frequencies below. Simply set the frequency on the machine based on the pain you feel:
- Acute pain: If you suffer from acute pain then you must set the frequency to between 80 and 120Hz for optimum pain relief.
- Muscle Stimulation: TENS units aren’t solely for pain relief. You can also use the device to stimulate your muscles. If that’s the case then you can set the frequency to between 35-50Hz.
- Chronic pain: For chronic pain relief, it’s recommended that you set the frequency to between 2 and 10Hz and the burst mode is often most helpful.
Which Body Parts Are No Go Areas with a TENS Unit?
These devices will provide you with much needed pain relief—but only when used correctly. Though they’re considered to be safe and FDA approved, there are some parts of the body you must never use the unit on including:
- Infected areas
- Anywhere near - or around - your eyes
- On your chest
- In front of your neck
- On open wounds
- Over a tumor
- Across cardiac pacemakers
Pain is highly subjective depending on each individual and can’t be quantified. What you consider to be intense pain can be the next individual’s moderate pain. This is why it’s important to note that the above are merely suggestions. It’s important to experiment with the settings to determine what works for your pain relief whether it is chronic pain or acute pain.
TENS units can also be used for muscle stimulation broadening their usefulness. The good news is that a TENS Unit can work for almost anyone; check out our top TENS unit picks to find the right one for you.