The Correct Placement for Your TENS Machines Electrode Pads

TENS is acknowledged and claimed to be a non-invasive and drug-free method for pain relief, but a HUGE and completely essential part of reaching the benefits of using a TENS machine is to know the correct placement of the pads.

This is because the electrical current need to be both connected to the injured area as well as between the two (or four) pads in order to “triangulate” the area. This lets the electric pulses move through the nerve fibers within the damaged area.

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One of the key goals in pain management in, for example, physical therapy is to have a modality that is non-invasive and efficient. Transcutaneous electrical nerve stimulation (TENS) is a great tool to use when a patient experiences pain resulting in they having difficulty participating in their rehabilitation.

A TENS Machine can be used for more than this, but whenever mentioning any “result” or “success” in dealing with T.E.N.S, this is what I am referring to.

Please Note: The information provided in this article is not intended as a substitute for professional medical advice or treatment for specific medical conditions. Always seek professional advice with any questions you may have regarding a medical condition mentioned in this article and use your best judgment.

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How Does Transcutaneous electrical nerve stimulation (TENS) Work?

Whenever using a TENS Machine, two pads are placed over or at the perimeter of the injured area of the body.

The unit sends an electrical current, or an electrical pulse, from and to the pads whenever activated. This electrical pulse stimulates the release of the body’s own natural opioid pain-relieving chemicals.

A HUGE and completely essential part of reaching the benefits of using a TENS machine is to know the correct placement of the pads. This is because the electrical current need to be both connected to the injured area as well as between the two (or four) pads in order to “triangulate” the area.

This lets the electric pulses move through the nerve fibers within the damaged area.

However, one area of the benefits of TENS can be beneficial regardless of this occurring. For example, the electric pulses created by the unit can in one way “confuse” the body from locating the pain, causing a pain interrupt.

This is however only temporary pain-release and can work for example a migraine.

What Kind of Pains can a TENS Machine Help You WIth?

As mentioned, if you want a thoroughly detailed guide on how the TENS machine can help with different kinds of problems and symptoms, you should visit this guide. But some of these injuries can be as follows:

  • Soft Tissue Injuries
  • Cervical radiculopathy
  • Hip Pain
  • Carpal Tunnel
  • Tennis Elbow
  • Frozen Shoulder
  • Sciatica
  • Chronic Conditions
  • Arthritis
  • Multiple Sclerosis
  • Fibromyalgia
  • Migraines

What is the purpose of sending electrode signals from a TENS machine?

TENS is acknowledged and claimed to be a non-invasive and drug-free method for pain relief.

In the early days of TENS machines, they were used by doctors and Physical Therapists to a very restricted extent.

Nowadays, due to the advancement in technology and research, TENS machines can be both used and bought by pretty much everyone.

A TENS machine produces low-voltage pulses that, when the electrode pads are applied to your skin, stimulates the nerve fibers to help block pain signals to your brain. Some say that, due to the blocking of nerve signals, a TENS machine also causes one to increase natural endorphins also known as “The feel-good-chemical”.

Manage your TENS Machines Results and Expectations

Even though this unit has gained a lot of traction thanks to its very smart and convenient way to reduce pain, it is important to manage the results and expectations.

  1. The TENS machine usually won’t work immediately, so patience is really a virtue. Sometimes you have to use it for a longer period the first sessions, or sometimes you have to use it a couple of times before really noticing anything. This is also really personal, what is “considered pain relief”.
  2. The relief of pain or discomfort you are hopefully feeling during the time of using TENS might be lost whenever you switch it off.
  3. It’s important and crucial (as shown in this guide) to know where exactly to attach the pads, or else you could lose on the whole experience. A quick move of one of the electrode pads could make a huge difference.
  4. What works for others might not work for you. If you have heard someone having great benefits from using a TENS machine and you’re not experiencing the same – don’t give up! Many TENS machines have a lot of different settings and combining these with the right placement will eventually make it work for you!

This is How You Should Place Your TENS-Machine’s Electrode Pads

A great advice to follow throughout this guide is to place the electrodes as close to the area of pain as possible, with the injured area “in between” the pads, while at the same time adhering to these general guidelines:

  1. Your skin must be dry and clean.
  2. Put a small amount of gel in under each electrode (depending on the specific instructions that come with each unit). This helps the electrical pulses reach the nerves under the skin. If the pads start to lose their stickiness, rub a few drops of water into the gel side of the pads before putting them back on. The more firmly the pads are stuck on, the better they’ll work.
  3. Don’t be shy in using some force in placing the electrode pads. If they are not correctly placed flat on the surface of your skin, it can actually send pulses to the outside of your skin instead, so be firm when placing them!
  4. Hook the pin connectors on the end of the electrode wires to the electrodes. Then plug the electrode wires into the TENS unit.
  5. When starting the unit, adjust slowly to find the correct setting. It will usually result in feeling a slight tingling feeling.
  6. ALWAYS read the manual before using your TENS machine since there might be things you need to be aware of before using it.

The main thing to take away from this segment is that you should always start on a small intensity and work yourself up to something that you can tolerate. Only then can you test your limits.

15 General Body Parts to place the Electrode Pads

  1. Ankle
  2. Arm
  3. Back
  4. Cervical
  5. Neck
  6. Elbow
  7. Finger
  8. Wrist
  9. Foot
  10. Hip
  11. Knee
  12. Rib Cage
  13. Shoulder
  14. Thigh
  15. Wrist

How Do I Place my TENs Machine’s Electrode Pads for Sciatica

To handle and pain related to sciatica, use either two, or most preferably, four electrode pads placed above and under the area on pain. DO NOT place the pads directly on the spine, but you can without any problem place the pads vertically on either side of the spine.

You can also place two of the electrode pads on the high part of the backside of your legs and experiment with the placement of them as shown in the image.

How Do I Place my TENs Machine’s Electrode Pads for sciatica

How Do I Place my TENs Machine’s Electrode Pads for my Tennis Elbow

To handle pain related to the elbow, the electrode pads should be placed on the outside of the elbow as the image suggests. Two pads are enough in treating your tennis elbow, but if you have more pads to spare, you can put one on the inside of the joint as well.

For treating the upper part of the forearm as well, extend any pad vertically to reach out on the forearm to “triangulate” the area of pain.

How Do I Place my TENs Machine’s Electrode Pads for tennis elbow

How Do I Place my TENs Machine’s Electrode Pads for Frozen Shoulder

To handle pain related to the shoulder, place the electrode pads, in this case preferably with four pads, at the perimeter of the area of pain. You can extend the placement as much as down to your upper arm, your upper chest and your upper back.

Because of the lower amount of sensitive areas around the shoulders, feel free to experiment with the placement and the intensity to a degree that it is not painful or if it feels like your hurting too much.

How Do I Place my TENs Machine’s Electrode Pads for frozen shoulder

How Do I Place my TENs Machine’s Electrode Pads for Lower Back Pain

When you want to place the electrode pads on either your back on your lower back, it’s preferred to have someone help you find the preferred placement, at least the first couple of times.

Also, if you end up finding a great placement – make them mark it with a marking pen so that you or the next person attaching them would know where it worked for you the last time.

You can use both two or four pads for treating lower back pain, but I always suggest four, since it will triangulate the area of pain much better.

You can benefit from using a TENS machine in which you can control the intensity of the different channels, and in that way alternate the pressure by combining the channels as shown in the images.

How Do I Place my TENs Machine’s Electrode Pads for lower back pain and labour

How Do I Place my TENs Machine’s Electrode Pads for Neck Pain

The way to place the electrode pads is similar to how to place them for the lower back pain, except of course place them higher.

Here is also suggested to use four pads to better triangulate the area of pain. You can either place two of the electrode pads on either side of the spine at the base of the hairline and two lower on the shoulder or cross them as an “x” as the image suggests.

How Do I Place my TENs Machine’s Electrode Pads for neck pain

How Do I Place my TENs Machine’s Electrode Pads During Labour

This is actually an extension to how to place the electrode pads for your back and is not really that much different.

But remember, you should ask your doctor and ensure that you only use a TENS machine in the early stages of labor.

NOTE: You may need to take off the TENS pads if your baby’s heart has to be monitored electronically because the pads could affect the signals to the monitoring machine.

Follow these steps:

  1. Place the two or four electrode pads as suggested for “lower back pain”. Follow the steps under the guidelines of placement as well, and remember If the pads start to lose their stickiness, rub a few drops of water into the gel side of the pads before putting them back on. The more firmly the pads are stuck on, the better they’ll work.
  2. Start with the absolute lowest setting and slowly work your way up, making sure you’re not overdoing it.
  3. Use the boost button at the peak of each contraction. The boost function results in more intense, wave-like tingling or buzzing sensations. Don’t forget to the boost button off again when the contraction has ended. This is so you feel the benefit of the boost next time you have a contraction. This works super-great!
  4. As mentioned above in the “expectations management”, don’t give up just because you’re not feeling anything at first. Give it some tweaks and some time and you will most surely find some benefits.
  5. Take the opportunity to move around! If you have any decrease in pain by using a TENS machine, this is the perfect time to do something the pain otherwise is distracting you from.
  6. Don’t forget that the electrode pulses are under your control. If you feel any discomfort, just turn it off or lower the intensity!
How Do I Place my TENs Machine’s Electrode Pads for lower back pain and labour

How Do I Place my TENs Machine’s Electrode Pads for Carpel Tunnel Syndrome

To handle pain related to any carpal tunnel syndrome, first, recognize where you are feeling the pain the most. Also, since the wrist is such an exposed area for a lot of ligaments, do consult with your professional healthcare provider if you come across any uncertainties.

If your carpal tunnel syndrome extends into your forearm, place the electrode pads along the inside of your forearm, one pad at the wrist and one pad just below the elbow joint.

If you are feeling pain more in the center of the wrist area, you may place one electrode pad sticky side down on the inside of the wrist and one on the outside of the wrist, just below the back of the hand.

How Do I Place my TENs Machine’s Electrode Pads for tennis elbow

How Do I Place my TENs Machine’s Electrode Pads for Chronic Hip Pain

To handle pain related to chronic hip pain, place two or four electrode pads in a diamond shaped structure, two stacked vertically and two horizontally, at the perimeter of the most intense area of pain as the image suggest.

How Do I Place my TENs Machine’s Electrode Pads for chronic hip pain

How Do I Place my TENs Machine’s Electrode Pads for a Migraine?

A TENS machine is often recommended as a solution to deal with the pain of their attacks. But as opposed to the other symptoms in this article, a migraine attack isn’t a pain disorder, but a neurological disorder. Attacking the attack itself is not the best way to go.

As mentioned at the beginning of this article, a TENS machine is designed to disrupt the pain pathways, rather than “fixing” the attack.

What a TENS machine can do for a migraine is to “confuse” the source of pain for a while, but even though some suggests a way of placing the electrodes, I won’t suggest using this method as a cure for your migraine.

When Do I Know that the Electrode Pads Needs to Be Replaced?

The best indicator that you need to replace your electrode pads is when they are not sticky anymore. And this depends on a number of factors, such as how regularly you use it, at what capacity you use it, what the quality of the pads are and how good you are at maintaining them.

Some general rule to keep the electrode pads last longer is to always place them on dry and clean skin and never expose them to any water since this will decrease the stickiness really fast. So be sure that your skin is dry before placing them!

If you have more than one set of electrode pads, treat them as your shoes and rotate between them in order to make them last longer and not get worn out as fast.

Also, consider your body hair. If you are a hairy person or if you want to regularly place your pads on a hairy area, make sure that as small amount as possible gets stuck to the pads, since by then removing the hair will decrease the longevity of the pads significantly.

What to do When You Need to Replace Your Electrode Pads

No matter how careful you are, it is important to know that these are consumable products. They are intended to be replaced after a while and to be honest, they are not that expensive. Check with the brand you bought them from or look for universal pads that could work on any brand!

What to do with a broken or malfunctioning TENS Machine?

Contact your retailer, Almost every TENS machine comes with a warranty. Dispose your old TENS machine according to the label or return it to the retailer.

About the Author Paul Thomas

I've been plagued with lower back pain since my late teen years. As an avid fitness enthusiast, I've struggled for years trying to balance my active lifestyle while avoiding injury. I've done physical therapy, visited a myriad of specialist and sports physicians, and tried everything under the sun to continue my journey.

But it wasn't just me. It seems it runs in the family. I've watched my Dad and Aunts struggle with debilitating back pain.

As President of MisterBack, my goal is to help as many people enjoy a healthy, happy lifestyle as I can - picking up their kids or grandchildren, hiking, biking or even simply walking to get the mail with less pain.

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