TENS Machine

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What Is A TENS Machines and How Does A TENS Machine Work

If you suffer from knee, back, neck, joint pain or are in labour, then there is an effective therapy that’s helping people 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. It then sends gentle electrical energy to your nerves that’s proven to block or alter pain signals.

You see, there is a pain pathway to your brain. The pain really comes from your brain no matter what condition you may have. For example, say your knee hurts. The pain is not actually inside of your knee. Your knee is sending signals through the pain pathway to your brain and your brain is basically saying, yes that hurts. So the TENS machine sends electrical impulses through that same pathway to prevent these pain signals from reaching the brain.

Which helps relieve pain and relax your muscles.

These same electrical impulses help your body produce a natural painkiller called endorphins according to Medical News Today. These are 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:

Not only that, the specific waveforms used in this type of therapy can reduce and even eliminate muscle spasms while improving circulation at the same time.

In this guide we will explain everything you need to know about TENs machines from all the benefits, what types of conditions it successfully treats, how to choose the right one for you, how effective it is for labour (pregnancies), and 3 easy steps to get your insurance to pay for it.

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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Get a personalized care plan so you can feel better in as few as 3 visits. We use advanced therapy techniques proven to ease pain, accelerate recovery, improve mobility and overall health.

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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.

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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’s small and portable. Allowing you to take it anywhere and use when you need it. This compact device can provide pain relief for a wide variety of conditions like:

Back pain caused by an unsuccessful surgery, disc problems, or spinal degeneration.  It does this by blocking pain signals sent from your nerves to your brain or spinal cord.

Also TENS reduces chemicals in the brain that turn on pain while at the same time stimulates more of your natural pain killers that turn off pain. Such as opioids, serotonin, and endorphins. 

Plus 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.

But according to a study on “554 patients with chronic lower back pain. They found that TENS machines helped 51% experience a better and longer sleep while having fewer periodic leg movements.”

Another study In 2013 was done on Fibromyalgia patients and found that it significantly decreased pain and fatigue during movements.

Tens is a great alternative to ease pain for those that don’t want to use medication or 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 (pregnancies)?

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

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

Here’s how it helps during labour.

When a woman experiences pain during labour. Pain signals are sent from the uterus and cervix to the brain. As I mentioned at the beginning of this guide, your pain is not coming from the painful area, instead it’s your brain that says yes this hurts. Causing you to feel pain.

TENS helps by preventing these pain signals from the uterus from reaching the brain.

Helping to ease contractions without drugs.

Here are some more advantages of using TENS during labour:

  • It’s safe for you and your baby.
  • Can be used to lessen the pain during home birth.
  • Easy to use so you don’t need a midwife or physician to administer it.
  • TENS does not interfere with Labour.
  • Fits into your pocket allowing you to treat yourself anytime and anywhere.
  • No known side effects for the mother or baby.

However you should never use this device in a birth pool, shower, or bath.

How To Choose The Right TENS Machine For You.

First it’s best to talk with your Physical Therapist or primary care Physician to help you determine which unit is right for your condition. However, I will guide you through the process of picking the right one for you.

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 3 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 more benefits you will experience. Plus 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.

Each channel has 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. If you have a smaller area like the elbow or you just want to target a specific area, then you only need two electrodes.

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

Tens machine placement of electrodes.

You don’t have to be that specific. 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, each channel the electrodes 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.

Tens machine for sciatica

For sciatica you would just follow the path of the sciatic nerve down. So you place each electrode on the nerve a few inches apart from each other. If pain runs to your calf, you can place one on the top of the calf.

Image from tens-ems.com

Just make sure you have clean skin with no oil on it. Also don’t place 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, save you the hassle and cost of buying new batteries.

Either way both are portable and you can take 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 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

You’ve seen the symptoms. Now let’s look at some of the medical conditions they can lead to. 

Now that you know how effective TENS can be.

Which one should you buy? There are many TENS machine Canada websites with hundreds of different types of units, so it can get overwhelming to find out which unit is right for you.

So we asked the leading Physiotherapists in Canada who work with TENS machines regularly to give you advice.

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

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 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. Even helps to prevent muscle atrophy, maintain, and even increase strength.

So this combination unit gives you fast pain relief and muscle conditioning as you go about your day.

Features 4 channels to give you 8 electrodes to cover the largest surface area as possible.

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 one above but still highly effective. 

You can use this machine for all types of muscle pains such as chronic back and neck pain. 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. 

However, it allows you to adjust the intensity for the right therapeutic effect. 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, to reduce muscle spasms, and back pain caused by pregnancy.

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

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

But, it has to be prescribed by your doctor in order for your insurance to cover it.

Here’s how to get your insurance to pay 100% of the cost.

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

Ask them if TENS machines are covered with your plan and how much coverage do 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:

  • 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) but has successfully treated these conditions below as well:


Frequently Asked Questions

Many feel tingling, tapping, buzzing, or muscle twitching. Your body may eventually get used to it and you won’t feel anything. That’s why you need to turn up the intensity when this happens. 


Yes! For the past 30 years they’ve proven effective for a wide range of conditions. Tens machine uses include: 

  • Knee pain
  • Neck pain
  • Sports injuries
  • Arthritis
  • Chronic pelvic pain
  • Tendinitis
  • Bursitis
  • Osteoarthritis
  • Fibromyalgia
  • Sciatica
  • Headaches and Migraines
  • Whiplash,
  • Labour Pain
  • Aching Joints
  • Muscular Pain

No, if you experience pain, turn it down to a strong but comfortable intensity.


No, but some may experience a little skin irritation caused by the patches.



No, as long as you keep your unit away from water. Turn it off before you take off the patches and do not touch bare wires on a damaged cord. Just like any other electrical device.



Yes! Generally you want to attach the patches in a circle around the painful area, but not over boney sites. 

Just don’t attach them to these areas below:

  • On the front or sides of your neck
  • Your temples, mouth, or eyes
  • Numb areas
  • Varicose veins
  • Your chest and upper back at the same time
  • Anywhere on your head, face, or throat
  • Directly on the backbone
  • Swollen, irritated, infected, or inflamed skin
  • Open cuts and rashes

Basically, It sends electrical impulses from the problem area to the brain to block or alter pain signals.



First clean the area of your skin where the electrodes will be placed. Then let your skin dry. You don’t want any oils on your skin.

Put a thin coat of gel on the bottom of each electrode. Aloe vera gel works great. This helps the electrical signal get into the nerve better.

Place the electrodes on your skin around the painful area.

Plug the electrode wires into your TENS unit.

Turn knob or press up arrow depending on your machine until you feel a tingling sensation. Lastly, set the treatment time.

Experts suggest for around 30 minutes at a time. However, you can go longer, just need to take a 20 minute break in between sessions to give your skin a rest.

Yes. In fact, many find that they can reduce or completely eliminate their pain management drugs.


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.



Some experience pain relief for the whole day. Others may need another treatment throughout the day.

If your patches fall off. No worries, just turn off your unit and then take out the wire from the patch. 

You can either replace it with a new patch or dry and clean it. Whichever you choose, just make sure your skin is dry and clean before placing the patch on. This keeps the patches sticky for much longer.


Typically 150 uses or 5 months of daily use.



No. Your goal is to increase the intensity to as strong as comfortably possible. The stronger the intensity, the more beneficial.



Yes you can. If the pain is manageable, you may want to not use it until a flare up occurs. Many use daily or when they feel a flareup coming on.



No. Just like any electrical device there is a chance you could get shocked if it’s exposed to water. Plus can damage your machine.

No. Smaller areas on your body, you won’t be able to fit them all like the elbow. If the area is large enough, it’s best to use all 4 to get better pain relief.


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

No. It’s a safe and effective treatment with no known side effects.


IMS treatment 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.