TENS for long term persistent pain

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What is TENS?

TENS is an abbreviation for Transcutaneous Electrical Nerve Stimulation. It is a small lightweight, portable, battery operated device, which attaches to some electrodes (sticky pads) placed around or near the painful area on your body. This works in a number of different ways:

  • TENS stimulates the body’s own defenses’ against pain which are called endorphins; these are your body’s own pain killers.
  • TENS also stimulates nerve fibres that can block pain messages from reaching the pain centre of the brain. It is similar to but stronger than, rubbing a pain better.
  • Some evidence has shown that TENS can increase the blood supply to the area of the electrodes and help to make the muscles relax


  • DO NOT use a TENS machine if you have a CARDIAC PACEMAKER, EPILEPSY or if you are PREGNANT (apart from when in labour). Please discuss further with the pain team.
  • DO NOT place the electrodes on your THROAT or the FRONT of your NECK or CHEST.

A step by step guide to using TENS

  1. Wash and dry the skin thoroughly. Do not use talc or lotion in the area of your body where the TENS pads are placed.
  2. Before putting on the electrodes (sticky pads), ensure the machine is switched off.
  3. Plug the leads into the electrodes and place the electrodes onto your body as shown to you in the clinic. You can then connect to the TENS machine.
  4. Turn on the machine and increase the intensity until you can feel a ‘tingling’ sensation. You do not need to have the intensity so high that it hurts, but you must be able to feel a ‘strong but comfortable’ sensation.
  5. You should begin by using the TENS for a minimum of 40 minutes, between 3 and 4 times per day, every day. If necessary you can gradually increase the length of time that you use the TENS.
  6. When your treatment is finished, turn the machine off before removing the electrodes.
  7. Replace the electrodes on their special backing and place in the plastic bag provided.
  8. Wipe the skin with cool water after taking off the electrodes to remove any stickiness.

Some practical/safety advice

  • Switch your TENS off if you are driving or operating machinery, for safety reasons.
  • The TENS Machine and the electrodes (sticky pads) should be removed when you have a shower, bath or go swimming.
  • Check your skin for redness. You may find the skin is a little red after removing the electrodes, but this should disappear within 15 – 20 minutes.
  • If you have an allergic reaction to the electrodes or your skin becomes sore, please contact us or see your GP.
  • The TENS can be an additional mode of helping manage your pain alongside you medication. At first, take your normal pain medication as you need them.  With time, you may find you need fewer pain medications. Discuss this with your GP or pain team.
  • It may take a couple of weeks of regular treatment to build up pain relief and you can continue normal activities in this time


  • To broken skin, varicose veins or recent scars
  • Across the chest, temples or on the front of your neck
  • Over any area of the skin which is numb to the touch
  • Anywhere on your body if pregnant (other than in labour)

Will the pain go away completely?

  • Probably not initially, but you may experience a noticeable reduction in pain. Some people do experience complete pain relief, but not all.

What if it does not work?

  • Try the different modes of stimulation on the device, which you discussed with the pain team.
  • Make sure you are using the TENS regularly and find a regime that suits you.
  • If you still do not notice a reduction in pain, slightly change the position of the electrodes.

Can TENS ever make the pain worse?

  • This can happen with some people. If the TENS makes your pain worse, we would suggest you change the position of the electrodes slightly and re-try the TENS. If you continue to have problems with an increase in your pain when using the TENS, contact the pain management team. If you are no longer attending the pain clinic, please discuss this with your GP.


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Self referrals

You can self-refer into community physiotherapy services. Simply call 0207 871 0545 to make an appointment. Your initial contact with one of our chartered physiotherapists may be over the phone, where you will either be given advice on appropriate treatment, or a face-to-face consultation will be arranged.

Should you wish to speak to your GP first, simply make an appointment with your local practice. If your GP refers you, one of our patient care advisers will contact you within 48 hours to arrange an appointment.

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