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Transcutaneous electrical nerve stimulation (TENS)

Transcutaneous electrical nerve stimulation (TENS) is the application of a small electric current. It can be used in the management of some types of pain in multiple sclerosis, such as:

  • dysasthetic extremity pain or central pain - burning, tingling or shooting pains where there is no obvious reason
  • back pain - often caused by reduced mobility, poor posture and the use of wheelchairs and other aids;
  • spasticity and painful leg spasms, where anti-spasmodic medications are not tolerated.

TENS can reduce pain in the short-term but does not get rid of the pain or the underlying problem permanently. Often TENS is something that needs to be used on a long-term basis, but it can improve quality of life and reduce the need to take pain medications.

How TENS works

A TENS machine is a small battery operated unit that delivers a small current through electrically conductive pads that are applied to the skin. A buzzing, prickling or tingling sensation is felt when the TENS machine is switched on. It is portable and should not restrict a person's activity in any way except when showering, swimming and in some instances, when driving. The skin is not pierced or broken by a TENS machine. 

TENS machines typically have two modes:

  • a continuous mode, which produces a continuous tingling sensation
  • a burst mode (also known as acupuncture TENS) in which a pulsing sensation is experienced.

You can buy TENS machines from high street chemists, but ideally you should have the proper use of a TENS machine demonstrated by a trained healthcare professional before you buy one. That way you will be able to to determine its suitability for you, and get the most benefit from using it. The healthcare professional will be able to advise on the most appropriate settings to use for the type of pain you experience, as well as the best position for the pads.

Many pain clinics, physiotherapy departments and some GP surgeries have machines that can be borrowed or hired to determine whether TENS works for you before buying your own machine.

References

  • Sawant A, et al. Systematic review of efficacy of TENS for management of central pain in people with multiple sclerosis. Mult Scler Relat Disord. 2015 May;4(3):219-27 Summary
  • Fu X, et al. A mixed treatment comparison on efficacy and safety of treatments for spasticity caused by multiple sclerosis: a systematic review and network meta-analysis. Clin Rehabil. 2018 Jun;32(6):713-721 Summary
  • Cuypers K, et al. Long-term TENS treatment improves tactile sensitivity in MS patients. Neurorehabilitation and Neural Repair 2010;24(5):420-427. Summary
  • Chitsaz A, et al. Sensory complaints of the upper extremities in multiple sclerosis: Relative efficacy of nortriptyline and transcutaneous electrical nerve stimulation. Clinical Journal of Pain 2009;25(4):281-285. Summary
  • Miller L, et al. The effects of transcutaneous electrical nerve stimulation (TENS) on spasticity in multiple sclerosis. Multiple Sclerosis 2007;13(4):527-533. Summary
Pain

Pain

The two main types of pain in multiple sclerosis are nerve (neuropathic) pain and musculoskeletal (nociceptive) pain. Find out more about pain in this A-Z entry.

Spasticity and spasms

Spasticity and spasms

Spasticity is a symptom of MS where the muscles feel stiff, heavy and difficult to move. A spasm is a sudden stiffening of a muscle.

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