How to Place Electrodes for a Tens Unit

Three Parts:Placing the Electrodes SafelyKnowing What Not to DoKeeping your Expectations Realistic

TENS stands for "transcutaneous electrical nerve stimulation." This is a pain management technique in which small electrodes are placed on the skin and used to administer low intensity, rapid electrical pulses. The electricity is thought to block the pain signals pathways traveling to your brain and also to cause your body to reduce your pain by releasing chemicals called endorphins. The pulses, if slow and strong enough, can cause noticeable, involuntary muscular flexing, "contracting and relaxing." The faster pulses can be more like rubbing/quivering. Whether it is effective or not for pain management is currently under scientific study, but some people report that it helps reduce their pains.[1] It is important you understand where it is safe to use the electrodes on your body and when you should avoid using TENS at all (like if you have a heart pacemaker, defibrillator or heart monitoring device).

Part 1
Placing the Electrodes Safely

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    Try starting with the lowest settings. Then increase them to an effective setting. See a physiotherapist to get help adjusting the settings. This will reduce the likelihood of your using a setting that is too high or too low. Ask about common massage points useful for relaxation on your body. The physiotherapist will have experience and will be able to advise you as to what is best for your condition and what to avoid.[2]
    • To relieve your personal pains find the pain points with finger tips and apply electrode pads around there.
    • The better settings are different for each person, depending upon how sensitive you are and what your condition is. The body gets resistant to a unit that has only one pattern of electro "tapping". Some have a random pattern.
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    Place the electrodes at least an inch apart. This will prevent you from having too much electricity delivered to too small an area.Turn the TENS device off while you are adjusting the electrodes. You can arrange the electrodes in several ways, depending on what works best for you:[3][4][5]
    • Around the area that hurts or over acupuncture points that the physiotherapist can show you on a chart.
      • If the electrodes are colored red and black, you want to position the black electrodes farther from your trunk or torso, such as on your arms or legs, and the red electrodes should be closer to your torso. This will help prevent unpleasant impulses from going to your central nervous system. It will also stimulate muscle contractions.
    • You can arrange the electrodes in lines, in X formations, or in squares, but they must be at one inch or farther apart. To make an X, place one pair of matched negative and positive electrodes for one diagonal and another pair for the crossing angle.
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    Adjust the amount of electricity slowly, gradually and carefully. Start with the machine off, then turn it on when the dial is at its lowest setting.[6]
    • Slowly raise the electrical current until you feel a pleasant tingling feeling. If it hurts, then the current is too high.
    • More is not necessarily better. Turning it up too high will not increase the amount of pain relief.
    • Your body may get used to the effect of a certain level of current after a while. If this happens to you, slowly increase the current slightly.
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    Remember the setting that works for you. Once you know how much electricity is beneficial for you and where to put the electrodes, keep using that setting.[7]
    • This doesn't necessarily mean starting at that setting, which might be painful. Start out with a low number, then increase it slightly until you get to your preferred setting.
    • You can use TENS as long or as often as you want. If you use it for long periods of time, while doing other things, you can clip it to your belt or keep it in your pocket.
    • The amount of time that you’re going to use the TENS unit will differ depending on the condition being treated, the chronicity of your health condition and the way your body will respond. A physiotherapist will be able to provide the proper recommendations on the amount of time to use the TENS, in addition to the number of times that you can use the TENS.
    • Be aware that using it too often will lead to your body getting ‘used’ to the impulses. Eventually, the effects may diminish over time.
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    Make sure the pads have sufficient gel or water on them. Not only are you going to respond to a certain group of settings more than others, it’s important to know that having enough gel or water on the pads can also result in different experiences. Having enough gel or water can help conduct the impulses better.

Part 2
Knowing What Not to Do

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    Do not place the electrodes on areas of the body which could harm you. You should not apply electricity to areas that are close to your heart or that are likely to be particularly sensitive. Keep them away from your:[8]
    • Temples
    • Mouth
    • Eyes/Ears
    • Front or side of your neck near the major arteries
    • Spinal column (can be crossing from opposite sides of the spine though)
    • Left side of your chest, i.e.: near your heart
    • Front of your chest with one on your back
    • Varicose veins
    • Broken skin or a new scar that is still healing
    • Areas that are numb
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    Do not use TENS at all anywhere on your body if you have a condition that makes it unsafe for you. Some health conditions make using TENS risky.[9]
    • If you have a pacemaker or another electrical device in your body, the electrical impulses could interfere with these devices or their signals, or cause a failure.
    • If you have epilepsy, you may be more sensitive and it is better not to use TENS.
    • If you have a disorder which affects the rhythm of your heart/heartbeat, your heart might be particularly sensitive to electrical impulses, and malfunction.
    • If you are allergic to the electrode pads, you may be able to get hypoallergenic electrode pads.
    • If you are pregnant or might be pregnant, do not use TENS without it being prescribed. The risks of using TENS during pregnancy aren’t known, so do not use it without consulting your doctor. Some women find it helpful for pain relief during labor pains, but be sure to ask your doctor whether it is safe for you and your baby before using it.
    • If you are unsure whether TENS is safe for you, consult your doctor.
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    Do not use TENS while you are engaged in certain activities. These activities make using TENS more risky.[10]
    • If you are in the bath, shower, or swimming pool, the water will change how and where the electricity is conducted.
    • Do not use TENS while you are sleeping.
    • If you are driving a motor vehicle the sensations caused by TENS may be a distraction.
    • If you are operating machinery, do not use TENS to avoid unexpected confrontations.
    • The electrical impulses that TENS devices produce should not cause problems for airlines, but ask them before you use it during flight.

Part 3
Keeping your Expectations Realistic

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    Reduce disappointment by knowing what to expect. TENS usually doesn’t work immediately, so you may need to be patient.[11]
    • Some people find that it takes about 40 minutes of use before their pain subsides.
    • Most people only experience pain relief while using TENS. When you switch it off, your pain may return.
    • If the TENS loses its effectiveness, it’s important to make an appointment with your physiotherapist to learn how to change up the settings. This can help in finding the right settings for your specific condition.
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    Learn about what conditions TENS is most likely to help. TENS is generally most beneficial for people experiencing pain and / or muscle spasms in certain areas of the body or for certain problems:[12]
    • Back
    • Knees
    • Neck
    • Menstrual cramps
    • Sports injuries
    • Arthritis
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    Maximize the benefits by pairing TENS with other pain management techniques. While people who can’t take pain medications often find it very helpful, you are most likely to get relief if you use TENS and other methods of pain reduction. TENS can complement:[13]
    • Medication. This includes prescription strength or over-the-counter medications.
    • Exercise. Ask your doctor what forms of exercise he or she recommends for your condition.
    • Relaxation techniques. Depending upon what the cause of your pain is, you may be able to use TENS simultaneously with relaxation techniques like meditation, deep breathing, visualizing calming images or yoga.


  • Always follow the manufacturer’s instructions when using your TENS device.
  • As stated above, do not use the pads on the brain, eyes/ears, tongue, jugular veins nor arteries, etc. Do not place pads in a line upon the spine nor along blood vessels.
  • If you are unsure whether TENS is safe for you, consult your doctor.
  • Again, do not use it at all, if you have a heart pacemaker, defibrillator or heart monitoring device.

Article Info

Categories: Pain Management and Recovery