How To Guide: Understanding TENS Unit Placement

tens unit placement

A TENS machine or, a transcutaneous electrical nerve stimulator, to use the full term, is an electrical pain relief machine that can be used effectively on various parts of the body for mild to acute muscular pain.

It works equally well for sudden, temporary pain and muscle strain as well as chronic pain.

It is regularly used by sports people or those suffering from, sciatica, fibromyalgia, muscle strains and a variety of other body pains such as lower back pain, legs, hips and arms.

It is fully FDA approved and has helped thousands of pain sufferers for many years.

Hows Does It Work?

tens unit guide

While numerous studies have been done, there is still a lot to learn about the functioning of the TENS unit and how it helps relieve pain.

TENS machines are thought to work in two ways:

Electrical pulses produced by the unit (at a normal rate of 90-130 Hz) interferes with the transport of pain messages to the brain thereby blocking it.

That is putting it very simply but it effectively blocks the gate mechanism that allows pain messages to get through the central nervous system and brain and, as a result, the user feels less pain due to the messages not getting through.

They are also believed to stimulate specific non-pain-carrying nerves which also cause the gate to close.

This small machine comes with a number of pads that the user connects to the affected parts of the body. It is controlled by the user quite simply by turning it on, up or off. Generally, one would use it for approximately 20-minute durations a few times a day or as required.

TENS machines are available either through a doctor, physical therapist or chiropractor or they can be purchased online or over the counter. The drawback to the latter option is that many people are somewhat intimidated by them and a bit bewildered as to how they should be used correctly.

While it might be a bit intimidating at first, it is not that complicated and if you follow a few basic guidelines, which we will share with you, you will be able to use it effectively and soon start feeling relief from your pain.

Before we get into placement, let’s look at a few words of caution.

A Few TENS Unit Placement Don’ts

Do not place pads on the following areas:

  •  Heart
  •  Eyes
  •  Open or healing wounds
  •  Directly on joints

Another few things to bear in mind are to never use pads when they are wet or when they are worn or damaged. You also don’t want pads to touch or be on top of each other.

TENS machines are also not recommended (unless advised by a doctor) during pregnancy or for people that suffer from heart conditions or epilepsy as well as patients that have a pacemaker.

Apart from those few pointers, you can’t really do any damage if you get it wrong. It might be an idea to experiment with different positions and angles to see what gives you the most pain relief.

TENS Unit Placement Guidelines

There are a number of options with regards to tens electrode placement.

The first step is to establish exactly where the pain is situated, where it starts and where it ends.

Depending on the TENS system you have, always use 2 or 4 pads.

According to the size and shape of the area in pain, pads can be placed horizontally, vertically or at an angle.

The electrical flow can be altered by changing the distance or angle of the pads.

For a pain that extends a long distance on your body, place one pad at the top of the pain and the other at the bottom of the pain area.

  • In a smaller area, position the pads parallel on either side of the pain area.
  • For joint pain, place pads parallel on the soft tissue above and below the joint.
  • In wider areas, place pads vertically on either side of the affected area.


Although these guidelines are important and useful, TENS unit pad placement is often more of an art than a science. No one knows exactly where your pain is better that you.

Sticking to the basic advice above, TENS electrode placement is something you will need to try in various ways for maximum effect and pain relief.

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