How Does A TENS Unit Work

'How Does It Achieve Pain Relief And Why......'

TENS machines can provide safe, easy to use, pain relief if used properly. But how does a TENS machine work? Can the electrical impulses from a TENS machine really affect your pain and if so, then how?

We put TENS machines under the microscope and explore the concept of ‘Gate Control Theory’.

The Basic Concept Of How A TENS Unit Works

A TENS (or Transcutaneous Electrical Nerve Stimulation) machine is a handy little device that creates small electrical impulses.

An image of a man lying on his bed with TENS unit pads stuck on his back

These tiny electrical charges are then delivered along small electrical wires to pads (electrodes) that attach to your skin. By doing this, the electrical impulse is delivered direct to your body.

The effect of doing this is designed to be two-fold.

1) Firstly, the electrical impulses will start to disrupt your normal pain signals being delivered to your brain, through what is known as ‘Gate Control Theory’

2) Secondly, the electrical impulses should stimulate the production of natural pain relieving hormones known as endorphins. These are natural pain relievers in themselves.

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How Does A TENS Machine Work (Mechanism 1) – Gate Control Theory.

Gate Control Theory is the idea that pain signals are not actually completely free to travel straight to the brain on being created at the site of a trauma (injury).

Instead it is thought that they need to pass through a number of neurological ‘gates’ at the spinal cord, which determine what pain signals are free to travel to the brain and be processed in to physical feelings.

It is largely accepted that these ‘gates’ are behind why rubbing or massaging a sore area can make it feel better. On the basis that such a concept exists, the rubbing is thought to temporarily close the gate which disrupts the pain signals and stops them from reaching the brain safely.

The less nerve signals that reach the brain, the lower the amount of pain felt.

Electrical wars…

One of the ways that a TENS machine works is by sending lots of electrical pulses through the skin to the relevant nerves and to the ‘gates’ at the base of the spinal cord.

A mass of tiny electrical messages from the electrodes (pads) then confuse the gates into shutting temporarily – thus reducing the amount of pain signals that can travel up the spinal cord to the brain.

The end result is less pain signals to be processed in the brain and less pain overall.

A set of gates with the headline - gate control theory is based on one pain signal at a time

How Does A TENS Machine Work (Mechanism 2) – Hormones

Endorphins are the bodies’ own hormonal version of pain killers. They are activated by the brain and come from the words ‘endogenous’ and ‘morphine’

This is relevant to TENS therapy, because as well as blocking the gates to pain stimuli, it is thought some electrical TENS travel to the brain via the PNS and the spinal cord.

In the brain, these electrical signals then stimulate the release of endorphins, which then spread out through the body via the spinal cord and peripheral nervous system.

In turn these endorphins activate what are known as ‘inhibitory nerve cells’ which prevent pain stimuli from being carried back upwards.

Tips On How To Use Your Machine.

From a TENS machine perspective, you will have a variety of controls depending on the make/ modal. The best units offer both EMS and TENS as options (What Is The Difference Between EMS and TENS) and multiple electrode (pads).

Drawing of a TENS unit in action

All TENS units typically have both an intensity and frequency controls. These are the most important on a TENS machine.

The intensity, as the name suggests, covers the strength of the electrical pulses generated, whilst the frequency regulates how often the tiny pulses are transmitted.

Different intensities have been found to have effects on different types of pain, with acute pain being more effectively treated by high intensity pulses.

Avoiding ‘tolerance’ build-up

Similarly varying the frequency can help to avoid building up a tolerance, as this has been observed in various clinical trials.

Before using a TENS machine it is vital to understand what makes a good machine and how to use a TENS unit.

Once you have done this, TENS treatments can be started whenever it is convenient and with very little risk to you whatsoever.

The Final Word –

How does a TENS machine work? Well, the little TENS unit creates electrical impulses that transmit down the wires and out through the electrodes (pads) in to your body.

From here they have two ways in which they can reduce the pain you feel.

In the first instance, they can prevent genuine pain signals reaching your brain by blocking the ‘gate’ to your spinal cord which acts effectively as a train track to your brain. By blocking some of these messages, your pain will be greatly reduced.

Then secondly, electrical pulses travel up to the brain via the spinal cord and PNS, stimulating the production of endorphins that act as natural painkillers, further enhancing your chances of good pain management.

If you choose a reasonable quality TENS machine and learn how to use it properly, you can achieve similar pain relief. It is true that not everyone will see a similar result – that is the case with all forms of pain management, but a good result is more than achievable.

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