Sending electrical currents through your skin to stimulate your nerves may sound pretty painful, but it can actually have the opposite effect.
In fact, this kind of physical therapy treatment has been used for decades to help reduce pain. Transcutaneous electrical nerve stimulation (TENS) is a type of therapy that uses electrical currents to disrupt pain signals that travel across nerve strands in aching areas. Basically, TENS therapy uses electricity to trick your nerves into transmitting fewer pain signals to your brain. It can also stimulate the production of endorphins, the body’s natural painkillers.
TENS machines, once available mainly only in physical therapy offices, are now sold widely for home use, with no prescription needed. These at-home units usually cost between $30 and $100 and can provide safe, controlled electrical stimulation. They can be used to reduce pain associated with arthritis, fibromyalgia, multiple sclerosis, endometriosis, everyday muscle aches, and many injuries.
TENS therapy is not a magic cure. Some experts still doubt the long-lasting effectiveness of TENS since there’s limited scientific evidence available. Also, depending on your pain level, the therapy may only work when used as part of a broader treatment program including exercise, physical therapy, or pain meds. Before trying this kind of treatment, it's a good idea to ask your doctor if implementing a TENS machine to your routine could be beneficial.
TENS is considered a noninvasive treatment option that’s safe for most people. However, it’s seriously recommended that pregnant women and people with epilepsy, heart problems, pacemakers or other types of electrical or metal implants consult a doctor before use.
TENS machine buying guide
Most TENS machines are battery-powered and completely portable — small enough to fit in your pocket. They come with several sets of electrode wires and pads of different sizes. These pads are self-adhesive and can be easily placed on any area of the body, as long as it’s directly on skin.
Once the pads are in place, you can turn on the machine and it’ll deliver low voltage electrical currents to the targeted area. These currents inhibit how nerves in the area transmit pain signals to the spinal cord and brain, resulting in some pain relief and muscle relaxation.
All TENS machines have the same basic functionality, but might differ in their massage modes and intensity, or the number of electrode pads they can power at the same time. Here are some factors to consider when searching for a model that’s suitable for you:
• Massage modes. Most TENS machines have at least 20 preset massage modes. These can include traditional massages for commonly injured areas such as the lower back or neck. Others are designed to mimic more niche therapies such as cupping — a form of traditional Chinese and Middle Eastern massage that involves creating suction on the skin with a glass cup to promote circulation and healing.
When shopping for a TENS machine, take into account the specific body areas you would like to treat, and research which machines have the appropriate massage modes for those areas.
• Intensity levels. TENS machines have intensity settings that can be used to adjust how deep (or not) the massages feel. Many models have a range of about 20 different intensity levels, although some machines have even more, allowing for incremental adjustments and a more customized experience.
• EMS Therapy. In addition to TENS massages, some machines include EMS modes. EMS stands for electric muscle stimulation. While TENS therapy uses lower currents to target nerve strands in injured areas, EMS delivers slightly stronger currents that cause muscles to contract — and is said to help strengthen them. It also promotes blood flow to the area, which can help shorten recovery time from an injury or warm up the muscles before exercising.
• Wired or wireless. Traditional TENS machines have wired electrode pads, but there are now several models featuring wireless electrode pads that can be controlled with a remote. Others can be paired up with your smartphone and controlled with an app.
Whether you choose a wired or wireless TENS machine is a matter of preference, since their massage modes and intensity levels are very similar. Wireless machines can be somewhat easier to maneuver, since there are no cords to untangle or sort out. However, they do tend to be more expensive.
• Replacement pads. The typical TENS machine comes with around 10 reusable self-adhesive pads, but these won't last forever. The pads eventually lose their stickiness, especially if used daily. Replacing the pads is an added expense, so consider that cost when choosing a machine.
TENS machine users often also recommend purchasing conductive gel for electrodes. The gel not only helps the pads stay sticky for longer, they also increase the machine’s conduction of electricity.
Best TENS machines
1. Best overall: iReliev iRenew TENS + EMS Combination Unit
The iReliev iRenew TENS + EMS Unit combines the pain-relieving benefits of TENS therapy with the slightly stronger currents from EMS (Electrical Muscle Stimulation). The currents from EMS treatments stimulate muscles and cause them to contract, which can lead to faster recovery periods and strengthening.
The machine features 14 preset therapy modes: eight for TENS (including one specifically for arthritis pain) and six for EMS. With 25 intensity levels, it’s easy to make adjustments for a more customized experience. Sessions can be set to last anywhere between five minutes and an hour.
The dual channels feature allows you to customize treatment further: You can connect multiple electrode pads (four small ones or two large) to target several areas at the same time, and you can set each channel to deliver a different massage setting and intensity level.
This model has received clearance from the FDA, meaning that its cables and the output currents the machine produces comply with safety standards to prevent shocks, skin irritation, and other accidents.
The iRenew TENS + EMS Unit ($60) is battery-powered. If this is a turnoff, the newer iRenew Plus ($100) works using a rechargeable battery. Its display is also larger and backlit, though the the massage modes and intensity setting remain the same as the lower-priced model.
2. Editor’s pick: TechCare Massager Touch X Tens Unit Muscle Stimulator
TechCare Massager gives a modern twist to traditional TENS machines with the Touch X, a model that’s around the size of a smartphone and has a touchscreen.
Other TENS machines that are small enough to fit in a pocket can be kind of annoying to use; to make adjustments, you typically have to push a single button numerous times to find your preferred treatment. But with the Touch X’s touchscreen, you can make adjustments with just a few quick taps.
The Touch X offers 24 massage modes, including Tai-chi, reflexology, and classic Swedish massage. It has 20 levels of intensity, a 20- to 60-minute adjustable timer, and a rechargeable battery that can last up to 20 hours.
3. Best for low prices: Belifu Dual Channel TENS EMS Unit
For less than $40, the Belifu Dual Channel is both a TENS and EMS machine that can help relieve sore muscles and strengthen them while speeding up recovery.
It features 24 preset modes and 20 intensity levels to simulate therapeutic massages such as cupping, acupuncture, and the traditional Chinese Tuina. Thanks to its dual-channel design, you can connect up to six electrode pads at the same time and set different intensity levels for each channel. That way, one set of pads produces a deeper (or lighter) massage than the other.
The Belifu Dual Channel has a rechargeable battery that can last up to 20 hours. It comes with a USB charging cable, a storage bag, 10 self-adhesive electrode pads, and three electric wires. Take note that the power output for this unit is lower than some of the higher-priced machines. That means the Belifu's currents may be less intense than competing models.
4. Best smart TENS machine: PowerDot 2.0 Duo Smart Electric Muscle Stimulator
The PowerDot 2.0 Duo is a wireless, FDA-cleared machine that can be controlled from your smartphone.
Setting it up is simple and straightforward. Download the app and follow the on-screen instructions to pair the Duo receiver pod with your phone. Once paired, the app asks for some general information — for example, whether you want to increase strength or improve flexibility, and how often you exercise (or not).
With the app, you can measure your progress, receive safety advice, and get therapy recommendations. You’ll also find placement guides for each massage mode to guarantee electrode pads are placed correctly and maximize the therapeutic benefits.
The Duo features 10 preset massage programs, including active recovery, warm-up, muscle endurance, and explosive strength, or you can choose to focus on a specific injured area. A manual program lets you adjust settings such as number of contractions, contraction length, rest time, and pulse length.
As with other TENS machines, you can adjust the massage intensity. However, while most TENS machines only have between 20 and 25 levels, the Duo offers an impressive 100 intensity settings.
The Duo, which retails for around $350, comes with two receiver pods, four electrode pads, and four lead cables. If that’s too much for your budget, there’s also the PowerDot Uno (approximately $200), which offers the same features, but comes with a single receiver pod and two electrode pads.
5. Best portable massager: RAKZU TENS Unit Muscle Stimulator AS8015
Like the TeachCare Massager Touch X, the RAKZU has an easy-to-read touchscreen that makes it simple to switch between massage modes, even in mid-session. And, retailing for a little under $30, it’s more than $20 cheaper than our Editor’s Pick, the Touch X.
While the RAKZU does have fewer massage modes (only 12 compared to the Touch X’s 24), it still offers a wide variety of styles, including tuina, acupressure, tapping and cupping.
The RAKZU also stands out for just how easy it is to use while on the go. Unlike many other TENS devices, this model lets you lock both the touchscreen and the unit’s side buttons. This prevents any accidental changes in the settings, even if you’re moving around.
Like other dual-channel massagers, the RAKZU can be customized to provide two different kinds of massages and intensities at the same time. So, for example, if your neck needs a gentler approach than your lower back, you can customize your session accordingly.
Many users praise the RAKZU’s long-lasting battery and powerful massages — a pretty impressive combination, especially given its small size.
6. Best for multi-target treatment: Belifu 4 Independent Channel TENS EMS Unit
The Belifu 4 Independent Channel Unit boasts four connection channels, whereas most TENS machines have only two. With four channels, you can connect up to 16 electrode pads to target multiple areas simultaneously and set different intensity levels for each channel.
Like other TENS machines, it has 24 preset massage modes, but it has 30 intensity levels — other models around its price range (approximately $50) have 20 or 25. The adjustable timer has more options than other models as well. It can be set to a maximum running time of 80 minutes, compared to one hour for most others.
The Belifu 4 Independent Channel Unit includes 10 self-adhesive electrode pads and its battery is rechargeable and lasts up to 20 hours.