TENS Machine

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What Is A TENS Machines and How Does it Work?

what is a tens machines and how does it work

If you suffer from knee, back, neck, or other pains, then there is an effective therapy that can help you get lasting pain relief in as little as 20 minutes.

It’s called Transcutaneous Electrical Nerve Stimulation or TENS for short. How it works is adhesive pads are attached to specific points on the person’s body. These pads are connected to wiring that sends gentle electrical energy to the local nerves to alter pain signals.

You see, there is a pain pathway connecting your tissues to your brain. The experience of pain really comes from your brain no matter what condition you may have. For example, lets say your knee hurts. The sensation of pain does not actually come from inside of your knee. When there is a threat to the knee it sends signals through a pathway to your brain. Your brain then creates pain in the knee to protect that area and draw your attention to it and remove whatever threat there may be. The way TENS comes into this is that the machine sends electrical impulses through that same pathway to alter the pain signal coming from the pain. 

Additionally, these electrical impulses help your body release neuro-chemicals that naturally relieve pain. These are like the the “feel good” chemicals that you get from a good workout.

Check out this photo (Read the caption too) from Haldimand Physiotherapy Centre, they are using a TENS machine for knee pain:

The specific waveforms used in this type of therapy can also reduce and even eliminate muscle spasms.

In this guide we will explain everything you need to know about TENs machines from all of its benefits, what types of conditions it successfully treats and how to choose the right one for you.

So let’s get started!

The Ultimate Guide to TENS Machine - Everything You Need To Know

Start Feeling Better In As Few As 3 Visits

Overcome Your Back Pain, Neck Pain, Shoulder Pain & More.

Tell us what hurts, and we will treat your pain in the shortest time possible. Get effective treatment for your condition in less than 30 minutes so you can get back to doing what you live… pain-free.

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This appointment is your opportunity to tell us what hurts and discover whether physiotherapy is a good fit for you! During this session, you will talk with a physiotherapist on a phone call (or online) and create the right care plan specifically for your pain. There is no obligation, this session is only to find out if physiotherapy can help you getting back to doing the things you love in life.

About PainHero

If you’re like most you don’t want to wait days or weeks to get treated for your pain. And you don’t want to have to spend your time calling nearby clinics to find the one who can see you the fastest.

That’s where PainHero comes In – Canada’s largest network of physiotherapists, chiropractors, and registered massage therapists. 

Our Platform is used by clinics where they post their open appointment times. So you can quickly compare availability and wait times for clinics near you without having to pick up the phone. Then book an appointment within seconds and even see someone that day if you want. So you can get back to doing the things you love faster.

Plus unlike other sites who let anyone on or just rely on google reviews. We hand pick clinics based on a 50-point inspection, which includes everything from checking reviews, ratings, reputation, history, complaints, satisfaction, trust, cost, and general excellence.

Why PainHero?

Improve the way your body moves so you can continue to do the things you love. PainHero is Canada’s largest network of physiotherapists, chiropractors, and registered massage therapists. Our mission is to make it easy for you to find the top clinics in your community. We handpick the top clinics using our 50 point inspection based on patient reviews, complaints, and patient outcomes. 

Whether you’re seeking pain relief or preventative care, you can expect our patient-centric approach to be new and different from any healthcare experience you’ve had before. Perhaps even life-changing.  




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The Ultimate Guide to TENS Machine

More Benefits of using a TENS Machine

It was believed that TENS theory was used back in 60 A.D. by the Roman Physician Scribonius Largus. He would connect his patients to “electric fish” from the ocean for pain management.

There are even ancient records where they would use “electric eels” for pain relief. 

TENS is a non-invasive method for pain relief that has the benefit of being small and portable, allowing you to take it anywhere and use when you need it. 

Are you experiencing back pain from disc problems, muscle spasm, or just tired and aching muscles? This convenient tool can help decrease your back pain allowing you to move better throughout the day. 

Plus, it may even help you sleep better.

As you know, chronic pain doesn’t just affect you during waking hours. It can also interrupt your sleep patterns causing you to feel groggy the next day.

TENS is a great alternative to ease pain for those that don’t want to use medication or for those who want to reduce their meds.

Check out this great post from Koonar Physiotherapy and learn more about TENS machine and its benefits (Read the caption):

Why use a TENS machine for labour?

Fact: about 1 in 5 women in the UK plan to use a TENS machine during labour.

More and more women are using this therapy as a safe alternative to drugs during delivery.

Here’s how it helps during labour.

When a person experiences labour pain, a TENS machine unit placed on the back can help naturally decrease pain. Some TENS machine units come with a special attachment that has a push button for a sudden burst of pain relief during particularly painful moments. 

Here are some more advantages of using a TENS machine during labour:

  • It’s safe for you and your baby.
  • It can be used to lessen the pain during home birth.
  • It is easy to use
  • TENS machine does not interfere with Labour

How To Choose The Right TENS Machine For You.

how to choose the right tens machine for you.

First it’s best to talk with your Physiotherapist or primary care Physician to help you determine which unit is right for your condition. However, below is a general guide to further help you understand your TENs unit. 

Here’s what you should look for:

You need to be able to adjust it for the right amount of pain relief for you by altering these 6 critical features.

Intensity – the device should allow you to adjust the intensity of the electrical stimulation. Your goal is to find a strong enough intensity that is as comfortable as possible. The stronger the stimulus the more benefits you will experience. Your body will eventually adapt to the intensity so it’s important to turn up the intensity when this happens.

Every device will have a different intensity range so a Physical Therapist can help you determine the range that will give you pain relief. So make sure you review the range before buying.

Benefits of TENS Units (Read the caption), courtesy of Body Works Sports Physiotherapy

Frequency – this refers to the number of electrical impulses per second. If you have acute pain then it’s best to use a High frequency (HF) pulse range from 80 to 120 per second.

For chronic pain use low-frequency (LF) pulses ranging from 1 to 20 cycles per second.

Treatment Times 

Look for a TENS device that allows you to set the duration for treatment so it automatically stops once finished. For example, many devices will have a 30 minute treatment time. However, you may need longer or shorter depending on your condition. So make sure the unit allows you to adjust the treatment times to fit your needs. 

Channels and Connections

Channels are referred to the number of outlets for your lead wires to connect to.

Each channel has leads for two electrodes.

Some devices have multiple channels that you can use for different purposes. For example, if you have a big surface area to treat like the knee you want to use at least 4 electrodes (from 2 channels). If you have a smaller area like the elbow or you just want to target a specific area, then you only need two electrodes (from one channel).

If you need to use it on your lower back, then you should use at least 4 electrodes to target the largest area possible.

You don’t have to be that specific with where the pads are placed. It’s more about finding which area works best for you. Just find the pain area and surround it with electrodes. Now if you are using 2 channels, the electrodes from the channels need to criss cross each other like the image below.

Image from buyelectrodes.com

This criss cross pattern is typically the most effective way for easing the pain.

Here is an example for a common condition: For sciatica you would stimulate your back and follow the path of the sciatic nerve down. So you place each electrode on the back and the nerve a few inches apart from each other. If pain runs to your calf, you can place one on the calf.

Image from tens-ems.com

Just make sure you have clean skin with no oil on it. Also don’t place them on rashes or open wounds.

The next criteria to consider when buying a unit is:

Battery or Rechargeable

A TENs unit can be battery powered or rechargeable.

Battery powered units are less expensive. You don’t have to recharge it. However, you need to replace the batteries and have extra batteries on hand.

Then you have the Rechargeable units. These are more expensive. However, it saves you the hassle and cost of buying new batteries.

Either way both are portable and you can take them anywhere. So it’s up to your personal preference.

Size and Weight

This is important for some. Some are small enough to fit into your pocket, purse, or to clip on to your belt. Others require more room. The battery size is one of the main factors that affect the size and weight.



Find out whether physiotherapy can help you get back to doing the things you love in life. 

The Top 3 Best TENS Machines

Now that you know how effective TENS can be, which one should you buy? There are many TENS machine companies in Canada with hundreds of different types of units, so it can get overwhelming to find out which unit is right for you.

We asked the leading Physiotherapists in Canada who work with TENS machines regularly to give you advice. This included Darryl Yardley, an accomplished physiotherapist who teaches at 4 Canadian Physiotherapy schools. We handed him our top 10 best-selling TENS units that received the highest marks from Physiotherapists across the country.

Darryl inspected them and put them through a rigorous testing protocol to narrow them down to the top 3 based on a wide variety of factors.

Here they are:

Cefar Primo Pro Digital Tens Machine 

This Dual channel unit is designed to treat chronic muscle pain. Not only does it offer the TENS stimulation but it also massages your muscles at the same time for deeper pain relief.

You can easily adjust the intensity to provide just the right amount of stimulation by tapping on the up or down arrow.

Also, you can set the treatment time to whatever you want or use one of the preset settings for different types of conditions.

You can even run each channel with a different therapeutic frequency to provide greater flexibility for your treatment plans.

The large easy-to-read digital interface lights up for easy reading in the dark.

You can use this for many different types of muscle pain like neck pain, back pain, and it can even help reduce muscle spasms.

It is one of the more expensive units, however it will last for many years.

Comfy Stim Ultra Combo TENS/EMS Unit

This unit combines two therapies in one compact and portable device. TENS and EMS mode. TENS is strictly for pain relief. EMS stands for electrical muscle stimulation which is for muscle training or getting a person’s muscles to fire again after a stroke or after a fracture. This setting can even help to prevent muscle atrophy and maintain and increase strength.

The device features 4 channels to give you 8 electrodes to cover the largest surface area as possible.

It also contains 12 TENS presets and 12 EMS presets giving you a wide range of waveforms to attack even the most difficult to treat conditions.

Plus it’s half the price of the unit above but still highly effective. 

You can use this machine for all types of muscle pains such as chronic back and neck pain. It can even can reduce spasms and has been proven effective for relieving tension headaches.

TENS 4000 Machine

This is one of the most affordable TENS machines you can buy at just $49.95 while still giving you effective pain relief.

Now it doesn’t have all the presets functions as the two above, but it still allows you to adjust the intensity for the right therapeutic effect. It also provides different modes and waveforms. You can even adjust the pulse rate and width.

Also, you can set the treatment time.

This unit is great for lower back pain, tension headaches, muscle spasms, and back pain caused by pregnancy.

Knee pain treatment with TENS courtesy of PhysioPlus Health Group (Read the caption)

Can I Use a TENS Unit Every Day?

Most Tens units can be used for up to 30 minutes at a time, and can be used multiple times per day as needed.

Can Tens Machine Be Harmful?

As long as you use it correctly it’s generally safe. If you use it incorrectly by setting the intensity too high or placing the pads on the wrong body part, it can burn or irritate your skin.

3 Easy Steps To Get Your Machine At No Cost To You​

TENS machines are 100% covered by most extended health plans. The reason is, this device is classified as a “medical device” so many plans have no limits and no deductibles.

But, it has to be prescribed by your doctor in order for your insurance to cover it. Here are the steps to get a TENS machine covered through your insurance.

1.) Get on the phone with your insurance company.

Ask them if TENS machines are covered with your plan and how much coverage you get.

2.) Get your doctor’s note.

Most insurance companies require a doctor’s note.

Here’s what typically needs to be on your doctor’s note in order for you to qualify:

  • A medical diagnosis that would benefit from a TENS machine (ex. chronic knee or back pain)
  • How long will the expected treatment take. Your physiotherapist or physician will know this however it is usually at least 12 weeks.
  • Anticipated application of treatment (e.g. for daily use)
  • Goal of using this therapy (improve sleep, reduce meds, etc).
  • Lastly, mention what type of machine you will use. Just refer to the Top machines we talked about earlier. They are covered by most insurances.

Step 3:  Get Reimbursed.

Simply submit your receipt for proof of purchase and your doctor’s note to your insurance company.

That’s it! 

Common Injuries Successfully Treated with TENS Machines

Not only can you use TENS machine for back pain (upper and lower), it can also treat these conditions below as well:


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Frequently Asked Questions

It depends. Many experience pain relief after just 20 minutes. Others may take a little longer. Also, it may take some time to find the best placement of the electrodes for you.



Most insurance covers it. Please refer to the section in this guide about how to get your insurance to cover 100% of your unit.

There are potential side effects such as burns, excessive pain, etc. for people who are contra-indicated to using a TENS machine. TENS should not be applied to areas with impaired sensation, have an active cancer process, has an open wound, has any surgical hardware, near a pacemaker or over a bloodclot.


TENS Machine is one of several possible methods for relieving pain that do not rely on prescription medications and all the side effects and baggage they come with. Not to mention that most drugs can only mask pain, but rarely address root causes. Find a clinic if you are suffering from muscle tightness, soreness, or pain to improve your quality of life, today.