Léa | ⏳ 3 min read

TENS and Pain: The Complete Guide to Understanding and Using Pain-Relieving Electrostimulation

You have heard of TENS for pain relief, but you are wondering what exactly it is, how it works, and if it is right for you? Used in physical therapy for decades, this transcutaneous electrical nerve stimulation technique is now attracting many people seeking a non-drug alternative to soothe everyday pain: painful periods, sciatica, lower back pain, muscle tension, or even discomfort related to endometriosis. In this reference guide, we will break down the TENS principle together, its application areas, electrode placement, appropriate settings, and, most importantly, the contraindications to know before getting started.

What is TENS and how does it work?

The acronym TENS stands for Transcutaneous Electrical Nerve Stimulation. Concretely, it is a small device that sends mild electrical impulses through the skin via self-adhesive electrodes placed on or near the painful area.

These painless impulses produce a tingling, buzzing, or tapping sensation depending on the chosen settings. TENS has been used since the 1970s in physical therapy and rehabilitation to help manage various pains. Unlike a painkiller, it does not introduce any substance into the body: it acts solely by modulating the nerve signals transmitted to the brain.

Note: TENS is not a curative treatment: it does not heal the cause of the pain, but can help reduce its perception. It is used as a complement to medical follow-up if your pain is chronic or intense.

The principle of action on pain

TENS operation is primarily based on the gate control theory, formulated by Melzack and Wall in 1965. By stimulating large-diameter nerve fibers (those that transmit touch), the device "saturates" the nerve pathways in a way that limits the transmission of pain signals to the brain.

At lower frequencies, TENS can also promote the release of endorphins, molecules naturally produced by the body and known for their soothing effect. According to the French National Health Insurance, transcutaneous nerve stimulation is among the non-drug techniques offered for the management of certain chronic pains.

Application areas and use cases

TENS can be used on a wide variety of body areas. Here are the most frequent uses for people discovering pain-relieving electrostimulation:

• Lower abdomen and lower back during periods: to support menstrual cramps and back tension.
• Back pain and lower back pain: muscle tension, contractions, back pain related to posture.
• Sciatica and cruralgia: to soothe pain radiating down the leg.
• Neck and trapezius: against tension related to stress or screen work.
• Endometriosis-related pain: as a complement to medical follow-up, to relieve certain daily pelvic discomforts.
• Knees, shoulders, elbows: mild to moderate joint pain.

For people suffering from particularly painful periods, TENS can be an interesting alternative to regularly used medications, or a useful complement to space out doses.

Electrode placement and settings

Electrode placement is essential for effective relief. The general rule: place electrodes around the painful area, never on a wound, irritated skin, or directly on the spine.

Some placement guidelines by area:

• Painful periods: two electrodes on either side of the lower abdomen, or two electrodes on the lower back.
• Lower back pain: electrodes on each side of the spine, on the paravertebral muscles.
• Sciatica: one electrode on the lower back, the other following the painful path on the buttock or thigh.
• Neck: electrodes placed symmetrically on the trapezius, never on the throat or the front of the neck.

Regarding settings, most TENS devices offer several preset programs. In practice, there are two main modes:

• Conventional TENS (high frequency, 50-100 Hz): fine tingling sensation, rapid effect, can be used for 20 to 60 minutes.
• Endorphin TENS (low frequency, 1-10 Hz): more pronounced tapping sensation, effect builds up progressively.

And additionally, always start at the lowest intensity and increase very gradually until you feel a clear but comfortable tingling. Stimulation should never be painful or cause involuntary muscle contraction.

Contraindications and precautions

Although TENS is recognized for its good tolerance profile, certain situations require avoiding its use or seeking prior medical advice. This is a point we take very seriously at Madame Patch.

Warning: TENS electrostimulation is contraindicated in cases of: pacemaker or implantable defibrillator use, pregnancy (unless specifically indicated by a healthcare professional for the lumbar region), epilepsy, unstable heart condition, venous thrombosis, or open wounds in the application area. Never place electrodes on the throat, eyes, or in a transthoracic position. When in doubt, consult your doctor before use.

To delve deeper into the subject, our article dedicated to the risks and contraindications of electrostimulation details point by point what you really need to know before starting.

The Madame Patch TENS: an everyday ally

At Madame Patch, we designed our TENS device with a simple idea in mind: to make pain-relieving electrostimulation accessible, safe, and easy to use in daily life, without needing to be a physical therapist to figure it out. Preset programs for different zones, progressive intensity, and a compact format to take everywhere: TENS can find its place both at home and at the office, especially during days of painful periods at work.

Used for a few minutes a day, TENS easily integrates into a broader pain management routine, alongside other approaches such as heat, gentle physical activity, breathing, or a suitable diet. It is this combination of simple tools that often makes the difference over time.

Léa | Editorial Manager for Menstrual Health, Madame Patch

Since 2022, I have been writing content to educate you on all topics related to painful periods (PMS, endometriosis, adenomyosis, PCOS, simulator, etc.).

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