The best way to ensure you’re using your TENS unit for back pain correctly is to speak with a medical professional. Any reputable machine should come with extensive instructions—and this is not an instance where you want to skip the instruction manual. “TENS is a relatively safe treatment, so long as those instructions are followed,” Starkey confirms.

That said, before you decide to charge up your TENS unit, Starkey says you’ll want to make sure you have an understanding of where your pain is coming from. “It’s cliché, but TENS (or anything else) should not be used to treat pain of unknown origin or used for more than two weeks without being examined by a medical professional.”

As for pad placement during sensory level pain control (no muscle contraction), Starkey recommends an “X” pattern with the painful area at the center of the X. The electrodes on each set of wires should be placed so that the current crosses over the area in pain.

In terms of frequency of use, “Sensory-level pain control can be used for days at a time,” Starkey advises. He recommends moving the electrodes slightly with each use to avoid irritation from the adhesive. 

The TENS unit should feel like a tingle or buzz that gradually increases in intensity to a sharp, prickly sensation. If the TENS treatment is successful, you should feel some pain relief within the first 30 minutes of treatment. If it is not successful, change the electrode placements and try again. And if you’re seeking 24-hour pain control, portable units are best.

Mark Barroso, MS, LAT, ATC, CSCS, NSCA-CPT

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