How to use a TENS machine to relieve back pain

You might have been recommended a TENS (transcutaneous electrical nerve stimulation) mechine as part of your treatment for back pain. This helpful medical device won’t ‘cure’ your symptoms but it can provide short-term pain relief and it’s a useful alternative or addition to pain medication.

What is a TENS machine and how does it work?

A TENS machine is a small battery-powered unit which adheres to your skin via  sticky pads  called electrodes. The electrodes trasmit small electrical impulses,  creating a tingling or pins and needles sensation in your skin which distracts the nerves in the area to reduce pain signals and help relax muscle spasm. The effects can last for up to 4 hours afterwards.

How to use a TENS machine properly

Each individual TENS unit comes with an instruction manual which will explain the different settings and most include pictures to show you where to stick the the electrodes. Every brand of machine is slightly different so please do read your instruction manual.

You can choose to use either 2 or 4 electrode pads depending on how large the area of pain is that you are treating.

If your lower back pain is on one side, try using two electrodes. Place one pad at the top point of the pain and one pad below (about 1 inch apart). Try to place the pads on the muscle as opposed to directly onto your back bones:

If you have pain in the middle of your back or either side of your spine, try using 4 electrodes. Place placing one electrode either side of your spine at the top point of your pain about 1 inch out from the spine. Place the other two either side of your spine at the base of your pain, again 1 inch out from the spine:

The unit itself can be hooked onto a belt loop or the top of your trousers, so you can carry on with your normal activities whilst using it.

Settings

• For pain that has started recently (acute pain) – use the ‘constant’ or ‘normal’ setting. Set the pulse rate to between 80Hz – 120Hz and a pulse width between 175uS – 200uS.
• For pain you have had for more than a few weeks (chronic or persistent pain) – use the ‘modulation’ setting to prevent your body getting used to the stimulation, which would make the unit less effective. Set the pulse rate to between 2Hz – 10Hz and a pulse width between 175uS – 200uS.
• Time – you can leave your machine on for 30 to 60 minutes at a time and use around 4 times a day. If you have the machine on constantly throughout the day you will find it becomes less effective.

Do not use TENS without first seeking medical advice if you have any of the following:

• Pacemaker/heart problem
• Epilepsy
• Pregnancy – do not use during the first trimester. TENS can be used later in pregnancy but please consult a medical practitioner first.
• Do not use to mask undiagnosed pain

Other precautions:

• Do not drive, shower/bath or sleep whilst using your TENS machine.
• Do not apply heat or ice to the area at the same time as using the TENS unit.
• Do not place the electrode pads over broken skin, near/over your eyes, at the front/sides of your neck, over your mouth, over any numb areas of skin or on your abdomen during pregnancy.

Most people do not experience any adverse side-effects to using TENS. However very occasionally your area of pain may become more sensitive – if this occurs then stop using immediately. Some people may also experience a reaction to the electrode pads, such as itching/rash. Again, stop using immediately if this occurs.