Background

Transcutaneous Electrical Nerve Stimulation (TENS) is used to reduce pain by conducting small amounts of electricity to the body. The electricity is delivered through electrodes that are placed directly on the skin or around the area of pain. TENS is thought to work by using electricity to activate nerves that decrease the sensation of pain. TENS may also work by helping the body release endorphins that decrease pain. The amount of electricity delivered causes a sensation of tingling, vibration or muscle twitching, but does not “shock” or cause pain.

TENS is generally inexpensive and can be done with portable devices at home. These devices often allow the operator to change the intensity of the electricity and the pattern in which it is delivered. TENS is safe, although those with certain medical conditions, such as a pacemaker or epilepsy, should not use this treatment. A sports medicine doctor may assist you in deciding whether TENS may be beneficial or safe for you to use.

Why is it used?

TENS is used primarily to reduce pain, though it is generally not thought to have a significant role in healing tissue or speeding up recovery. It is used in a variety of conditions, including low back pain, neck pain, knee arthritis and other chronic musculoskeletal pains. TENS has also been used for non-muscular pain, including for nerve pain related to diabetes, childbirth pains or pain during or after medical procedures.

Does it work?

The effectiveness of TENS may vary depending on the individual and the condition for which it is used. Some research studies have shown TENS to be helpful in reducing pain from knee arthritis or diabetic nerve pain. However, other research has found TENS not to be helpful in improving chronic low back pain or chronic neck pain. Research on the use of this treatment in various other conditions continues, and certain insurance companies may consider TENS experimental.

Sports Medicine Evaluation

Evaluation by a sports medicine doctor can be helpful in deciding whether TENS may be beneficial for your condition. The initial evaluation would be a typical clinic visit, with questions about your medical history and a physical examination. Your provider may decide to run further tests. They may recommend medications, injections or therapies to help your condition. Other techniques similar to TENS, including electrical stimulation via electrodes that pierce the skin (electroacupuncture), delivery of topical medications using electrical current (iontophoresis) or dry needling may also be discussed.

Return to Play

TENS devices can often be worn during light activity or exercise, although they should not be used while swimming. Use of TENS should not impact your ability to return to sports, as long as your provider has given you clearance to participate. TENS is generally safe to use on your own at home, if you follow the instructions from the manufacturer and the advice of your health care provider. One possible complication from TENS is skin irritation from electrodes. This can be minimized by washing the skin prior to placement and alternating the electrode sites.

AMSSM Member Authors
Amy Valasek, MD, MS, and Daniel Chen, MD

References
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3. Dubinsky RM, Miyasaki J. Assessment: Efficacy of transcutaneous electric nerve stimulation in the treatment of pain in neurologic disorders (an evidence-based review): Report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Neurology. 2009;74(2):173-176.
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