The best type of pain management treatment often depends on the condition you suffer from and whether you are looking for simple pain relief or needing to improve muscle tone. There are many types of non-invasive, simple and safe pain management treatments available today. TENS and EMS are two types of treatments used to improve the quality of life for pain sufferers. If you are trying to determine the difference between TENS vs EMS and which is the right treatment for you, here is a breakdown of the two options.

What Is TENS?

TENS is the acronym for transcutaneous electrical nerve stimulation. This battery-operated pain management device uses electrical currents to provide short-term pain relief. Many patients find TENS units effective in relieving back, foot and neck pain. TENS treatments are painless and have proven helpful in treating pain and diabetic neuropathy.

Using a TENS Unit

TENS creates a tingling sensation that blocks the pain signals by distracting the brain. Low voltage electrical currents travel from the TENS machine through the skin with the help of tiny electrodes. Electrodes should be placed about 2-3 inches from metal, including body piercings.

For back pain, TENS units are worn like belts around the waist and attached to two electrodes. The device has multiple settings and modes to control the strength of the electrical stimulation. The TENS devices can be programmed so that the therapy targets an individual’s needs.

Risks Associated with TENS

Most consumer TENS units are very low-risk pain management devices. Skin irritation is possible around where electrodes are placed, but this typically only occurs with over-use.

Patients with pacemakers and defibrillators or who are pregnant should not use TENS to treat pain. In addition, the treatment may not be as effective for patients suffering from sensory deficits. Users should not use TENS while sleeping, driving or showering.

Nerve Disorders

TENS units are designed to eliminate nerve pain and therefore are often the best choice for patients with nerve disorders. TENS may stimulate nerves enough to cause relaxation and decrease tension in some users. Physiotherapists and pain management specialists can often loan patients TENS units if they are considering trying this type of therapy for nerve disorders.

Pain Relief Effectiveness

TENS works differently for different people and is not for everybody. The American Academy of Neurology found the TENS ineffective for relieving chronic lower back pain. Another scientist argues that TENS are sensation-enhanced placebos and that the unit cannot really stop the brain from doing its job. Overall, it is most likely that TENS alone won’t help relieve back pain and there isn’t enough scientific evidence that suggests TENS is a reliable method of pain relief.

Despite the lack of research proving TENS effective, some researchers remain optimistic that some TENS are good medicine and can relieve the right kind of pain for some patients. They argue it is worth a shot if patients are desperate for pain relief. TENS may be especially worth trying for trigger points, or muscle knots because it’s a safe and inexpensive treatment option.

What Is EMS?

EMS is short for electronic muscle stimulator. EMS machines pass electric currents through muscles, enabling them to contract. These devices are most effective in initially strengthening and promoting growth in muscles. Pain relief is not the primary use of the EMS machine, but they can serve a pain management purpose. Both TENS and EMS devices use electrodes on the skin.

Using An EMS

Self-adhesive electrodes are placed on the skin, similar to a TENS unit. The EMS machine typically has different modalities in one compact device and operating them is quite easy. TENS vs EMS can be understood and thus used throughout the day as often as needed. The recommended use for EMS machines is one muscle group at a time and alternating muscle groups each day.

Muscle Strengthening Machine

EMS treatment causes muscles to contract by mimicking the signals that originate in the central nervous system. TENS, on the other hand, do not cause muscles to contract. EMS uses a stimulation cycle instead of micro-current pulses. This encourage muscles to grow and get stronger, making healing possible and decreasing inflammation. EMS machines are used to tone and retrain muscles rather than to relieve pain in the body.

The repetitive stimulation of weak muscles is the driving force behind EMS. EMS appears to be most effective when muscles are very weak, which is why many physical therapists utilize this electronic medical device for patients who need to re-learn how to use certain muscles. EMS machines have also been used for cosmetic muscle toning.

Risk Associated with EMS

Most EMS devices are used during physical therapy or rehabilitation under the supervision of professionals. Non-medical, nonprescription use of EMS devices may be dangerous, but the risks associated with medical use are low. Pregnant women and people with heart conditions or pacemakers should also not use EMS to treat pain or muscle spasms. There are no side effects to using EMS.

Treating Pain with EMS

EMS is used mostly for muscle tissue pain relief. Muscle fibers are charged by the EMS machine, and this causes them to contract and ultimately reduce pain caused by swelling. EMS machines are particularly useful in enhancing circulation in the back and neck. These areas are most susceptible to pressure after muscle loss.

EMS machines have been used to treat paralysis and patients with poor blood circulation. Physicians may order EMS treatment after surgery in order to prevent venous thrombosis in the lower legs. If you are on pain medication to treat muscle stiffness or spasms, EMS treatment may be the right choice.

If your pain is caused by muscle tension, EMS units can help more than a TENS unit. Exercising muscles without moving joints is an important component of using EMS. This makes it a popular choice for people who are in pain following surgery, injury or disease.

Tens vs Ems: Which Is Better for Pain

TENS and EMS are interrelated. Both are electrotherapies designed to relieve pain. Understanding the difference between TENS vs EMS is a crucial first step in determining which therapy is better suited to treat your pain. TENS has been a staple in pain management clinics for decades and is somewhat of an old-school therapy.

TENS units stimulate healing and the release of endorphins while also blocking pain signals to the brain. Pain patients who have experienced back, shoulder, neck or diabetic foot pain, will surely want to try TENS. Patients suffering from rheumatoid conditions, such as arthritis and fibromyalgia or from pain conditions associated with carpal tunnel, sciatica and cancer will benefit more from the TENS treatment too. Typically, patients with nerve pain will find the TENS unit more beneficial than the EMS.

Patients rehabbing an injury or looking to prevent atrophy as they heal will find EMS machines more helpful than TENS. EMS devices can be useful for preventing edema, which is one of the leading causes of muscle pain and loss of muscle function. Joint pain suffers may also see benefits from EMS because the device helps reduce inflammation and prevent joints from being dislocated by muscle strain. EMS machines are also better at increasing range of muscle motion. If you are trying to determine whether TENS vs EMS is right for you and your pain is mostly muscular, the EMS treatment is probably recommended.

In some cases, TENS and EMS may be used in combination to help relieve back, neck and foot pain. If a patient suffers from chronic nerve and muscle pain, the TENS vs EMS choice may be simple. There are combination units available for these unique situations. For example, a patient who is rehabbing an injury may need to strengthen their muscles but also suffer from pain as a result. Many patients find the best results using high performing TENS and EMS units in these cases.

Some chronic pain patients have found that understanding TENS vs EMS and using a combination provides the most extreme outcomes. These combination machines should only be used with the guidance of a physician or physical therapist. Once a patient is comfortable using TENS and EMS for pain therapy, the devices are easy to use at home on your own. The devices come with instructions and guidance and covered by most insurances with a prescription.


Both TENS and EMS stimulate nerves and both treatments are drug-free pain relief options. TENS stimulates sensory nerve endings, and EMS stimulates muscles. A good understanding of the cause of pain is required before choosing TENS vs EMS. TENS units have been around for decades, but the research on their effectiveness is mostly inconclusive. EMS devices are more proven in terms of their ability to relieve muscle spasms and increase the range of motion in patients with sustained injuries or illnesses.
Whether you are choosing a TENS, an EMS, or unit offering both capabilities, this non-invasive pain management therapy is a popular and safe option. It’s always wise to consult with your physician if you are unsure about either of these treatments and their effectiveness as it relates to your condition.