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TENS Therapy: A Practical Guide to Pain Modulation

Not a cure, but a tool — understanding how TENS fits into your rehabilitation

TENS (Transcutaneous Electrical Nerve Stimulation) works through neuromodulation, helping the nervous system temporarily reduce pain signals. It does not heal tissue, but it can be a valuable support tool in your recovery when used correctly.

1. What a TENS Machine Actually Does

TENS works through neuromodulation, helping the nervous system temporarily reduce pain signals. It does not heal tissue.

Mechanisms:

Pain Gate Theory

Fast-acting relief by competing with pain signals

Endogenous Opioid Release

Releases natural pain-relieving chemicals in your body

2. When TENS Can Be Useful

TENS is useful when:

  • Pain is too high to start rehab
  • Flare-ups limit movement
  • Pain interferes with sleep
  • You need symptom relief while active rehab continues
3. When TENS Should NOT Be Used

Avoid using TENS over:

  • Open wounds or infected skin
  • Carotid artery
  • If you have pacemakers/defibrillators
  • Pregnancy abdomen
  • During driving or sleeping
4. How to Use a TENS Machine Properly

Pad Placement:

Place pads around—not directly on—the painful area.

Intensity:

Strong but comfortable tingling; no muscle contraction.

Duration:

15–45 minutes, up to twice daily.

Settings:

High Frequency (80–120 Hz)

Fast, short-term relief

Low Frequency (2–10 Hz)

Slower onset, longer relief

5. Expected Outcomes

Short-term benefits:

  • Reduced pain sensitivity
  • Easier movement
  • Decreased muscle guarding
  • Improved sleep

Relief may last minutes to hours depending on the person.

6. What TENS Will Not Do

It will NOT:

  • Heal injury
  • Rebuild tissue
  • Resolve biomechanical causes
  • Replace strength or mobility training
  • Cure chronic pain

It is a passive tool, not a long-term solution.

7. How TENS Fits Into Rehab

TENS works best as:

  • A precursor to movement
  • A calming tool after activity
  • Support during flare-ups
  • A facilitator of graded exposure
8. Signs TENS Is Helping
  • Increased confidence in movement
  • Less guarding or bracing
  • Reduced irritability after activity
  • Improved tolerance for exercise
9. When to Avoid Relying on TENS

Reduce dependence if:

  • You need it multiple times per day
  • You avoid movement without it
  • It replaces your rehab program
  • You push through high pain using it
10. Summary

TENS:

  • Modulates pain
  • Supports movement
  • Helps short-term function

TENS Does NOT:

  • Heal tissue
  • Serve as a standalone treatment

Used correctly, it acts as a bridge toward active rehabilitation and long-term recovery.

Questions About Using TENS?

Book a session to discuss how TENS therapy can support your specific rehabilitation goals.

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