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2.9: Transcutaneous Electrical Nerve Stimulation (TENS)

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    Transcutaneous Electrical Nerve Stimulation (TENS) involves the delivery of electrical stimuli with the aim of relieving acute and chronic pain. Primary mechanism of action is likely through inhibition of nociceptive processing (bottom-up) and stimulation of endogenous pain inhibitory mechanisms (top-down) (de Oliveira et al., 2020; Peng et al., 2019).

    Based on randomized controlled trials and systematic reviews TENS therapy does not have a large body of evidence, but there is still some research that supports the use of TENS as part of a multidimensional approach for patients suffering from fibromyalgia (Dailey et al., 2020).

    The University of Vermont: How to Use a TENS Unit

    Key Takeaways

    Transcutaneous Electrical Nerve Stimulation (TENS) involves the delivery of electrical stimuli that stimulates afferent nerve (A-beta, A-delta and C fibers), which triggers neurological responses in the periphery, spinal cord, and brain that may help modulate the experience of pain.

    References and Sources

    Behm, D. G., Colwell, E. M., Power, G., Ahmadi, H., Behm, A., Bishop, A., … Ryan, M. (2019). Transcutaneous electrical nerve stimulation improves fatigue performance of the treated and contralateral knee extensors. European journal of applied physiology, 119(11-12), 2745–2755. doi:10.1007/s00421-019-04253-z

    Binny, J., Joshua Wong, N. L., Garga, S., Lin, C. C., Maher, C. G., McLachlan, A. J., … Shaheed, C. A. (2019). Transcutaneous electric nerve stimulation (TENS) for acute low back pain: systematic review. Scandinavian journal of pain, 19(2), 225–233. doi:10.1515/sjpain-2018-0124

    Butt, M. F., Albusoda, A., Farmer, A. D., & Aziz, Q. (2020). The anatomical basis for transcutaneous auricular vagus nerve stimulation. Journal of anatomy, 236(4), 588–611. https://doi.org/10.1111/joa.13122

    Costa, B., Ferreira, I., Trevizol, A., Thibaut, A., & Fregni, F. (2019). Emerging targets and uses of neuromodulation for pain. Expert review of neurotherapeutics, 19(2), 109–118. doi:10.1080/14737175.2019.1567332

    Dailey, D. L., Vance, C., Rakel, B. A., Zimmerman, M. B., Embree, J., Merriwether, E. N., Geasland, K. M., … Sluka, K. A. (2020). Transcutaneous Electrical Nerve Stimulation Reduces Movement-Evoked Pain and Fatigue: A Randomized, Controlled Trial. Arthritis & rheumatology (Hoboken, N.J.), 72(5), 824–836. https://doi.org/10.1002/art.41170

    de Oliveira, H. U., Dos Santos, R. S., Malta, I., Pinho, J. P., Almeida, A., Sorgi, C. A., Peti, A., Xavier, G. S., Reis, L., Faccioli, L. H., Cruz, J., Ferreira, E., & Galdino, G. (2020). Investigation of the Involvement of the Endocannabinoid System in TENS-Induced Antinociception. The journal of pain: official journal of the American Pain Society, 21(7-8), 820–835. https://doi.org/10.1016/j.jpain.2019.11.009

    Gibson, W., Wand, B. M., & O’Connell, N. E. (2017). Transcutaneous electrical nerve stimulation (TENS) for neuropathic pain in adults. The Cochrane database of systematic reviews, 9(9), CD011976. doi:10.1002/14651858.CD011976.pub2

    Gibson, W., Wand, B. M., Meads, C., Catley, M. J., & O’Connell, N. E. (2019). Transcutaneous electrical nerve stimulation (TENS) for chronic pain – an overview of Cochrane Reviews. The Cochrane database of systematic reviews, 4(4), CD011890. doi:10.1002/14651858.CD011890.pub3

    Heidland, A., Fazeli, G., Klassen, A., Sebekova, K., Hennemann, H., Bahner, U., & Di Iorio, B. (2013). Neuromuscular electrostimulation techniques: historical aspects and current possibilities in treatment of pain and muscle waisting. Clinical nephrology, 79 Suppl 1, S12–S23.

    Johnson, M. I., Claydon, L. S., Herbison, G. P., Jones, G., & Paley, C. A. (2017). Transcutaneous electrical nerve stimulation (TENS) for fibromyalgia in adults. The Cochrane database of systematic reviews, 10(10), CD012172. doi:10.1002/14651858.CD012172.pub2

    Leemans, L., Elma, Ö., Nijs, J., Wideman, T. H., Siffain, C., den Bandt, H., Van Laere, S., & Beckwée, D. (2020). Transcutaneous electrical nerve stimulation and heat to reduce pain in a chronic low back pain population: a randomized controlled clinical trial. Brazilian journal of physical therapy, S1413-3555(19)30687-2. Advance online publication. https://doi.org/10.1016/j.bjpt.2020.04.001

    Macdonald, A. J. R. (1993). A Brief Review of the History of Electrotherapy and Its Union with Acupuncture. Acupuncture in Medicine, 11(2), 66–75. https://doi.org/10.1136/aim.11.2.66

    Martimbianco, A., Porfírio, G. J., Pacheco, R. L., Torloni, M. R., & Riera, R. (2019). Transcutaneous electrical nerve stimulation (TENS) for chronic neck pain. The Cochrane database of systematic reviews, 12, CD011927. doi:10.1002/14651858.CD011927.pub2

    Mokhtari, T., Ren, Q., Li, N., Wang, F., Bi, Y., & Hu, L. (2020). Transcutaneous Electrical Nerve Stimulation in Relieving Neuropathic Pain: Basic Mechanisms and Clinical Applications. Current pain and headache reports, 24(4), 14. https://doi.org/10.1007/s11916-020-0846-1

    Parseliunas, A., Paskauskas, S., Kubiliute, E., Vaitekunas, J., & Venskutonis, D. (2020). Transcutaneous Electric Nerve Stimulation Reduces Acute Postoperative Pain and Analgesic Use After Open Inguinal Hernia Surgery: A Randomized, Double-Blind, Placebo-Controlled Trial. The journal of pain, S1526-5900(20)30108-5. Advance online publication. https://doi.org/10.1016/j.jpain.2020.11.006

    Peng, W. W., Tang, Z. Y., Zhang, F. R., Li, H., Kong, Y. Z., Iannetti, G. D., & Hu, L. (2019). Neurobiological mechanisms of TENS-induced analgesia. NeuroImage, 195, 396–408. doi:10.1016/j.neuroimage.2019.03.077

    Sanchis-Gomar, F., Lopez-Lopez, S., Romero-Morales, C., Maffulli, N., Lippi, G., & Pareja-Galeano, H. (2019). Neuromuscular Electrical Stimulation: A New Therapeutic Option for Chronic Diseases Based on Contraction-Induced Myokine Secretion. Frontiers in physiology, 10, 1463. doi:10.3389/fphys.2019.01463

    Sato, K. L., Sanada, L. S., Silva, M., Okubo, R., & Sluka, K. A. (2020). Transcutaneous electrical nerve stimulation, acupuncture, and spinal cord stimulation on neuropathic, inflammatory and, non-inflammatory pain in rat models. The Korean journal of pain, 33(2), 121–130. https://doi.org/10.3344/kjp.2020.33.2.121

    Toth, M. J., Tourville, T. W., Voigt, T. B., Choquette, R. H., Anair, B. M., Falcone, M. J., Failla, M. J., Stevens-Lapslaey, J. E., Endres, N. K., Slauterbeck, J. R., & Beynnon, B. D. (2020). Utility of Neuromuscular Electrical Stimulation to Preserve Quadriceps Muscle Fiber Size and Contractility After Anterior Cruciate Ligament Injuries and Reconstruction: A Randomized, Sham-Controlled, Blinded Trial. The American journal of sports medicine, 48(10), 2429–2437. https://doi.org/10.1177/0363546520933622

    This page titled 2.9: Transcutaneous Electrical Nerve Stimulation (TENS) is shared under a CC BY 4.0 license and was authored, remixed, and/or curated by Richard Lebert (eCampus Ontario) via source content that was edited to the style and standards of the LibreTexts platform; a detailed edit history is available upon request.