Setting The Pulse Rate
- Pulse Rate is the number of electrical pulses you will feel in one second. Frequency is measured in Hertz . Pain relief can occur at various frequencies. Acute pain is usually most effective between 80 and 120 Hz. Chronic pain can also benefit from lower settings 2 to 10Hz that stimulates an endorphin release. A setting between 35 and 50Hz is commonly used to stimulate muscles for strengthening or even relaxation.
The following settings are recommended:80 to 120Hz-acute pain2 to 10Hz chronic pain
How Do Tens Units Help Control Pain
Transcutaneous Nerve Stimulators decrease pain two ways:
- Physiological: TENS stimulate peripheral and spine/brainstem receptors, dampening the brains perception of pain. Same receptors targeted by opioids.
- Gate Control Theory: TENS fills the pain pathway with electrical stimulation distracting the brain causing it to perceive the pain as diminished.
There is a third way TENS can reduce pain. This technique uses the burst mode and stimulates acupuncture points.
Recent studies show TENS causes physiological changes that help decrease pain. These physiological changes take place at the furthest reach of the nervous system, the many kinds of receptors embedded in the skin.
The TENS electrode is placed on the skin and the areas under and between the electrodes changes the physiology of the nerve-ending receptors.
The more pain-stimulus signals these nerve-ending receptors are sending to the bain, the more pain a patient is feeling.The more pain-inhibiting signals these nerve-ending receptors are sending to the brain, the less pain the patient is feeling.TENS changes the signal going to the brain.
Physiological Pain Reduction Mechanism
The human body has its own mechanism of dampening pain input from the pain receptors through nerve pathways called descending inhibitory pathways
This electrical stimulation of the nerve-ending receptors pass the signal up the nerve, into the spinal cord, and ends up in the brain stem.
Gate Control Theory
What Exactly Does A Tens Unit Do
A Transcutaneous electrical nerve stimulation or TENS therapy uses a low voltage electrical current to manage pain. A TENS unit consists of a battery-powered device that delivers pulses of electricity through electrodes placed on the skin surface. These electrodes are usually placed at key locations:
A TENS unit is generally safe. This treatment is nonpharmacological, noninvasive, inexpensive, and easy to use.
This device produces different effects on the body. The use of a low frequency of less than 10 Hz with high intensity is used to produce muscle contractions. On the other hand, less than 50 Hz is used with low-intensity stimulation to produce paresthesia or tingling without muscle contractions.
Why can’t I move my neck without it hurting?
A joint or nerve issue is usually the cause of intense pain. A nerve may be pinched, stretched, or compressed thereby causing pain. Or, the nerve may be irritated by chemicals produced by inflammation. To protect a pinched nerve, the brain signals the body to produce muscle spams, preventing the person from moving the head in case of neck pain or back pain.
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Tens Machine Pad Placement For Knee Pain
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This article will give you directions on TENS machine pad placement for knee pain and help you understand your knee pain better
Contents
What do you do during knee pain? Whether you walk, run, get in or out of your car, cook, sit, your knees are the ones carrying your weight responsibly. Knee pain can be as worse as anything. Completing daily life tasks becomes tough.
The pain can be because of n number of reasons. It is not making you feel uncomfortable, but it can later lead to less muscle control, low strength, motion restriction. Earlier it was the case in older people only. But now youngsters are also in its reach. One-third of Americans have knee pain at some time or another.
But this is just a problem statement what about the solution you have come for? The TENS machine for knee pain is the best solution you can get! It is a proven method based on many scientific studies. Many people are aware of TENS machines and their benefits, but they dont know it is correct pad placement.
This article aims to educate you about TENS machine pad placement for knee pain.
Multiple reasons can cause you severe knee pain.
There are more on the list.
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How Do I Place My Tens Machines Electrode Pads For Frozen Shoulder

To handle pain related to the shoulder, place the electrode pads, in this case preferably with four pads, at the perimeter of the area of pain. You can extend the placement as much as down to your upper arm, your upper chest and your upper back.
Because of the lower amount of sensitive areas around the shoulders, feel free to experiment with the placement and the intensity to a degree that it is not painful or if it feels like your hurting too much.
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This Is How You Should Place Your Tens
A great advice to follow throughout this guide is to place the electrodes as close to the area of pain as possible, with the injured area in between the pads, while at the same time adhering to these general guidelines:
The main thing to take away from this segment is that you should always start on a small intensity and work yourself up to something that you can tolerate. Only then can you test your limits.
Electrical Stimulation And Total Knee Replacement
In another study it was found that you may experience a decrease in pain after total knee replacement with the use of a TENS machine.
Evidence has also been collected indicating that electrical stimulation could delay total knee replacement in addition to strengthening the muscles and easing pain.
One clinical study was conducted at 23 different centers around the country. The study involved 157 men and women suffering from knee osteoarthritis and for six to ten hours each participant would wear an FDA-approved electrical stimulation device. This took place on a daily basis.
There was also a control group of 101 participants who were not treated with the device. Out of those who used the electrical stimulation device, 62 percent were able to postpone replacement of their knee joint for four years.
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Can Tens Cause A Heart Attack
As a general rule, do not apply TENS if a person has heart disease, heart failure, or arrhythmias. There are no studies yet directly linking the TENS unit with a heart attack. Most likely, TENS therapy gives off a minimal current that is unlikely to interfere with heart rhythm.
If you have a bleeding disorder, TENS can cause bleeding at the site because of skin irritation or cause more bleeding in some persons.
If you have a pacemaker, do not use TENS. Other devices that may warrant inadvisability of the use of TENS are bone growth stimulators, cardioverter defibrillators, indwelling BP monitors, or neurostimulators in the brain or spinal cord. Discuss with a cardiologist or neurologist the use of a TENS device.
Does A Tens Unit Promote Healing In A Total Knee Replacement Surgery
The use of a TENS unit may promote wound healing of a total knee surgical site by causing the release of substance P and calcitonin gene-related peptide.These two substances present at the surgical site would increase blood flow to the surgical site and speed up the healing of the surgical wound.
The potential to produce this healing effect on a new surgical wound after a total knee replacement surgery is supported by a study in the National Institute of Health: The effects of transcutaneous electrical nerve stimulation on tissue repair.
This, in my estimation, is just a beneficial side-effect to using it to help control pain.
I have seen many total knee replacement patients that have needed help to control pain, with or without the use of opioids, but I do not see total knee patients that have trouble with healing unless there is an infection involved.
That makes me wonder if the speed-up of the healing process would have any impact on whether or not the infected total knee would have become infected if it had healed faster.That would be an interesting study compare new total knee infection rates and healing time between patients using TENS and patients that did not use TENS.
Infection is a rare occurrence with my patients as Im lucky enough to be working with cutting-edge doctors operating out of university hospitals. The referring doctor that makes up the bulk of the total knees I see has the lowest infection rate in California.
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How To Placeelectrodes When Using A Tens Unit
While a goodrule of thumb is to place electrodes near the injured or painful area, we findits useful to have diagrams to show proper placement. Having illustrateddiagrams for electrode placement is also useful for patients who purchase homeunits and want to use their TENS unit on their own.
The belowillustrations are provided by Current Solutions. They show recommended electrodeplacement for the common areas of the body where pain is treated with TENStherapy. The electrode placement diagrams shown here display electrodes fora 2-Channel Venti TENS unit, which uses 4 total electrodes 2electrodes per channel.
When apatient is using a unit at home, its important for them to follow therecommendations of this TENS Unit Electrode Placement Guide, but also followthe directions of their healthcare practitioner.
Example TENs Electrode Placements |
Some otherprotocols that should be adhered to when using a TENS unit are:
Whentreating in physical therapy, modalities are utilized to help decrease pain andincrease function. With the diverse treatment applications of a TENS unit, itsa perfect addition to many rehabilitation regimens. And with its ability to beused by the patient at home, TENS units are a great non-invasive painmanagement alternative to oral medication.
How Do You Start Tens Treatment
The skin should be clean and dry. This is to prevent the patches from slipping off. Make sure to switch off the TENS unit and then put in the batteries. Follow the instructions below in using TENS.
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Tens Unit Placement For Trapezius Pain
Trapezius muscles might be trickier to treat with electrical stimulation results from a task force on neck pain in 2008 found no clinically significant benefit to TENS for the treatment of neck pain when compared to placebo treatment.
Thus, be warned that time spent with TENS on neck pain may not prove effective, so you might want to concentrate efforts on the shoulder and back, targeting your pain by moving the pads.
Weve made it clear which TENS unit placement for shoulder pain is scientifically better for you, but we also have another article strictly covering which TENS units to buy for shoulder pain, so we recommend checking that one out for even more of our in-depth research.
Even additionally to shoulder pain, we found it interesting the TENS devices are proving to be useful for migraines, and for labor pain during childbirth.
A TENS device for the head was approved by the FAD in March 2014 with the specific intent to prevent -not just reduce- migraines. See Schoenen J, Vandersmissen B, Jeangette S, Herroelen L, Vandenheede M, Gérard P, Magis D . Migraine prevention with a supraorbital transcutaneous stimulator: a randomized controlled trial. Neurology. 80 : 697704. doi:10.1212/WNL.0b013e3182825055. PMID 23390177. S2CID 38716692.
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Where do you have pain?
Setting The Pulse Width

These are the ON periods of the current. Generally speaking, pain relief will occur with low to mid time periods. Muscle stimulation requires a longer pulse width to successfully reproduce a muscle contraction.You can alter the time that each pulse lingers before resetting. The time period is extremely small. Its measured in microseconds uS . While you may not notice the difference, your nerves can.The following setting is recommended:175 to 200uSYou can strengthen the power of your machine by increasing the pulse width.
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Follow These 10 Helpful Tips To Alleviate Pain With Tens Therapy
Do you suffer from muscle pain? Its possible that your muscle pain came from an injury, strain or overuse. Today, many Americans turn to TENS Unit Therapy to relieve muscle pain in the lower back, hips and arms. The use of a TENS Unit at home may be part of the overall treatment program developed by a physical therapist like myself, a physician or chiropractor. These professionals understand the musculoskeletal system and know how to most effectively place the electrode pads onto your skin for optimal pain relief.
You can also buy a TENS unit over the counter from your local drugstore or purchase an At Home TENS Unit online from a recognized retailer. Yet, without the advice and training of a healthcare provider, you may not feel comfortable about where to place the electrode pads. I would like to allay some of your fears with a little professional advice about electrode pad placement.
In order to obtain the best degree of pain relief with TENS, we recommend the following TENS pad placement guidelines:
Does The Placement Of Patches Matter
Yes, it matters. It plays an important role in recovery. It would be best if you put the patches on fleshy areas and not hard bony joints. Try to place the patches surrounding the painful area. This way, you get relief faster. Although it wont harm you for the wrong placement, you will get no effective result.
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The History Of Tens Units
TENS units have been used for a few decades and go back to the 1960s. Chiropractors learn how to use them and many chiropractors in practice sold the units to their patients. The advantage to the patients was that they could have more input into doing something for their pain without increasing pain medications.
The National Institutes of Health funded clinical studies on the TENS unit and positive results were found. One study in 2011 found that the muscles alongside the spine were stabilized with the unit and the patients pain ratings were significantly improved.
In 2016, patients who had curvature of the spine called kyphosis where the spine curves to the front instead of to the side, were tested with the TENS unit. The stimulation resulted in stabilizing their degenerative condition and stabilized the muscles.
In 2018, patients with lumbar disc herniation were tested. Some of these patients had sciatica, pain that travels down the back of the leg and may even extend down into the foot. The difference in pain the patients felt was significant, favoring of course the relief of the pain.
The TENS stimulation prevented the damage to the heart from free radicals created by the disc herniation and also relieved the clinical symptoms and signs. Those patients must have been quite happy with their results!
They also performed movements better and could function better in their daily living tasks.
All these studies provide some hope for seniors for several reasons:
How To Use A Tens Machine For Carpal Tunnel
Are you dealing with the aches and pains of carpal tunnel? Maybe its time you give TENS/EMS therapy a try and see what all of the commotions around TENS & EMS therapy devices are! Using a TENS machine for carpal tunnel can be a great way to alleviate some of the pain and discomfort that comes from having carpal tunnel.
Can Carpal Tunnel Be Treated?
There are a few different types of carpal tunnel syndrome treatments, including surgical and non-surgical therapies and treatments. Additionally, there are preventative measures that you can take to avoid experiencing carpal tunnel. Traditional hot-cold therapies such as the use of heating pads, compression wrist wraps, and TENS therapy can help you keep the pain under control throughout the day. If the pain from carpal tunnel is too severe, a doctor may recommend open or endoscopic surgery to treat the pain.
Using a TENS Machine for Carpal Tunnel
Your body sends electrical pulses from nerve endings through your nervous system and up to pain receptors in the brain. TENS and EMS treatment work to manage pain and discomfort, such as the kind felt from carpal tunnel, because of how TENS and EMS disrupt pain signals. When a TENS device is activated, it sends vibrations and pulses up through the nervous system and mimics those pain signals. So TENS and EMS arent restricted to just treating carpal tunnel pains, but rather, they can work for any kind of muscle or joint pain that you experience.
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