This Surprisingly Simple Device Can Help Ease Back Pain In Less Than 30 Minutes

If you’re considering a transcutaneous electrical nerve muscle stimulation (TENS) unit, you’re likely experiencing some degree of chronic pain—and you’re not alone. A 2019 National Health Survey found that over 50 million US adults1 (about 1 in 5) reported pain on most days, if not every day. Chronic pain has been linked with a reduced quality of life and can be extremely disruptive to your daily routine. While some therapeutic treatments and modalities are expensive and intrusive, the best TENS units for back pain can be an effective and efficient pain-relief method.

A TENS unit consists of an electrical signal generator, a battery and a set of electrodes (adhesive pads). In order to understand how TENS units affect pain, we spoke with experts to dive deeper into the neurophysiologic mechanisms of pain control. Below, learn more about who these devices are good for, and find our picks for the best TENS units for back pain.

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The best TENS units for back pain:

A TENS unit uses low-voltage electrical currents to stimulate your nerves and ease pain in your body. These devices have been used for relief from neuropathic pain, fibromyalgia, osteoarthritis pain, and chronic low back pain2. TENS can also be used as part of a postoperative plan of care.

These machines are battery-powered, with small electrodes that are placed on your skin, either where you have pain or on corresponding trigger points. The belief is that these electrical currents are not so much as treating the pain, but rather changing your perception of it by blocking the transmission of pain signals or raising the level of endorphins in your body.

“Sensory-level treatments use what is known as the Gate Control theory, where non-painful stimulus closes the gate (overrides) the transmission of painful impulses,” explains Chad Starkey, P.h. D., author of Therapeutic Modalities. “In addition to the sensory effects of sensory-level pain control, motor-level pain control uses relatively -intense muscle contractions to release endogenous opiates (the body’s morphine-like substances). This arguably provides better, longer pain relief than sensory level, but does require a deeper understanding of electrical stimulation parameters and neuroanatomy.” 

The noxious-level TENS method typically involves a point-and-shoot probe, or a large, dispersive electrode and a smaller electrode where current is concentrated. This form of TENS is less studied, and, while your physical therapist may experiment with this noxious-level TENS, at-home TENS units should be used for sensory level, gate control theory pain relief only. “I do not recommend noxious-level stimulation for home use,” Starkey confirms.

The best way to ensure you’re using your TENS unit for back pain correctly is to speak with a medical professional. Any reputable machine should come with extensive instructions—and this is not an instance where you want to skip the instruction manual. “TENS is a relatively safe treatment, so long as those instructions are followed,” Starkey confirms.

That said, before you decide to charge up your TENS unit, Starkey says you’ll want to make sure you have an understanding of where your pain is coming from. “It’s cliché, but TENS (or anything else) should not be used to treat pain of unknown origin or used for more than two weeks without being examined by a medical professional.”

As for pad placement during sensory level pain control (no muscle contraction), Starkey recommends an “X” pattern with the painful area at the center of the X. The electrodes on each set of wires should be placed so that the current crosses over the area in pain.

In terms of frequency of use, “Sensory-level pain control can be used for days at a time,” Starkey advises. He recommends moving the electrodes slightly with each use to avoid irritation from the adhesive. 

The TENS unit should feel like a tingle or buzz that gradually increases in intensity to a sharp, prickly sensation. If the TENS treatment is successful, you should feel some pain relief within the first 30 minutes of treatment. If it is not successful, change the electrode placements and try again. And if you’re seeking 24-hour pain control, portable units are best.

Our picks for the best TENS units for back pain:

Best portable: PowerDot 2.0 Duo

Pros:

Long battery lifeSleek travel caseApp with guided methods

Cons:

Some say the pads lose stickiness quickly

Battery life: up to 20 hours

Number of pads: 6

Therabody’s PowerDot Duo is an easy-to-use device with app-controlled capabilities. If this is your first time trying out TENS, this unit is a great place to start. The PowerDot app has a ton of helpful information to guide you through where to place the pads, and how to choose the right intensity. Choose from preset settings or customize to your own preferences. It’s also sleek and portable, with a simple carrying case you can easily throw in your gym bag or luggage.

Best massager: truMedic PL-009 TENS

Pros:

Portable & lightweightPreset modes for different body parts

Battery life: Not chargeableuses four AAA batteries

Number of pads: 4

This affordable, pulsing TENS unit has preset programs for different muscle groups: back, shoulder, joint, hand-leg, and sole. Simply select your program using the large LCD screen, and choose between standard massage, beat, or knead. You can then adjust the speed and intensity until you find what offers the best relief for you. It’s lightweight and a great option for travel or any time you’re on the go.

Best wireless: Compex Wireless Mini

Pros:

App-enabledAlso features NMES

Cons:

Short battery lifeOnly 2 pads

Battery life: up to 6 hours

Number of pads: 2

Budget-friendly for a wireless device, this mini TENS unit is great for on-the-go relief. In addition to TENS, it also features NMES, which is meant to improve muscle performance. The app comes equipped with six fitness programs, which you’re meant to perform while wearing the two electrode pods to manage muscle soreness, increase blood circulation, loosen stiff muscles, and temporarily reduce pain.

Best with heat: OMRON Total Power + Heat TENS Unit

Pros:

HeatedDigital screen for easy controlPortable

Battery life: Not specified

Number of pads: 2plus 2 heat gel pads

For an even more powerful pain relief experience, this unit uses a combination of heat and TENS. You can also use the TENS stimulator alone, if you’d prefer no heat. The settings are extremely customizable, with preset modes for your arms, lower back, legs, feet, joints, and shoulders. It’s also a massager, and can be set to tap, knead, or rub, with 20 levels of intensity to choose from for each.

Best advanced: Chattanooga Primera

Pros:

40 padsAdvanced technology

Battery life: Not chargeableuses one 9V battery

Number of pads: 40

This TENS device is made by the same manufacturer as clinically-used electronic stimulation units, so the quality is top-notch. It has 8 TENS programs, 6 neuromuscular electrical stimulation (NMES) programs, a whopping 40 pads, and a unique HAN TENS waveform which provides the noxious stimulus to release endogenous endorphins. Keep in mind, this is definitely a more advanced TENS unit, and should only be used by those who fully understand the technology. It’s best to discuss with your doctor if you aren’t sure if this is right for you.