Written by Mike Price, OT
For individuals dealing with chronic or acute pain, TENS (transcutaneous electrical nerve stimulation) units offer a compelling solution by delivering low-voltage electrical currents through skin-placed electrodes to alleviate discomfort. When selecting a TENS unit, consider its adjustability, the variety of pulse patterns, and the ease of use, all of which can significantly enhance the effectiveness of pain management. These devices provide a drug-free alternative to managing pain from conditions like osteoarthritis, fibromyalgia, and post-operative recovery, potentially improving overall quality of life.
As noted in the buying guide, How to Choose the Best TENS and EMS Units, there are several factors to consider when choosing the TENS unit that best fits your needs.
It’s wise to discuss your TENS therapy with a healthcare professional to determine the ideal current to relieve your pain. Most TENS devices offer a range of intensity you should familiarize yourself with to pick the device that will deliver the stimulation you need.
It’s common for a full treatment to last 30 minutes, and sometimes, the machine will shut off after that time. Your healthcare provider can explain how much time you should spend in a treatment session so you can purchase a device to accommodate that recommendation.
Typically, there are two connections for electrodes extending from each lead wire, and the available outlets for the lead wires from the device are called channels. With a single-channel device, you use two electrodes at a time. With a dual-channel, you can use two or four, and so on. For treating a wider area, more leads are better, and for treating a smaller area, fewer leads are needed for effective treatment.
Battery-powered devices have no charging time and they require a less initial investment. Rechargeable devices cost more upfront, but you don’t ever replace batteries. The choice of a battery-powered or a rechargeable TENS unit will depend on your lifestyle and how you plan to use the device.
The size and weight of a TENS unit can vary greatly, depending mostly on the size of the battery. Be sure the unit you choose meets your requirements for portability. Review the specs so you know how much a TENS unit weighs and how much space it takes up before you decide.
Clean the skin where you’re going to put the electrodes with rubbing alcohol. After it’s dry, put a thin coat of gel on the bottom of each electrode (unless they come pre-gelled). Put the electrodes on your skin and cover them with medical tape or a sticky patch. Hook the pin connectors on the end of the electrode wires to the electrodes, then plug them into the TENS unit and turn them on.
It delivers small electrical impulses through electrodes attached to your skin near a pain point. These impulses reduce the nervous system’s ability to transmit pain signals to the brain through the spinal cord.
Those same electrical impulses also stimulate your body’s production of endorphins, which are natural pain relievers.
Attach the electrodes near the pain point and set the intensity to your comfort level. Although a TENS unit won’t treat the underlying causal spinal condition, it can deliver targeted, on-demand relief when your back hurts.
It’s common for people to feel relief for about four hours after a treatment, but some people experience pain relief for up to 24 hours after a session. Generally, for short-term pain, an average patient will use a TENS unit for 20 to 69 minutes up to four times a day. For people who suffer from chronic pain, 20 to 30 minutes up to five times a week is standard.
 | Wireless TENS and EMS Unit - iReliev - Wearable Therapy System from Excel Health View Product |
Our number 5 choice is the Wireless TENS EMS Unit iReliev Wearable Therapy System by Excel Health, an innovative device offering all-natural, drug-free relief from musculoskeletal pain. This completely wire-free system combines TENS and EMS (electrical muscle stimulation) therapies into one portable, wearable unit. The TENS therapy delivers gentle electrical stimulation to the skin and underlying tissues, rapidly relieving pain by easing pain receptor activity. Meanwhile, EMS therapy targets muscles, helping to increase strength and speed up recovery from stress or strain. Equipped with 14 preset therapy programs, the iReliev system supports on-the-go use and easy portability, making it an invaluable tool for athletes, manual laborers, and individuals with arthritis or chronic pain.
 | Acupuncture Simulation | TENS Unit Kit | OTC Version - Dolphin Neurostim View Product |
Our number 4 pick is the Acupuncture Simulation TENS Unit Kit OTC Version by Dolphin Neurostim. The home version of the Dolphin Neurostim, this direct-current stimulator, does not require a prescription to help you manage pain.
This TENS unit, especially effective in addressing persistent back issues, combines modern technology and traditional Chinese medicine to conquer pain and inflammation. Its special features include a polarity switch to control hot and cold sensations and a sensitivity control switch to set the intensity.
The handheld Dolphin Neurostim OTC TENS Unit detects and stimulates the body’s areas of low resistance. Finding the trigger points is key to relieving pain, and this device's simulated acupuncture addresses the root of the problem, not just the symptom. It utilizes an all-natural approach to pain relief that has been tested and proven successful for more than 30 years. You can choose a single or double kit, with or without a carrying case. A 9-volt battery conveniently powers it.
This TENS unit delivers the traditional concepts of acupressure via modern technology for at-home treatment of back pain. If you are suffering from mobility restrictions and pain because of back issues, this device will release the tension in those muscles. For more freedom of movement and less pain, this unit is a great choice for back pain sufferers.
 | Neuromuscular Electrical Stimulation Device - TENS Unit - Saebo Stim Pro View Product |
The SaeboStim Pro NMES, TENS, and E Stim Machine is our number 3 choice for effective muscular development, re-education, and pain treatment. This advanced portable electronic stimulation machine features 10 NMES and 3 TENS programs, providing varied treatment options for various conditions. It is designed for ease of use, with a one-touch operation and a large, easy-to-read display. The device includes two independent channels for multiple nodes, allowing for more comprehensive treatment. Its unique trigger mode supports functional muscle training, making it an excellent tool for recovery and muscle strengthening.
Coming in as our number 2 choice, the Acupuncture Simulation TENS Unit Kit by Dolphin Neurostim is a professional-grade, natural pain-management device that uses microcurrent point stimulation (MPS Therapy) to alleviate pain and stress. It sends concentrated DC micro-impulses to primary neurological points, helping to calm the sympathetic nervous system. This drug-free, non-invasive device is used by over 60,000 healthcare professionals worldwide and is suitable for home and clinical use. The kit includes a sensitivity control dial, a convenient carrying case, and a comprehensive manual for acupuncture and pain management. Whether treating migraines, menstrual cramps, back pain, insomnia, sciatica, or stress, the Dolphin Neurostim offers an effective solution for various conditions.
 | Hooga Red Light Therapy at Home - HG200 View Product |
The Digital EMS, TENS, IF, and Russian Combo Unit by Roscoe Medical is in the top spot. This impressive four-channel device combines TENS, EMS, IF (interferential current), and Russian stimulation, which is similar to EMS but with higher frequencies, in one compact unit.
If it is ordered by a hospital or physical therapy practice, it does not need a prescription. However, a prescription is needed for this professional-level unit for delivery to a home address. It has separate intensity controls for each channel, and with fully adjustable parameters, you can easily customize your therapy. You can treat large areas, or multiple sites simultaneously. It has an adjustable ramp time setting, an easy-to-read display, two timers, and a meter to store the operational records of this device.
Not just for muscle pain, this unit has also been featured in the article, Stroke Recovery Rehab Equipment, and Methods because it helps mitigate muscle spasticity, spasms, and post-stroke pain while facilitating normal nerve and muscle function. It reduces swelling and inflammation, and it is a perfect tool for re-educating muscles. You control the intensity with the press of a button, and it can be powered by four AA batteries or via its AC adapter.
With its multiple therapies, this combination model offers the most options for people who want to relieve pain, encourage healthy muscle growth, and minimize muscle stiffness. Its separate controls and large treatment area allow for therapy sessions that can significantly impact overall health and well-being. If you would benefit from these multiple therapies, this combo device will cover every need you have.
In our comprehensive review of the 5 Best TENS Units, we've explored a range of options that cater to various needs, from managing acute pain to facilitating long-term pain relief strategies. Each unit we discussed offers unique features, such as preset programs, customizable settings, and portability, ensuring that there is a solution for every type of pain management requirement.
Our top recommended product, the Digital EMS, TENS, IF, and Russian Combo Unit by Roscoe Medical, stands out due to its versatile four-channel system, combining TENS, EMS, IF, and Russian stimulation in one device. This unit not only addresses pain but also aids in muscle recovery and health, making it the most comprehensive choice for those looking to enhance their quality of life through effective pain management. For further insights and advice on selecting the right TENS unit for your needs, consider visiting Caregiver University for expert guidance and resources!
Co-Founder of Rehabmart and an Occupational Therapist since 1993. Mike has spent his professional career working in multiple areas of Occupational Therapy, including pediatrics, geriatrics, hand therapy, ergonomics and inpatient / outpatient rehabilitation. Mike enjoys writing articles that help people solve complex therapeutic problems and make better product choices.
