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.
- Mult Scler Relat Disord. 2015 May;4(3):219-27 Summary Systematic review of efficacy of TENS for management of central pain in people with multiple sclerosis.
- Clin Rehabil. 2018 Jun;32(6):713-721 Summary A mixed treatment comparison on efficacy and safety of treatments for spasticity caused by multiple sclerosis: a systematic review and network meta-analysis.
- Neurorehabilitation and Neural Repair 2010;24(5):420-427. Summary Long-term TENS treatment improves tactile sensitivity in MS patients.
- Clinical Journal of Pain 2009;25(4):281-285. Summary Sensory complaints of the upper extremities in multiple sclerosis: Relative efficacy of nortriptyline and transcutaneous electrical nerve stimulation.
- Multiple Sclerosis 2007;13(4):527-533. Summary The effects of transcutaneous electrical nerve stimulation (TENS) on spasticity in multiple sclerosis.
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.
Pelvic floor training and electrical stimulation
5 April 2016
Find out more about research investigating how effective electrical stimulation treatments are for bladder symptoms in women with MS already doing pelvic floor training.
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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