How to use a TENS Machine

Got a new TENS machine and not sure where to start? 

The pads, the programmes and the dial can look a bit daunting the first time you open the box. The good news is that using a TENS machine is simple once you've done it once or twice.

This guide takes you through it step by step: what to check before you start, how to set up a wired or wireless machine, how high to turn it, how long to use it for, and the do's and don'ts that keep you safe and your pads lasting longer.

One rule sits above everything else here. Your machine's manual always comes first. Settings, session times and warnings differ between models, so use this guide alongside it, not instead of it.

Before you start: is TENS right for you?

TENS is a drug-free, non-invasive way to help ease pain, used at home by lots of people. It gives temporary relief, it works better for some people than others, and it's best used as part of a wider plan for managing your pain. If you're still deciding whether it's for you, our guide to the pros and cons of a TENS machine is a good place to start.

Do not use a TENS machine if you have a pacemaker or epilepsy, or if you're pregnant, unless your doctor or midwife has told you it's OK. Some machines, including our Med-Fit 1, should only be used in pregnancy during labour.

Speak to your GP, pharmacist or another healthcare professional before using a TENS machine if you:

• have a heart condition
• have another implanted electrical or metal device
• have pain that is new, severe, getting worse or hasn't been diagnosed

What you need

• Your TENS machine. A wired handheld unit, or a wireless unit with a remote or app.
• Electrode pads. These are the sticky pads that deliver the pulses. Wired and wireless machines use different pads, so make sure yours match. You'll find replacements in our TENS electrodes range.
• Lead wires if your machine is wired.
• Power. Batteries, or a charged unit. Rechargeable machines usually need charging before first use. Our Combo quick start guide recommends around 2 hours, or until the charging light turns green.
• Clean, dry skin. Soap and water is all you need. Skip any creams, oils or lotions on the area.

How to use a wired TENS machine: step by step

1. Check the machine is switched off. Every dial should be turned all the way down to zero.
2. Connect the leads to the pads. Push the pins in straight and gently. Forcing them in at an angle can bend them.
3. Plug the leads into the machine. Each lead goes into one channel. A dual channel machine takes two leads and four pads.
4. Clean and dry the skin where the pads will go.
5. Peel the pads off their backing sheet and press them on firmly. Leave a gap between them so they never touch. There's more on where to put them below.
6. Choose a programme or setting if your machine has them. Start with the default or the one your manual suggests for general pain.
7. Turn the intensity up slowly. On most wired machines, you turn the channel dial clockwise. Stop when you feel a clear tingling that is still comfortable.
8. When you're done, turn the intensity back down to zero and switch off before you touch or remove the pads.
9. Peel the pads off gently and put them back on their backing sheet straight away.

How to use a wireless TENS machine: step by step

1. Charge the unit and remote fully before your first session. Our Combo units can't be used while they're on charge.
2. Clean and dry the skin where the pad will go.
3. Remove the plastic film from the pad and attach the unit, making sure both studs click into both studs on the pad.
4. Stick the pad onto the area you want to treat and press it down firmly.
5. Switch on the remote or open the app, then select the unit (or channel) you want to control.
6. Choose a TENS programme. Many wireless machines also have EMS and massage programmes, so check you're on a TENS one if pain relief is the goal. Not sure of the difference? Read what's the difference between EMS and TENS.
7. Press + slowly until you feel a clear, comfortable tingle.
8. Switch off before you remove the unit and pad, then put the pad back on its film.

Because there are no leads, you can keep moving through your day while a wireless unit is on. It's a big part of why so many people choose one. Browse our wireless TENS machines if you're weighing it up.

Where to put the pads

For most aches, the best place to start is directly over the painful area or around it. It can take a few goes to find the spot that works best for you, so don't be afraid to move them.

• Leave a gap between pads so they never touch.
• For back pain, pads usually go either side of the spine rather than on it.
• For a larger area such as the lower back, many people use four pads in a square, so the pulses cross the sore spot.
• For sciatica, a common setup is one pair on the lower back and a second pair along the path of the pain in the buttock or leg.

Never place pads on: the neck, the head or near the eyes or mouth, across the chest or around the heart, over broken, irritated, infected or numb skin, or on the abdomen during pregnancy. And don't use pads on your chest and back at the same time.

For placement tips by body area, see our guides to lower back pain, sciatica, neck pain, shoulder pain, knee pain and period pain.

How high should you set a TENS machine?

This is the question most beginners ask, and the answer is simpler than you'd think. Turn it up until you can clearly feel a tingling or buzzing under the pads, and stop while it still feels comfortable.

It should never be painful. If it feels uncomfortable at any point, turn it down.

Don't be surprised if the tingle seems to fade during a session. That's your body getting used to the sensation, and it's normal. Nudge the intensity up a little to bring it back to a clear but comfortable level.

How long and how often should you use it?

This is where your manual matters most, because guidance varies between machines. As an example, our Med-Fit 1 manual suggests sessions of 60 to 90 minutes, 2 to 4 times a day, and says that for long-term pain, treatment times of 3 to 4 hours may work best. Our Combo quick start guide says a minimum of 1 to 2 hours is needed for effective pain relief.

That may be longer than you expected, so give it a fair go before deciding whether it suits you.

A few general habits help whatever machine you have:

• Take breaks between sessions.
• Move the pads slightly each time so the same patch of skin isn't covered all day.
• Check the skin under the pads during and after each session. If it becomes itchy, sore or red, turn the machine off, remove the pads and let it settle.

Your first session: what to expect

Most people describe the feeling as tingling, buzzing or a gentle pulsing. Some programmes feel smooth and constant. Others come in bursts or waves. None of them should hurt.

Give yourself time to experiment. Try a couple of programmes and a few pad positions over your first week, and note what feels best. Everyone responds differently, and what works for one person's back may not be what works for yours.

TENS machine do's and don'ts

Do

• Read your manual before your first session
• Switch off before attaching or removing pads
• Start at the lowest intensity every time
• Use clean, dry skin with no creams or oils
• Store pads on their backing sheet in the sealed bag, somewhere cool and dry
• Replace pads once they stop sticking properly
• Use TENS alongside any treatment or medication you've been advised to take

Don't

• Use it while driving, operating machinery, in the bath or shower, or while asleep
• Place pads on the neck, near the eyes or mouth, on the chest, or on broken, irritated or numb skin
• Turn it up to a level that feels uncomfortable
• Let pads touch each other
• Share pads with other people
• Use it if you have a pacemaker or epilepsy, or while pregnant, unless a doctor or midwife has told you to

Looking after your pads

Pads are the part that wears out, and how you treat them makes a big difference to how long they last. Always put them back on their backing sheet after use and keep them in their resealable bag, somewhere cool and dry, so the gel doesn't dry out.

How long they last depends on the pad, your skin and how often you use them. As a guide, the Med-Fit 1 manual gives around 3 to 6 weeks, and our Combo guide gives around 25 applications, with a maximum of 30. For Combo pads, the guide also recommends smearing warm water over the gel side every 3rd or 4th use, then leaving it 5 minutes to soak in before you reapply.

When a pad won't stay flat on your skin, it's time for a new one. A poorly stuck pad won't deliver the pulses evenly and can feel prickly. If standard pads irritate your skin, try sensitive skin electrodes. Wireless users can find their pads under Combo wireless electrodes and Painless wireless electrodes.

Common problems and quick fixes

I can't feel anything

Check the pads are firmly stuck down, the leads or both studs are fully connected, and the battery or charge isn't low. Then turn the intensity up slowly.

It feels prickly or sharp

This usually means the pad isn't making full contact. Press it down, refresh it or swap it for a new one.

My skin is red after using it

Turn the machine off, remove the pads and give the area a rest. Move the pads next time and consider sensitive skin pads. If irritation doesn't settle, stop using the machine and speak to a pharmacist.

My pain feels worse

The intensity may be too high, or the pads may be in the wrong spot. Turn it down or move the pads. If your pain keeps getting worse, stop and speak to a healthcare professional.

Using a TENS machine in labour

Lots of people use TENS in the early stages of labour, usually with pads on the lower back either side of the spine. It's a different setup from everyday pain relief, and not every machine is designed for it. Check your manual confirms your machine is suitable for labour, never use it in a birth pool or bath, and talk it through with your midwife first. Outside of labour, don't use TENS while pregnant unless your doctor or midwife has told you to.

FAQs

How do you use a TENS machine for the first time?

Read the manual, charge the machine or fit the batteries, and clean and dry your skin. Stick the pads on or around the painful area, switch on and choose a programme. Then turn the intensity up slowly until you feel a clear, comfortable tingle.

Should you turn a TENS machine on before or after putting the pads on?

After. Put the pads on first with the machine off, then switch on and turn up the intensity. Switch off again before you remove them.

How high should I set my TENS machine?

Turn it up until you can clearly feel the tingling and stop while it still feels comfortable. It should never hurt.

How long should you use a TENS machine for?

It depends on your machine, so follow your manual. Our Med-Fit 1 manual suggests 60 to 90 minutes, and our Combo guide suggests at least 1 to 2 hours. Some people with long-term pain use it for longer.

How often can you use a TENS machine?

Our Med-Fit 1 manual suggests 2 to 4 sessions a day, with breaks in between. Other machines may differ, so check yours, and move the pads slightly each session to look after your skin.

Can I sleep with a TENS machine on?

No. Don't use a TENS machine while you're asleep.

Can I use a TENS machine every day?

Yes. TENS machines are designed for regular use, and our Med-Fit 1 manual suggests 2 to 4 sessions a day. Follow your own manual, take breaks and keep an eye on your skin.

Do I need gel with a TENS machine?

Not usually. Modern self-adhesive pads already have gel on them. If a pad stops sticking, replace it rather than adding gel.

Ready to get started?

Using a TENS machine comes down to a few simple habits: clean skin, pads in the right place, a comfortable intensity and your manual close to hand. Browse our full range of TENS machines for pain relief, stock up on TENS electrodes, or get in touch with our team if you'd like help choosing or setting up your machine.

This guide is for general information only and isn't a substitute for medical advice. Always read the instructions supplied with your device, and speak to a healthcare professional if you're unsure whether TENS is right for you.