TENS Unit for Pain Management & EMS for Muscle Rehab – Ask Doctor Jo

TENS Unit for Pain Management & EMS for Muscle Rehab – Ask Doctor Jo

Hey everybody, it’s Doctor Jo. Today I’m gonna
talk about TENS units and EMS units. Hmm, lot of letters. What do those mean? I, for
one, am a big believer in these products. The TENS unit stands for Transcutaneous Electrical
Nerve Stimulation. And an EMS stands for Electrical Muscle Stimulation. So they’re a little different,
and I think people get confused sometimes. The TENS is more for a pain reliever type
of thing. I recently had hip surgery, and I have to say the TENS was on me every single
day, twice a day, and it took away the need to use pain medication. So if you have reactions
to pain medication, this might be a good alternative to get some of that pain out of there, relax
your muscles and be able to do the things that you need to be able to do. The Electrical
Muscle Stimulation, the EMS, is used to help gain muscle back, so it actually contracts
the muscle. It’s a different feeling, sometimes it’s slightly uncomfortable, but it’s a good
uncomfortable, I think, because it’s making those muscles work. The TENS to me has this
vibration feel, which is really comfortable, I like it. Some people aren’t a huge fan,
but basically in simple terms, what it does is it follows that, that vibration follows
the same pathway as the pain pathway. So it kind of cancels it out. So then that pain
that you’re feeling doesn’t go up to the brain, that vibration goes up to the brain. So I
always call it a little bit of a massage feeling, and when you get a good massage, massages
are always comfortable, it’s a “oh yeah that feels good” kind of feeling and that’s what
I think it feels like. The folks a FlexTone were nice enough to send us two different
TENS/EMS units. This bigger unit is usually more in the clinic that you’ll see. And it
has a couple of different outlets and it’s really nice. And then they sent us a more
mobile one. And when I opened it up, I was surprised at how small this thing is. It is
so cool, it almost looks like an old-school cellphone which I like. But you can slip it
in your pocket and then go about and do your activities throughout the day with it on.
And so if you have maybe some back pain, you can put on your back, set it for 15 minutes,
have it on, it turns off by itself and then you don’t have to worry about it. So it’s
really nice, I thought it was really cool, I just couldn’t get over how small this is,
it’s probably one of the smallest ones I’ve seen. So this is the Pro 16 and this is the
RX-8000. So what I’m gonna do is show you how both of them work and just what it does
while it’s working. You have these pads that you can use, and they’re actually slightly
different. These are the most common pads you’re gonna see, they’re pretty interchangeable
amongst TENS and EMS units, they just have kind of a push in with a pin right here, and
then you put them in. And then this one is a little slightly different for the smaller
one, but it just kind of snaps on. But again, they work the same. So, when you’re doing
a TENS, most of the time you’re gonna use 4 pads. And when you’re doing an EMS, you’re
gonna use two pads. With the TENS, they way you want to do it is a cross pattern. So they
two here, as you can see there’s two channels, you want to cross them so then the currents
go to where you’re kind of hurting. So let’s say it’s on the knee. If I’m hurting kind
of on that knee cap area, I’m gonna put one channel here, and one channel here. So I’m
gonna go ahead and do that now. So you can see they’re connected there. And what’s nice
about them too, is you can actually pull them a little bit, they’re connected, but you can
separate them without messing them up. So I’m gonna put one over here, then the other
one over here. And then just like that. It’s best not to have lotion on your skin when
you put these electrodes on. They are reusable so you have, you know, one set for you. And
then what’s really nice is in the big pack here, it comes with a whole bunch of them
in different sizes too. So once they wear out usually after about 3 – 4 weeks, then
you just get a new set. But there’s also some that you can put gel on it, and they’re reusable
and you put the gel on it and then wipe it off, clean it off, and then you can use those
again. So once you have it on. Make sure it’s turned off before I turn the power on. You
turn the power on here, and it has a whole bunch of different settings, so it’s almost
pre-set for you so you don’t have to figure out the current levels. Back in the day, you
actually had to kind of figure out the current levels and it was kind of tough. But now,
you can just pick knee/elbow, hip, foot, shoulder, leg/arm, and back. So I’m gonna go with the
knee/elbow. It starts off at 20 minutes, but you can just keep pressing this for more time.
Then here, the channel A and B for 1 is the one it’s plugged in to. So you just turn it
on til you hear that click. The green light comes on. And don’t crank it up fast cause
you have to get used to that feeling. And then you just start going until you feel,
it’s almost like a little “tap, tap, tap, tap” so like I said, again it’s a massagy
kind of feeling, it feels really good. And it’s up to you of how strong you want it.
So if it’s kind of one of those where “I don’t know I’m kind of worried,” you don’t have
to have it on high. The higher is not better, it’s just for your comfort level. So some
people actually like it pretty high because if you’re hurting, the higher you go, it’ll
cancel out that hurt a little bit more. And then you just, for the TENS, you just have
it on and relax. And as you can see with the TENS, you’re not supposed to see a muscle
contraction. Again, I think that’s where people get confused. If you actually see the muscle
contracting, it’s not quite doing what it’s supposed to do. So you can either turn it
back off and move the electrodes around a little bit so it’s not sitting on a muscle
that it’s contracting. Or just take the power down a little bit. But you don’t want that
muscle contracting for the TENS. And then you can just relax and let it go. You can
put an ice pack over it, you can put a heat pack over it. So these are nice because you
can put stuff over it, you don’t just have to have this on it. So, again, when I had
my hip surgery, I had these on, and then I had my ice cooler flowing ice water through
and it felt great. Like I said, I didn’t have to use pain medication very long. So then
you can turn that off. And again, both of these do TENS and EMS, but I’m gonna show
you the EMS with the smaller unit. Just to show you how powerful that little compact
unit is. And both of these you can use them without being plugged in and they’re rechargeable.
So you can charge them back up at night when you’re not using it. So now for the EMS, what
I’m gonna do is try and get my quad muscle to contract a little bit. So with this one,
you only need 2 pads, you don’t need the 4 pads. And sometimes this needs readjusting
as well. You put it where you think the muscle is, but you might have to readjust it a couple
of times, or have your therapist show you where to put it in the right spot. So the
little on button is here, and it’s really cool. Cool colors. And again, this one is
kind of set up for you again where you don’t have to do much except pick the one that you
want. And then it’s just got the power, “+” means stronger “-” means less. And then hitting
this button goes to the different channels. So I’m gonna go to the one that actually has
some contraction in there. And I’m just gonna start taking it up. And as you can see there,
that my muscle starts to contract and then it relaxes. So, again, this is one that’s
kind of you’re comfort level. But you want it to be strong enough where it’s actually
contracting the muscle now, so you might just have to tolerate it, a little bit of that
uncomfortableness, but you want the muscle to contract. So you really just want to kind
of tough this one out so you can get that muscle contraction ’cause that’s what you’re
looking for. If you’ve just had a surgery, and that muscles not quite firing on it’s
own, this will help. So what you can do with this, when you’re doing the muscle contraction
one, is do an exercise while it’s on there. So I’m gonna do a quad set. SO once I feel
that it’s gonna contract the muscle, then I push down and squeeze that muscle as much
as I can while it’s getting that stimulation in there as well. So these are some really,
really cool products. I really like them. I think that they help in recovery. Help recover
the muscles, get those muscles strong again, or help take away that pain which is super
important. So, if you have any questions, leave them in the comments section, if you’re
interested in purchasing either one of the Flextones, go to our product store at AskDoctorJo.com/products
If you like it, click the like button. And remember, be safe, have fun, and I hope you
feel better soon.

100 Replies to “TENS Unit for Pain Management & EMS for Muscle Rehab – Ask Doctor Jo”

  1. hi, i saw your video and it was very helpful. I currently came back from a very hard hike and ever since then I have been having bad kneed pains. I was just wondering if you could tell me if there is any way my knees will heal so i will be able to hike again. Im wondering if you know how long it takes to heal from knee pains from hiking. I have never had it before.:-) thank you.

  2. Hi, Great, easy to follow video-thanks! I have FSH Muscular Dystrophy. It's a mild (right now) progressive weakness in legs, arms and shoulders. Most of my pain is in the neck and shoulders area. And it can be almost debilitating at times (I rest with ice/heat, pain relievers, etc.) I'm in a group FB page with people of this same type of MD. Lots of them recommend TENS for pain. I've never used one, but after watching your video, it looks like maybe the TENS and EMS would be good too. I'm not sure about the EMS because once a muscle is weak, I cannot make it stronger, but can try to keep the strength I do have. Make sense? Do you have an opinion on which one I should use and/or can you do both…maybe alternate?

  3. is it normal to see the muscle contracting violently sometimes even on large areas?. cause im quite lean as i do bodybuilding im not sure if it the current just goes into the muscle easier as it doesn't have to go through fat. ive been lifting weights for over a decade and like to use the tens to recover from harsh leg workouts that cause severe doms and seems to be working i feel better everytime i use it.

  4. Can we use tens unit on my senior dog for hip arthritis pain? I'm using cold laser on him now and it has helped him a lot with the arthritic pain. Thanks Linda 9-11-16

  5. Hie, last month had 3rd degree trauma surgery on right knee , having hard time bending my knee for 40degree angle. Which device do you recommend?

  6. Hi,
    I have spinal stenosis in the lumbar spine as well as sciatic pain. I donated a kidney 19 years ago and part of the incision herniated so my muscle tone in my abdominal is not good. The sciatic pain is always on the side of the weakened muscles.
    I have used deep tissue massages and Vinyasa yoga for the last 3 years to manage and keep things flowing… However lately it doesn't take much to set it off.. Am wondering if TENS is an option?

  7. Hi Jo, I have had a persistent chest injury for about 2 years caused in the gym. Long story short, I did not give it enough time to heal in the weeks after the initial injury. Now there is a weakness in the muscle fibres which causes it to re-injure very easily and was wondering if using a TENS machine will aid recovery once I have worked my chest in the gym?

    Your advice would be most appreciated!

  8. Dr Jo I had knee surgery 4 days ago. I had a tear on my lateral and medial meniscus. I'm going to be doing my own home therapy I have everything I could possibly do a therapist place I was wanted to know when is it the best time to do the tens either before therapy or after

  9. I have a question about the portable unit.  I received  a very similar TENS/EMS unit today, but am curious which functions are actually TENS and which are EMS as they are all labeled as different forms of massage… The manual is a bit sketchy at best…  Can you identify which are modes are TENS and which are EMS since the manual doesn't do that?

  10. Dr Jo
    how can I use it for rhomboid, shoulder neck pain ?how many times can I use it?how long?because I have myofascial pain syndrome ,please advise

  11. you were so helpful. I find watching a video helps than the instructions they give u. I am experiencing extreme pain in my leg from my hip and would not have known to cross the pads. thank u!

  12. Thank you for the video. For muscle recovery I have access to a neuromed but not sure the setting for muscle;e recovery. Do you have any insight? Thank you again

  13. Hi Doctor Jo,

    My friend bought me a a tens unit knowing that I wanted an EMS but I don't think that she knew the difference. I understand the difference between a tens unit and an EMS but have a question about my tens unit. Although mine is exclusively a tens unit, it has the capability of producing forceful muscles contraction when I place the electrodes on my VMO and foot arch, for example. This works when I put it on the "Burst mode" only. I'm just curious if it is okay for me to use the product in this manner, as my goals are increased blood and lymphatic flow post exercise while I'm stuck sitting on a bus for a couple hours.


  14. I used this a while back because of shoulder pain unfortunately I left the machine on my body for more than 15 Mins and I started to feel my heart pounding, out of breath and faint that when I tried to turn it off the settings went up. After that I started to notice that I would get spasms, heart palpitations and chest discomfort, I've been told that all my symptoms are due to anxiety and panic attacks and there is no correlation with the TENS machine, could I have damaged my vagus nerve or something else? I can't wear tight pants, I can't stand for too long and no matter what I eat my stomach boats and my heart goes out of control.

  15. Hey Doctor Jo!
    I have been experiencing numbness in my toes and have attributed it to my walking regiment of 7 mile walks 5 days a week. I have found that re lacing my shoes has removed the pressure from the nerve that runs from the top of my foot to the big toe but the neuropathy lingers. Would an EMS be preferable to a tens unit to re establish the nerve conductivity?

  16. I have been wanting a tens unit for a while for the space between my shoulder blades. Long story short car accident and I was side swiped in my chevy Cobalt by a guy in a truck 6 years ago. And every time the weather changes I have this uncomfortable tightness and pressure/ pain. Thanks for doing this video cause I had no idea which one to pick! 🙂

  17. Hi Dr. Jo love your videos so very helpful! How would I know which of the two will benefit me best. will I need to consult with my Orthopedic doctor.

  18. Dr. Joe : Hi I'm Peggy . Thank you for showing me the correct way to apply the pads
    for my knees . I hadn't been crossing them in the X way . My question to you is : is there
    even a slight possibility that using the tens unit might stimulate new cartilage in the
    knees ? It seems like it would .

  19. What would be placement on hip with 2 channels? Do I need to use 2 channels? I have excellent results on my neck and lower back and would like to give my wife some relief. I will use one channel and massage (hehe, snort,snort) at this point.

  20. I found this extremely helpful. I was placing the pads incorrectly since I purchased a TENS unit two weeks ago.

  21. Hi there Dr Jo,
    Back in September 2nd 2015 I had a heart attack and ended up having an emergency operation.
    I had a triple heart bypass and the vein used was from my left leg, cut from ankle to just above the knee.
    Since then I have had knee aches and pains and back aches and also a lot of gout too.
    One good thing about it is that I am still alive though. Would the TENS benefit my aches and pains? It is painful when I walk now on one side of my hips but I do my best to plod on.
    I am 67 now but still young at heart and I want to be able to get around without knee and hip and back pains.

  22. Hi Dr Jo. What do you think about some ems-tens combo mini units? Are they any good? Or would I need one of each?

  23. Dr. Jo, I suffer from OA, especially my hands, I use a TENS on my chronic low back pain and absolutely love it, but I cannot get any relief for my hands. Most of the pain in the base of my thumbs. Any suggestions?

  24. hey there, Doctor Jo, i have a slight distal bicep tendon injury. should i get the tens or the ems to speed up recovery? thanks

  25. What would be the difference between TENS and/or EMS and/or the Thermatix to address pain and inflammation around the knee(outer knee-meniscus tear)? What would be the most effective/appropriate system to use, if any? Most interested! Thanks, in advance.

  26. Hai can I use tens unit for my ankel (bottom) As now a day's I am getting very badly pain when I keep my foot on floor Early in the morning when I get off my bed……

  27. Hello Dr. Jo, I really like your videos. May I ask Why did you have a Hip Surgery? I am 44 years old and I had my Hip replacement 6 years ago, it helped a lot with mobility and it extended my right femur improving the length of my leg, it was shorter since I broke my femur when I was 9 years old in a car accident. Usually I can walk without pain but as soon as I walk more or try to exercise, I start feeling pain. I just bough this machine to improve my legs muscles for strength and better appearance. Can you recommend legs exercises for hip replacement? Thanks

  28. Hi Dr. Jo I recently tore my acl and currently 11 days post op. I've started using the ems on my thighs at a moderate level. Should I have use it at higher setting at such an early stage in my rehab

  29. I have been bedridden for a few months with an impinged nerve in lower back which means can't stand or sit for no time at all hardly. I ordered a tens machine off amazon to help with my lower back muscle that has been basically locked on for these past months due to the impingement. I forgot about my legs wasting away until today they are aching real bad, I never had developed leg muscles to begin with (chicken legs) so really didn't have much leeway I guess for being laid up this long.
    Would the EMS unit help me to rebuild these atrophied quads? Or would I be ok with using those exercise bands to work the muscle and then use tens to make the ache afterwards disapate?

  30. Dr. Jo, do you know how one can find the motor point on a muscle with EMS? I was informed on it, but wanted clarification. I don't want to get an electric shock to my heart. My understanding is that you put one electrode down on the Pt. and then one in the palm of your hand. You then turn the machine up to a light intensity and run your finger down the muscle until you feel the electricity at its strongest point? Is that the (safe) way to go about it? Thanks.

  31. Hi! Thank you for your video. I have pathelofemoral pain sindrome in my left knee and now I have pain in my right knee too. (I guess it is from being over used) I started using TENS machine on both knees 30 min each, once a day and I feel a little better. I wonder how many days in a row can I use the TENS? Happy Thanksgiving!

  32. what if you're experiencing a pins and needles feeling? I tried it once and it felt like being stabbed by a thousand tiny needles.

  33. So, there is no difference between a tens unit and an ems.. basically, get the cheap small unit and just crank it high enough for a powerful contraction.

  34. Hi Dr Jo firstly let me congratulate you for your magnificent job that you do with this channel. I practice Kendo which requires a lot of strength on the knees as there is a lot of power and also landing after very short and intense movements,sadly I injured my knee ligament a couple of years ago and know I've been told that I need to strengthen my knee if I want to continue practicing. How would you position the electrodes to make it work?

  35. I have a pinched C6-7 nerve, resulted in pretty noticeable lateral tricep head atrophy. I went to PT. The neuropathy is gone, but the muscle will not activate during exercises that should make it contract- it’s all medial head working. I saw orthopedist for possible surgery. He thinks I might recover, but I’m still very weak in the tricep. No one has mentioned an EMS to reverse this wasting. Are they just not educated or are these devices modern day “snake oil”? Thanks

  36. I went on your site and it says you recommending a different TENS unit. Why are you not promoting the one you displayed in the video?

  37. I am staying in india but it is unavailable , i like the product and i want to buy , any other means of delivery is possible ??

  38. Hey Doctor. If I’m suffering from knee pain will the tens hell cure the pain completely, or just make it manageable?

  39. Can you please explain the difference between a NMES (Neuromuscular Electrical Stimulation) unit and a TENS unit I have a dual unit that offers both modes.

  40. Is it safe to use the unit for EMS on a calf muscle after broken ankle surgery when there are pins and plates in the ankle? Great video. Thank you.

  41. Hello. I have a herniated disc in my back (L5-S1) and am experiencing a lot of pain. Sometimes I can barely walk or move it is so uncomfortable. Consequently, I'm getting way out of shape and its increasing the back pain even more. Can I use one of these while I work out? I'd like to walk or try something for cardio. I'm dying. Help!

  42. Thank you for the info Dr. Jo!
    last week i had a rt shld slap tenodesis / re-anchor, and further cleaning up inside joint (2.5 hrs surgery). For day 2 – post-op was PT, and my therapist was very pleased with my state, nonetheless it was at this session where the t.e.n.s. unit was used for 6 min. Was stimulating in most areas, BUT ever 5 seconds or so I experienced this randomly sharp painful twitch sensation inside the joint, and it was stemming from i believe the electrode placed on the teres minor area. Can't describe it any better other than feeling red-flaggish. Anyhow, I am on day 4 of recovery now, I will mention this with my surgeon in 8 days. I am curious though, Is this a normal anomaly with the unit? Could this be related to something else, like an additional tear or nerve issue outside view of contrast images?

  43. it would be helpful to show us which "one" has the contraction. I ordered a similar device which says its ems but there is no clear indicator how to do that.

  44. Hello! I have a question please. I am suffering from full body atrophy. Doctors are clueless but I know it's from a spinal injury I've had years ago. Anyways, I am wasting away so I have been trying to combat it with weightlifting but I can only workout certain muscles at the moment due to lack of workout equipment. Will the ems unit help my muscles to stimulate and grow? Thanks.

  45. Can TENS useful in burning/pinching sensation left side of left leg behind knee( I think peroneal nerve) & numbness & tingling under foot? I am feeling my left leg weak and unable to walk properly. Pzz help

  46. If I was diagnosed with extensor tenosynovitis of the foot, which settings should I use in a manual TENS machine? Thanks doc!

  47. I have mild muscle contraction when I’m a tens setting. Is that ok? It isn’t anything like the ems contractions

  48. Use code DRJO to get 10% OFF a TENS/EMS Unit here: http://shrsl.com/10snv (affiliate link). Want more in-depth info about TENS Units and/or EMS Units, including step-by-step color photos for a wide variety of placements all over the body? Buy my book here: https://amzn.to/2GPQvzK

  49. I have MS and need to avoid atrophy of right leg muscles. I swim every day but I don't think the muscles are getting enough stimulation. Could I use a TENS machine to help?
    I tried the Walk Aide that shocked the peroneal nerve when the knee was bent but found it pretty distracting and painful as it jerked my drop foot with the shock. But I liked the idea of stimulating the nerve- just not the price tag of $5K. The TENS units are much cheaper and would they do the trick?

  50. Most chiropractic offices seem to use (EMS) when people are injured (car accidents). When you’re injured, you feel pain right…? So seeing that EMS is for muscle rehab, why does EMS seem to be used more often in a chiropractic setting than TENS?

    The way I see it, is that people feel pain regardless; and anyone looking into an EMS / TENS unit, is probably doing so because they feel pain somewhere. So it would seem as if TENS should be used in any case. How do you know if you should use TENS (block the pain) or use (EMS) stimulate the muscle. TENS sounds like a temp solution, but what will EMS do for the long run?

    And to clarify that question, I guess I’m basically just asking, how do you know if you need a pain management solution vs a muscle rehab solution…?

    I can only assume that you have to determine whether or not your pain is a muscle related issue or a nerve related issue…

  51. does that mean I have to stop using my 90 amp welder as an EMS? just kidding… is there a pdf instruction manual online? I can't seem to find one, even when using Google…

  52. Dr. Jo, could you please, please make a video on units that have massaging functions to relax the muscles? Not to exercise, not for pain, just muscle relaxation.
    The info available online, as well as the standard settings on the units are often contradicting as to how many microseconds should be used depending on which part of the body it’s applied to as well as which frequencies are best (5Mhz< and such).
    Your opinion would be greatly appreciated.

  53. Hi! For the neck, is a device pretty much, “you get what you pay for” ? What brand or model do you recommend ? Thank you.

  54. I have knots in my shoulder and mid-back. I have been using a TENS unit on my shoulders and I do get some relief. The TENS doesn't release the knots. I just ordered an EMS Device, where would you place the electrodes using the EMS?

  55. So it turns out I did tear my quad tendon while sprinting. I feel as if my tendon is still dangling and when I lift up my quad I get a dent in the middle of the quad. The sports orthopedic told me he feels I don't need surgery the tendon can heal on its own so he's sending me to these therapies with the electrode machine. I feel it's healing but incorrectly, should I baile out and change doctor's. What's your opinion?

  56. I used to sell these things, I dont like how people say they dont know how to use them. I was hoping to get more clinical studies or more doctor lingo rather than the practical application. Thanks for creating awareness about the difference between EMS and TENS I agree there's a big misconception out there usually the first one I have to clear up when I am talking about them.

  57. I use the smaller device. In fact, I had a high volume squat session three days ago. The DOMS was bad because of the new stimuli to the muscle group. Last night I put the large pads on the leg in the direction of the actual muscle pattern. I had it on the second highest setting to really dig in. It felt amazing and after I felt so much better. Today, the quad pain is almost non-existent, I also added it to the calf area, not as effective but a bit better today.

  58. Hello, my doctor is suggesting i use the kneehab for my ACL/ Meniscus Surgery. It is a bit pricey, what do you suggest to use instead that is more affordable.

  59. I always love your videos-very informative! I do have a question: is EMS good for muscle knots/spasms? Would the electrical contraction from EMS reset the already over firing of the muscle fibers or make it worse by contracting more? I use a TENS-it helps, but I'd really like to relieve knots so I can exercise to build up weak muscles in my lower back due to scoliosis.

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