10 Tips for TENS Pad Placement

Do you suffer from muscle pain?  It’s possible that your muscle pain came from an injury, strain or overuse.  Today, many Americans turn to FDA cleared TENS devices (transcutaneous electrical nerve stimulation) to relieve muscle pain in the lower back, hips and arms.  The use of TENS at home may be part of the overall treatment program developed by a physical therapist like myself, a physician or chiropractor.  These professionals understand the musculoskeletal system and know how to most effectively place the electrode pads onto your skin for optimal pain relief.

You can also buy a TENS unit over the counter (OTC) from your local drugstore to use at home. Yet, without the advice and training of a healthcare provider, you may not feel comfortable about where to place the electrode pads.  I would like to allay some of your fears with a little professional advice about electrode pad placement.

In order to obtain the best degree of pain relief with TENS, I recommend the following TENS pad placement guidelines:

1. Take note of exactly where your pain is located.  Outline the most concise and tender area of the pain.

2. Always use two pads (one channel) or four pads (two channels) at the same time depending upon the type of TENS unit that you have as it will not work with just one pad.

3. You can alter the flow of the electrical sensation if you change the distance between the electrode pads and/or the direction of the pads.

4. The pads can be placed in one of three directions 1. vertical   2. horizontal   3.  angulated.

5. The pads should never touch and should be at least, 1 inch apart. As the distance between the two pads increases the effectiveness decreases.

6. It is advisable not to place the pads directly over a joint such as the knee, elbow or ankle as its movement can alter the adherence of the pad.

Here’s some advice on which direction to place the pads:

7. When the pain extends across a significant distance of your body (e.g. low back to just above the back of the knee): Place one of the pads vertically at the top of the pain and the other pad vertically at the bottom of the pain. (see sciatic)

8. When the pain is more focused over a smaller area (e.g. calf pain): Place pads in parallel on each side of the pain. (see calf)

9. When the pain overlaps a joint (e.g. elbow pain): Place each pad on the muscle or soft tissue just above and below the joint in a horizontal and parallel direction. (see elbow)

10. When the pain is wide (e.g. between your shoulders below the neck): Place the pads to the left and right side of your spine in a vertical direction.  If pain extends out even further above or below the shoulder area, the pads can be angulated to encompass the region of discomfort. (For more details on pad placement, go to www.OmronPainRelief.com)

Jeffrey S. Mannheimer, P.T., Ph.D
Co author: Clinical TENS, F.A Davis, 1984

Tens Placement Guide