How To Use A TENS Unit / EMS Unit For Pain Relief and Muscle Strength

If you want to learn how to use a TENS unit for pain relief and/or muscle strengthening, then watch this video. You'll learn the differences between TENS and EMS and how to use each of them.

What is TENS Unit vs EMS Unit?

TENS and EMS are technically different, but many modern units do both TENS and EMS.

TENS stands for transcutaneous electrical nerve stimulation and is primarily used for pain control.

EMS stands for electrical muscle stimulation and is used for strengthening weak muscles.

The technical differences in electrophysiology and waveform can get quite complex. However, the basic difference is that TENS has high-frequency, shorter duration waves for pain relief, while EMS has less frequent but wider pulses for muscle stimulation.

TENS and EMS frequency and pulse duration

Depending on your TENS unit, settings vary.

In the video above, I demonstrate with the NURSAL TENS / EMS unit.

This unit is advertised as a TENS / EMS / Massager unit.  I tend to think that in functions more like an EMS unit in all of it's settings. However, it can still be used effectively for pain relief pain relief and muscle contraction.

How To Use A TENS Unit For Pain Relief

When using a TENS unit for pain relief, you should really just feel tingling or vibration.

With the NURSAL TENS unit above, I got mild muscle contractions even when using it in TENS mode, but that's OK, it still felt good.

How Does A TENS Unit Relieve Pain?

The vibration sense from a TENS unit travels along larger, faster nerves.

Therefore, that signal reaches your spinal cord before noxious (pain producing) signals, which travel along smaller, slower nerves.

TENS Units uses Gate Control to inhibit pain

In turn, the vibration signals get transported to your brain while the noxious signals do not.  This is known as Gate Control Theory.

How To Place The TENS Unit Pads For Pain Relief

In general you want to place the pads (electrodes) on either side of the painful area.  For smaller areas, you may want to just use 2 pads one wire (channel A or B).

For larger areas, you may use 4 pads placed in a square around the painful area. The pads from the two channels should form and "X" or cross pattern as shown in the video.

Pad placement will vary by body part though.

Here's a photo of the NURSAL TENS Unit user manual showing pad placements for various body parts.

How to place pads for an TENS Unit

What Settings To Use on a TENS Unit for Pain Relief

With old TENS units, you used to have to set the frequency, pulse width, and intensity (amplitude) of the treatment manually.

Most modern units have these settings pre-programmed.

Since TENS is primarily used for pain control, cycle through the various programs in your unit and choose the one that feels best for you.

How to use a TENS Unit / EMS Unit / Massager

Set the intensity on each channel to an intensity that feels comfortable.

Again, with TENS, you really should just feel tingling or vibration, but it's ok if you get a tiny bit of muscle contraction as long as it's not painful.

How To Use An EMS Unit For Muscle Strength

Now let's shift to using an EMS unit for muscle strengthening.

Place pads along the muscle you're targeting.  I show the quadricep muscle in the video above, but you can use an EMS unit on various different muscles.

Place 2 pads along a muscle length-wise to ensure that the motor point (neruomuscular junction) is somewhere between the 2 pads.

How to place pads for an EMS Unit

Turn on the unit to an EMS settings (9-18 on the unit above).

Gradually increase intensity until you get a muscle contraction.

To use EMS for muscle strengthening, you want a strong contraction.  It should be intense and maybe slightly uncomfortable, but tolerable.

You should NOT experience excruciating amounts of pain.  (If you do, turn the intensity down or turn the unit off.)

How To Use an EMS Unit for Massage

Lastly, there's a massage mode (19 to 24) on the EMS unit.  These are basically EMS waves but they don't cause a full strength contraction.  The contractions are shorter and feel more like a muscle kneading... kind of like getting a massage.

Find a setting and intensity that feels good for you.

How To Use A TENS Unit For Overall Recovery

Whether you're using a TENS unit for pain control or using an EMS function for muscle strength, neither one is a long-term solution.

TENS stops working shortly after you take it off.  Furthermore, EMS can strengthen weak muscles back to normal strength, but it doesn't get normal strength muscles stronger.

Both TENS and EMS can be used as a bridge to allow you to do other treatments such as physical therapy in order to get longer-lasting relief.

If you need help to find a long-term solution to your problem and live in the St. Louis area, we'd be happy to help you.

Just tap the button below to request an appointment with one of our specialist physical therapists.

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