Anyone who suffers from the widespread pain of fibromyalgia knows how difficult even the simplest daily tasks can be. If you experience pain flare-ups and other common symptoms of fibromyalgia, you’re likely looking for a treatment that actually works. If you are considering trying a TENS unit for fibromyalgia, here’s your guide to what it is, how it works, and how it might ease your fibromyalgia pain. Let’s get started.

What is a TENS unit?

TENS is an acronym for transcutaneous electrical stimulation. A non-invasive pain treatment option, a TENS unit uses small electrical pulses to replace pain signals. Electrical leads on electrodes (self-sticking patches) are placed on your skin in the area where the pain signals originate. These leads are attached to a cellphone-sized, battery-powered, patient-controlled device that controls the frequency and intensity of these electrical pulses.

You may have two or four electrodes placed on your body. Each set of two is controlled by two channels. How many electrodes you use depends on your pain condition and your overall treatment plan.

Because a TENS unit (and its leads) are housed on the outside of the body, this is a great option for those who are looking to avoid more invasive treatments. TENS units have very few (if any) risks. Use is generally well-tolerated and can be safely combined with other treatments.

How can a TENS unit for fibromyalgia help me?

If you are looking at a TENS unit for fibromyalgia treatment, you are in good company. One of the main issues with research into many pain conditions is the challenge of designing a scientifically valid study. However, there have been several high-quality studies in the last few years that point to the effectiveness of a TENS unit for fibromyalgia.

• January 2020: Researchers in a large, randomized, blinded, placebo-controlled trial found that 50% of participants had a significant reduction in pain and other symptoms of fibromyalgia with use
• March 2019: A study looking at the effects of TENS on the brain found decreased pain levels as the alpha power in the frontal lobe increased
• October 2018: In another randomized trial, 44% of study participants experienced a 30% or greater reduction in their pain when using a TENS unit for fibromyalgia

Most researchers and study reviewers agree that more research is needed, but for many people, a TENS unit for fibromyalgia decreases their pain and increases their quality of life. Because this treatment is non-invasive and can be typically used with other approaches, it’s a great option for many patients.

How to use a TENS unit for fibromyalgia

If you are ready to try a TENS unit and are thinking about buying one over the counter, it makes sense to do a little research before you get started. The type of TENS unit you buy matters, as does the placement of the electrodes and the settings you use.

As always, the best source of information will be your doctor. They can ensure proper placement and help you find the intensity and settings that work for you. Always work with them while setting up your TENS unit or ask them for product information. They can answer any questions you have and advise on the best settings for you. Further, they can discuss how TENS units can complement your other fibromyalgia treatments.

This is our general guide to give you an idea of what to look for and expect during treatment.

Find the best TENS unit for fibromyalgia

As noted above, a TENS machine for fibromyalgia can be simply purchased over the counter at your local pharmacy. There are benefits to getting one prescribed for you, though. For example, in many cases, a TENS unit for fibromyalgia (including replacement electrodes) will be covered by your insurance.

Another benefit to getting a prescription is that your doctor is likely familiar with the brand they prescribe. This means that they can help you troubleshoot your treatment if you need it.

If you are looking to buy a TENS unit on your own, consider looking for ones with the following features.

• Wiring: Some TENS units come wireless, while others feature leads connected to the controller
• Control buttons: They should be easy to access and adjust, but not so easy that you accidentally change the settings
• Display: The display should be easy to read with large text (and a backlit screen is a bonus)
• Levels of stimulation: Look for TENS units that have a variety of settings, frequency, and intensity so you can get the exact level you need for pain relief
• Warranty: Make sure your TENS unit is protected against flaws or damage
• Price: The cheapest is not necessarily the best, but the best isn’t necessarily the most expensive

Finally, consider things like how many electrodes the unit comes with and how easy the controller is to carry or store. Your unit should come with at least four electrodes, but more is better (no need to order spares). If the controller is bulky or hard to stow on your person, you will be less likely to use it—and consistency is key.

TENS unit placement for fibromyalgia

The correct TENS unit placement for fibromyalgia is the key to finding relief. Your doctor is the best determiner of where to place the electrodes. The TENS unit stimulates specific nerves, replacing the pain signals with a mild electrical buzz. Place the electrodes over the wrong area and nothing will happen but a mild tingle. If electrode pairs are too far away from each other, you will also not find any relief.

In general, TENS unit placement for fibromyalgia (example here) features two electrodes on either side of the spine just at the tops of the shoulder blades, with another two on either side of the lower back. This placement targets widespread nerve pain that is characteristic of fibromyalgia.

Of course, if you have specific pain in one area, your placement might be very different. Some people find fibromyalgia relief with electrodes on the front of the body or just down one side. It may take a few tries to get the correct placement for you.

Keep in mind that the electrodes should not touch each other on the body. Keep them spaced apart for safety and best results (more on that below).

TENS settings for fibromyalgia

Finding your perfect TENS settings for fibromyalgia may take some trial and error, too.

First, you will need to consider three main TENS settings:

• Amplitude
• Pulse width
• Pulse rate

Amplitude references how intense the electrical current is. Pulse width is how long each pulse lasts. Pulse rate determines how often an electrical pulse is sent.

Depending on your TENS unit, you may also have three standard settings.

• Conventional: This delivers a short-lived, high-frequency pulse at a low amplitude
• Acupuncture: The acupuncture setting uses a high amplitude current (at the top of your tolerance) delivered with long pauses in between
• Pulsed or burst: Often the least used setting, a pulsed setting delivers a low-intensity pulse with the briefest of pauses in between

Your setting will be as individual as your experience of pain and may take a while to dial in.

TENS unit safety: Dos and don’ts

Although using a TENS unit for fibromyalgia is remarkably safe, there are some dos and don’ts you should follow to improve the chance of a successful treatment.

Follow these guidelines

Here are some guidelines to follow when using your TENS unit for fibromyalgia.

• Ensure that the batteries in the controller are working (or the unit is charged) before using
• Clean and dry the skin on the area where you will place the electrodes
• Before you attach (or detach) your electrodes, make sure your TENS unit is powered off
• Place electrodes at least one inch apart from each other
• The larger the area you are covering, the more electrodes you will use

There is a possibility that after a few days of relief, your pain may return. This is entirely normal. Taking a break from treatment for a few days allows the nerves to rest. This also helps to make sure that the placement is correct and your treatment levels do not need adjustment.

Avoid with TENS units

Again, using a TENS unit for fibromyalgia is remarkably safe. There is no risk for drug interactions, and the treatment is non-invasive. However, there are some precautions to take to increase the chance of a successful treatment and ensure your safety.

• Don’t allow the electrodes to touch each other
• Don’t place electrodes on a joint (or anywhere they might become dislodged with movement)
• Keep the electrodes clear of metal jewelry (or metal of any kind)
• Keep the unit dry—do not shower with your TENS electrodes in place
• Don’t wear your TENS electrodes to bed
• Don’t apply electrodes to skin that is broken, irritated, or infected
• Avoid placing electrodes near the eyes, mouth, front or side of the neck, head, genitals, or reproductive organs

There are some people for whom TENS therapy is not recommended. If you have a pacemaker or other implantable device, TENS is not a good treatment option for you. Deep vein thrombosis is another condition that should not be treated with TENS therapy, as is any area where cancer has been diagnosed or is suspected.

Similarly, those who have epilepsy or are pregnant should not use a TENS unit without the supervision of their doctor.

When it comes to placement of the electrodes, do not place them on the chest if you have a history of heart disease.

Caring for your TENS unit

Taking good care of your TENS unit will ensure its proper function. Clean the unit regularly with a soft cloth. Do not use chemicals or rubbing alcohol to clean it, and do not submerge in water.

Store the unit in the case it comes in at room temperature. If you will not use your TENS unit for a long time, remove the batteries.

If you find that your electrodes are losing their stickiness, it may be time to replace them. Alternately, you can try to bring back the stickiness by washing gently under cold water. Allow them to air dry before reattaching to clean, lotion-free skin. Store unused patches in a sealed plastic baggie so they do not dry out.

Learn more

Fibromyalgia is one of the most challenging pain conditions to treat. The time to diagnosis is long, and it can be hard to find a treatment that works.

Most pain specialists agree that a combination of treatments offers the best chance for success. These treatments include lifestyle changes, comfort measures, and treatments like TENS therapy. Learn more about our full fibromyalgia treatment protocol here.

Arizona Pain takes an integrated care approach for all people who suffer from chronic pain. If you’d like to learn more about how a TENS unit for fibromyalgia can help you, call to schedule an appointment today.

If you or someone you love suffers from chronic pain, it’s crucial to know everything you can about your treatment options. A TENS, or transcutaneous electrical nerve stimulation, unit is a non-invasive treatment option that may offer relief. If you have ever asked yourself, “How does a TENS unit work?” here’s what you need to know.

What is a TENS unit?

TENS units are a battery-powered pain relief treatment option that has few side effects or risks. Utilized on the outside of the body, TENS units are considered non-invasive and safe for use for many in pain.

The TENS unit itself is about the size of a small cell phone. One or two sets of leads go from the device and attach to self-sticking pads (electrodes) you place on your body. These electrodes are strategically placed to deliver mild electrical current. You control these currents directly with programmable buttons on the unit.

Each TENS unit has two channels with two electrodes each to deliver electrical stimulation. Whether you use two or four electrodes is something to discuss with your doctor and depends on your pain location, as we’ll discuss.

How does a TENS unit work?

So how does a TENS unit work?

Chronic pain is defined as persistent pain that lasts for longer than three months. Generally speaking, you sense this pain because of your neurons. If you hit your elbow, the nerves in your elbow send a signal to the brain that is then interpreted by the brain and translated. Pain signals are sent back along the path of the nerves, and pain is felt in your elbow. This process is nearly instantaneous.

While pain signals are a necessary and protective part of human biology, sometimes neurotransmitters incorrectly switch on, sending chronic, frequent (or sometimes constant) pain signals to the brain. This can result in debilitating chronic pain. Additionally, when chronic pain occurs, the brain produces more glutamate, a brain chemical that stimulates pain, and less natural opioids and serotonin that might help relieve pain.

This can create a cycle of increased and worsening pain. TENS units serve as a disrupter to pain signals and can bring balance back to your brain chemistry. Remember the bumped elbow? When we feel pain, our usual response is to put our hands where it hurts, rubbing or grasping the elbow. This can make it feel better. We have replaced a pain signal with the signal of rubbing or warming as we touch our elbow.

The TENS unit does something similar. Mild electrical currents move through the leads and electrodes on your body. Instead of a pain signal, neurons in the brain receive a mild buzzing or tingling sensation in the spot. This electrical signal intercepts or blocks the pain signal transmission.

Why does a TENS unit work? 

Right now, it’s not 100% clear on exactly how a TENS unit relieves pain. One leading theory is that the electrical stimulation keeps nerves so busy that they are not able to process pain signals. These same high-frequency electrical pulses may encourage the brain to switch the balance of chemical production to more natural pain relievers (e.g., serotonin).

Regardless, many people find non-invasive pain relief from this type of device.

Which conditions can I use a TENS unit for?

TENS machines may provide pain relief for a variety of previously intractable pain conditions, including:

• Sciatica
• Neck pain
• Diabetic peripheral neuropathy
• Lower back pain
• Osteoarthritis
• Tendinitis
• Bursitis
• Shoulder pain
• Migraines
• Headaches
• Fibromyalgia

Let’s look at each of these in more detail.

Sciatic pain

Sciatic pain (also referred to as sciatica) is not in and of itself a pain condition but rather a particular type of pain that is produced from different conditions (e.g. herniated or bulging discs). Nevertheless, it is very common and effectively treated with a TENS unit.

The sciatic nerve is the longest, widest nerve in your body. It attaches at the lumbar spine (lower back) and runs across the buttocks and down the hip on the outside of the leg all the way to the feet. Any compression or pressure on this nerve can cause excruciating pain that radiates from the lower back to any point along the nerve’s pathway.

Other symptoms of sciatic pain can include numbness in the legs and feet and a burning sensation. Symptoms are most often felt on one side of the body and will continue to worsen without treatment.

Once the cause of the sciatica is determined, a TENS unit can provide relief from pain that is non-invasive and safe while you and your healthcare team address the root cause of your pain. The mild tingling sensation provided by the TENS unit replaces the pain, allowing you to participate in physical therapy and other active treatments to relieve your pain. .

Neck pain

Neck pain is becoming more common as we spend more of our days hunched over screens and steering wheels. When pain becomes a pattern, chronic pain may persist.

TENS unit therapy is one part of a comprehensive neck pain management plan that can also include ergonomic changes in our daily lives and physical therapy or exercise.

Diabetic peripheral neuropathy

Diabetic peripheral neuropathy is a type of nerve pain that originates from the spine as a result of nerve damage. This damage most occurs due to wildly fluctuating blood sugar levels found in diabetic patients. This pain can be incredibly difficult to treat and debilitating as it progresses.

Peripheral neuropathy is not only caused by diabetes. It can also occur due to the following:

• Vitamin deficiencies
• Alcoholism
• Autoimmune diseases
• Certain medications

Regardless of the causes, TENS units are one way to approach management of this complex condition.

Lower back pain

Lower back pain from any cause is a candidate for TENS unit therapy.

Because there are few side effects, TENS machines may even be a good first-line treatment for acute pain that is long-lasting but not yet severe and chronic.

Osteoarthritis

Osteoarthritis is a form of arthritis that is a wear-and-tear condition. As we get older and use our bodies, the cartilage that protects joints begins to gradually deteriorate. Once this occurs, painful bone-on-bone rubbing happens, causing pain and inflammation. If left untreated, bone spurs can also occur, turning a mild pain experience into a severe one.

As the most mobile and hard-working part of the spine, the lower back is a prime target for osteoarthritis and the pain that comes with it. TENS unit therapy can be a solid treatment option to reduce pain.

Tendinitis

Tendinitis can be notoriously difficult to treat. When tendons in the body become strained, stressed, or injured, pain can occur. In many cases, pain also leads to lowered activity levels, which in turn leads to longer healing times.

This vicious cycle can be broken by a TENS machine. Besides pain relief, a major TENS unit benefit is that it allows people in pain to be more active. After the acute phase of most injuries is over, physical activity is key in healing. This is true with tendinitis in most areas of the body.

Bursitis

Bursitis can occur in movable joints like the knees, but it also occurs in the lower back when the bursa that cushion your vertebrae and provide shock absorption begin to deteriorate or herniate.

Before surgery, a TENS unit and physical therapy may be a good choice.

Shoulder pain

The shoulder girdle is a complex piece of anatomy that has four joints that are highly mobile. These joints are surrounded by connective tissue and muscle, all of which are susceptible to injury from accidents or repetitive use.

Chronic shoulder pain can impact your daily life, making simple actions like lifting groceries or waving to friends across the room painful. The mild tingling of TENS can help you continue your active life with less pain.

Migraines or headaches

Migraine headaches are not normal headaches that can be treated with medication or a little rest. These headaches can become chronic and intractable, responding only to prescription medications that often come with a host of side effects.

TENS therapy is a researched-backed option that is incredibly effective in the treatment of migraines.

Fibromyalgia

Fibromyalgia is a connective tissue disorder that comes with other symptoms, like digestive issues, debilitating fatigue, and widespread pain. For many years, people with fibromyalgia (primarily women) were ignored in their suffering, with some doctors and researchers believing that the pain was in their head.

TENS machines can help reduce the pain and fatigue in many people who suffer from fibromyalgia, without the many side effects that come with prescription medications.

What are TENS unit benefits and research?

TENS unit benefits are easy to see.

• TENS unit therapy is affordable: Insurance often covers the price of these units, but if not, a TENS machine can be as little as $100 (even over-the-counter)
• Most people can use TENS: Pregnant women and people with pacemakers are not usually able to use TENS therapy, but it is generally safe for others
• TENS therapy helps you stay active: Because the unit is most effective when you are active, TENS therapy encourages you to keep moving during treatment

Research

Many TENS unit benefits are gaining support in the research.

In a randomized, controlled trial of 301 patients with fibromyalgia, 44% of those using TENS unit therapy experienced significant pain relief when compared to patients who were not using the therapy. An additional 29% of TENS users reported at least a 30% reduction in pain and a drop in levels of fatigue. And, 70% of the patients using the TENS machines reported feeling much better after four weeks of treatment.

For migraine pain, TENS unit therapy offered relief to an astonishing 81% of people who used it. The results, reported in The Journal of Headache and Pain, are great news for those who suffer from frequent migraines that impact their lives (and are not responsive to other treatments).

Other findings include:

• For knee pain related to osteoarthritis, a 2018 study found that TENS units did offer significant improvement in pain levels and walking ability over long distances
• TENS unit therapy may reverse nerve damage in people with spinal cord injury (a finding that could help those who suffer from peripheral neuropathy)
• In patients who are experiencing post-injection sciatic pain, TENS provided significant pain relief

Many of these studies point out that knowing how to use a TENS unit, including properly calibrating the level of electrical stimulation and accurately placing the electrodes, is key to a successful treatment.

How to use a TENS unit

The first thing to understand about how to use a TENS unit is that you will get the best results when you work with your doctor. Rather than just treating one symptom, your doctor will help create a comprehensive treatment plan for more effective pain management.

To start, placement of the TENS electrodes is crucial. Your doctor will help, but here are five general tips.

1. Identify the exact location of the pain (as closely as possible) and focus on the most painful area
2. Use either two channels or four channels for a proper circuit (never just one or three)
3. Place electrodes at least an inch apart and make sure they are not touching
4. Do not place electrodes directly on a joint that may loosen the pad with movement
5. Electrodes can be directly across from each other, one above the other, or diagonal to each other

The distance between the electrodes changes the electrical signals. If you have pain over a wide area of your body, place the electrodes at either end of that pain. If the pain is in a small area, place the electrodes closer to each other at the exact location. Finally, if the pain is in a joint, placing electrodes on opposite sides of the joint can help.

It may take a few tries to get the exact placement of the electrodes down for optimal pain relief. Working with your doctor can help.

Side effects

The most common TENS machine side effect is skin irritation at the site of the electrodes, a condition that can be addressed by using hypoallergenic pads.

Some patients may also find the mild buzzing to be too much. Many get used to it over time or their doctor can recalibrate it for more comfort. Some patients can also develop a tolerance to TENS. Address this by taking a break from the treatment to allow your nerves to rest.

Could TENS unit therapy help me?

Chronic pain can be treated, but only you and your doctor can decide if a TENS unit is right for you.

Getting a proper diagnosis of the condition causing your pain is a crucial first step. Treating any underlying causes of pain may go a long way towards relief. A TENS unit could help you walk those final steps in getting your life back.

Arizona Pain can help you decide is a TENS unit is right for you. Get in touch today for a consultation.