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Best TENS & EMS Units

Products Reviews of the Best TENS & EMS Machines for You

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Electrostimulation has earned a privileged place in medicine for being an effective method to improve the quality of life of people without using drugs, and especially for not generating any kind of side effects in its users. Thanks to it, it is possible to improve the health of the muscles, and also to alleviate all kinds of ailments.

The most valued aspect of electrotherapy is undoubtedly the fact that the sessions can be carried out anywhere and at any time, since devices have been developed with sufficient power to achieve effective electrostimulation, while maintaining a compact size and easy to carry.

What is a TENS Unit machine and What is Transcutaneous Electrical Nerve Stimulation for?

What is this?

It is a digital device capable of emitting low intensity and high frequency currents to influence the pain transmission mechanism in the nervous system. To do this, it sends electrical discharges successively, generating alterations in the production of pain neurotransmitters such as endogenous opioids, acetylcholine or serotonin, and in turn altering the neuroreceptors of these substances to slow them down, which results in a generalized relief and increases pain tolerance for a prolonged period of time.

What are they used for?

This type of electrotherapy is mainly used to make recovery processes from long-term injuries more pleasant, such as muscle or tendon rupture, as well as to alleviate ailments related to chronic pathologies of articular, bone, muscle or nerve origin. So you can use TENS to relieve pain in ailments such as:

  • Joint pain.
  • Muscle pain.
  • Tendinopathies.
  • Sprains.
  • Neuropathies.
  • Trigger points.

It should be noted that TENS electrotherapy has simply analgesic functions, which means that it will allow you to treat any pain as a symptom, but it does not have the quality of recovering from the injury that originates such pain. This is why it should be used as a complementary method within the recovery, but it will never replace the medical treatment that your trusted specialist has recommended.

How do they work?

The operation of TENS electrotherapy is quite simple. The device has at least one pair of electrodes; one positive and one negative. These must be positioned in such a way that the point of pain is in the middle of both, since the current will flow from one pole to the other.

Once you turn on the device you will feel a tingling sensation on the skin, which will be located in the area below and in the middle of the electrodes. This current will slowly penetrate until it reaches the nerve, and that is when the real work begins: the currents will first slow down the generation of pain neurotransmitters, and after a few minutes will begin to affect the nerve endings that receive them.

This is a process that will take from 5 to 10 minutes, and after that time you will begin to feel a progressive relief; first it will be slight and with the passing of the minutes it will increase until the pain stops completely, which can take between 20 and 30 minutes after starting the session.

  • 2-4 Hz: relaxing effect on the musculature. Ideal frequency to promote recovery after exercise and relieve pain after a demanding workout. It is also useful for undoing contractures.
  • 4-8 Hz: promotes endorphin secretion and therefore has an anesthetic effect. It is also useful for massaging muscles and increasing the pain threshold.
  • 8-12 Hz: improvement of local blood circulation and thus better tissue oxygenation, massage effect, reduction of metabolites and increased trophism.
  • 12-40 Hz: ideal for improving aerobic and endurance capacity as it exclusively affects slow muscle fibers.
  • 40-60 Hz: this frequency affects slow fibers, intermediate fibers and, to a lesser extent, fast fibers. It is perfect for increasing muscular endurance, oxygenation capacity and strength.
  • 60-80 Hz: muscle development and improved strength work by affecting intermediate and fast fibers.
  • 80-120 Hz: only fast fibers. Ideal for improving speed, strength and muscle power without feeling exhausted.

Health benefits, contraindications and side effects of TENS/EMS machines


Although both TENS and EMS have a main purpose, their regular use brings other benefits that will improve the user's quality of life. Among them we can highlight the following:

  • Increased pain threshold: it will increase the user's pain tolerance not only while using the device, but also after the sessions. In fact, it has been proven that regular use of TENS on a painful area will mean that the next time it is activated, the pain will be less intense even if it is not treated immediately.
  • Improves muscle endurance: fatigue is one of the main causes of injury in sports, and using EMS can help you reduce it by optimizing oxygen consumption in the muscles.
  • Prevents muscle injuries: regular EMS training helps maintain elasticity and proper muscle tone, especially in the elderly, which will greatly reduce the risk of injury.
  • Reduces muscle and joint weakness: weakness and tremors in hands and legs can be corrected thanks to the use of TENS, since this is a problem caused by weakened nerves.
  • Improves the recruitment of muscle fibers: every time we make an effort, the muscle needs a short period of time to activate its fibers. With EMS this reaction time is reduced, which can generate a slight improvement in performance in high intensity sports.
  • It avoids the use of drugs: without a doubt, its greatest benefit is the fact that you will not need to resort to any type of drug to relieve pain.


Although it is a widely supported method, it is not something that can be used by everyone and in all situations. There are several contraindications that should be seriously considered, such as the following:

  • Epilepsy: TENS currents may increase the risk of seizures in epileptic patients.
  • Cardiac pacemaker: it may cause damage or alterations in the functioning of the cardiac pacemaker, regardless of whether it is applied in an area far from the thorax.
  • Circulation disorders and problems: it is possible that the use of TENS may increase the formation of clots or generate changes in blood pressure.
  • Abdominal or inguinal hernias: it is not proven, but it is believed that these types of hernias may increase in size if exposed to TENS currents, or a contraction with EMS that is too intense may generate immediate pain.
  • Neurological disturbances: its use is not recommended in these conditions due to the risk of worsening the patient's condition, although this has not been fully proven.
  • Tendency to bleed: the vasodilatation generated by TENS or EMS currents may facilitate bleeding in people with this condition.
  • Skin irritation, burns or wounds: the patient may feel intense pain if electrotherapy is applied to an area with injured skin, especially with TENS:
  • Diseases affecting muscle metabolism, such as diabetes: its use is not 100% ruled out, but in case of diabetes or hypertension, it is better to consult a specialist.
  • High uric acid levels: this can cause renal damage and even reduce the effectiveness of electrotherapy treatment.

Side effects

Beyond the contraindications mentioned above, to date no side effects of any kind have been reported from the use of TENS and EMS electrotherapy. In fact, one of the great advantages of this therapy is the fact that it does not represent any risk to the patient's health, and avoids the use of analgesic drugs and drugs to relieve pain, which do not represent a risk to health in the long term.

However, there are other modalities of electrotherapy such as Iontophoresis, which can have side effects on users, such as the following:

  • Reddening.
  • Irritation.
  • Appearance of vesicles or even blisters in the exposed areas.
  • Burns and skin necrosis due to misapplication of the technique.

Types of Electrical Stimulation

Although TENS and EMS modalities are the most popular, electrotherapy has a wide range of options that go beyond these. Below, you will learn about the main types of electrotherapy that have been developed so far:

TENS currents

TENS: consists of applying galvanic currents by means of two or more electrodes with positive and negative poles. These currents are mainly used to alter pain transmission mechanisms and provide relief to the user, as well as a considerable increase in the pain threshold.

EMS NEMS currents

EMS/NEMS: consists of the application of electricity to stimulate the muscles, achieving a contraction in them that will allow them to be strengthened. It is a therapy with aesthetic purposes since it seeks muscle toning, although it can also have benefits such as a reduction in the risk of injury and an increase in resistance to fatigue.

Ionophoresis currents

Iontophoresis: consists of the application of active substances to the organism through the use of electricity, for which low intensity currents are used. This is mainly used for the localized application of drugs without having to use the oral route, although it is little used nowadays due to the risks and side effects involved.

Interpherential currents

Interpherential: like TENS, this modality is used to relieve intense pain caused by chronic pathologies such as osteoarthritis, or pain caused by trauma or postoperative processes. For this reason, currents of greater power and intensity are applied, so unlike TENS and EMS, this one does have slight side effects.

KOTZ currents

Kotz: directly attacks the irregular functioning of the muscle fibers, allows greater elongation and stimulation of the muscle structure and, as a curious fact, is used as a complementary treatment in case of urinary incontinence by placing intravaginal electrodes and applying this type of current.

FES currents

Functional Electrical Stimulation (FES): Uses small electrical impulses to activate specific muscles and nerves. These impulses trigger the desired function, such as contracting muscles to move a foot or lift an arm. FES is also used to block pain signals and restore or improve bodily functions, such as bowel and bladder control.


Microcurrent: utilizes micro-size, pulsating current to resonate with the body’s own bio-electrical exchanges that take place at the cellular level.When microcurrent is applied, it triggers impulses to facilitate a chemical reaction to activate the release of adenosine triphosphate (ATP) at the cellular level, which is used to facilitate wound or tissue healing.

Denervated currents

Denervated: Specific waveforms (square, triangular) are used for the rehabilitation of denervated muscle (loss of muscle function) where the individual stimulation impulses have a much longer duration compared to normal muscle stimulation programs. Thanks to electrical stimulation it is possible to maintain muscle tone and prevent muscle atrophy while awaiting motor nerve regrowth.

How to use a TENS Unit for pain relief?

A transcutaneous nerve stimulation device is quite simple to use. To relieve pain with it you must follow the steps that we will explain below:

  • Locate the point or area of pain as precisely as possible.
  • Now place the electrodes around that point or area, keeping in mind that the current will flow from one pole to the other. So if you have more than 2 electrodes, you should make sure that one is on the opposite side of the other, i.e., the other electrode is on the opposite side of the electrode. If you make a round to enclose the pain, one positive pole should go down and one up, and likewise one pole should go to the left and one to the right, so that the current from all four poles flows throughout the pain area.
  • Once you have correctly positioned the electrodes, start the program of your electro stimulator that best suits the pain you are suffering.
  • Now all you have to do is wait for the session to end. The relief will come after 10 minutes of use.

At this point, you may be wondering what is the correct intensity to use? This will essentially depend on the type of pain you have. Below, you will see a guide to the frequencies of a TENS device and its usefulness:

  • Frequency between 2Hz and 4Hz: endorphin release, relaxation and pain relief.
  • Frequency between 20Hz and 70Hz: nerve rehabilitation, reduction of tremors and muscle weakness.
  • Frequency between 80Hz and 100Hz: relief of severe pain, chronic pain in muscles and joints.
  • Frequency of 100Hz and above: as indicated by the physician.

What's the difference between TENS units and EMS machines?

While both are part of the electrotherapy modality family, TENS and EMS have many differences that might make you think they are complete opposites, mainly in the following aspects:

  • Sensations: while a TENS device works at a nervous level, generating a slight tingling in the skin, an EMS machine works at a muscular level, achieving a strong contraction of the muscle.
  • Effects: with TENS you can achieve relief from acute pain caused by a chronic pathology, such as osteoarthritis, or by an injury such as a sprain or contusion. EMS will stimulate your muscles to strengthen and tone them.
  • Utility: TENS is used for pain relief in recovery processes of muscle, nerve or joint injuries, while EMS has a purpose more focused on aesthetics with muscle toning, although it is also useful in rehabilitation processes to reactivate the muscles after a long-term injury.

F.A.Q: Frequently Asked Questions

How often can I use a TENS unit?

TENS machines can be used on a regular basis, so there is no impediment to having a session every time you feel pain. Although you should know that as you use this therapy, your pain threshold will increase, so you may reach a point where you feel pain, but you can tolerate it, so you will not need to use TENS so often.

How long should Electrical Muscle Stimulation be used?

Keep in mind that EMS is a therapy that follows the same principles as training in the gym, so it will be your own body that will tell you what your limit is. Just keep in mind that, in order to have positive effects, you must use the electrostimulation machine for at least 15 minutes for each part of the body you are training.

Are TENS machines safe?

The TENS electrotherapy devices that you will find on the market are perfectly safe, and comply with the necessary safety regulations to guarantee the user's well-being. As long as you take into account the contraindications above, there is no risk to your health.

Where should you not use a TENS unit?

Its use has become so popular that today we can see people in the office or at home applying electrotherapy to relieve pain, but, by common sense, there are several situations in which you should not use a TENS device. Some of these are:

  • During sports practice
  • While bathing
  • While dancing
  • During a nap
  • In the swimming pool
  • While running or jumping

Can I use a TENS unit if I have a pacemaker or defibrillator?

No, it is completely contraindicated to use TENS and any other form of electrotherapy in people with a pacemaker or defibrillator.

Can an Electrostimulation machine be used during pregnancy?

Yes, many pregnant women use them to relieve back pain during pregnancy, as well as contractions during childbirth. There are several studies that confirm that there is no risk for the development of the fetus, and it can be beneficial for the mother if used to stimulate the release of endorphins.

What does a TENS and EMS machine feel like?

It's all going to depend on the modality you use. TENS feels like a slight tingling on the skin that can be more or less intense depending on the frequency you use. On the other hand, EMS is more "aggressive" since it generates a clear muscular contraction similar to the one you feel when you make a muscular effort.

As the minutes pass, you will even feel your muscles burn, especially when you are closer to failure. It is important to know how to define the intensity of the training based on the size of the muscle, because if you apply too strong a current to a small muscle, you could injure it with a simple overload or even a tear.

Which electrostimulation machine should I buy?

It all depends on what you want to use it for. If you want a pain relief device that you can use to stop relying on drugs, then a TENS machine is best for you. But if instead you want a way to tone your muscles without leaving the house or going to the gym, then an EMS machine is best.

However, there are now devices that are mixed, and can deliver frequencies and currents that can be used for both TENS and EMS.

How much does a muscle electrostimulator cost?

Everything will depend on the quality of the product. Being such complex devices, it is likely that the cheapest ones are not the best option even though you can find them for less than $30. However, if you want equipment that meets basic safety standards, guarantees durability and correct stimulation, you have to sacrifice a little more money.

Is a prescription required to buy a TENS or EMS machine?

No. TENS and EMS electrostimulation devices do not require a prescription or a doctor's authorization. This type of document is requested when you wish to purchase more complex equipment for other forms of electrical stimulation such as iontophoresis.

Can a TENS unit help gain build muscle? What about EMS?

No, TENS has no such functions or capabilities. For this, the ideal is to use EMS as the constant contraction of the muscles allows to generate hypertrophy, a key process to stimulate muscle gain.

Can EMS and TENS be used at the same time?

No. It is important to use both therapies separately because, although they use similar frequencies, the current is different and applying both on the body at the same time can be risky and counterproductive to health.

Are the electrodes pads for electrical stimulation machines reusables?

Yes, but not all of them. In general, electrodes have a limit of use that is determined mainly by their materials. Each manufacturer states in its instruction manual how many sessions you can perform with each pad, as there are those that are reusable and others that are disposable.

Are all electrodes pads compatible with my TENS and EMS units?

There are "universal" models that are compatible with any unit, but there are also cases where manufacturers have their own brand of electrodes that are not compatible with others. All this will be specified in the instructions for use of your device.

How long do the electrodes pads usually last?

It all depends on the quality of the electrodes, but generally each electrode has a useful life of at least 25 or 30 uses. However, you should pay attention to the manufacturer's indications as there are brands that implement disposable electrodes.

When should I replace my electrodes pads?

When the maximum number of uses allowed by your manufacturer have been performed. Once the electrodes are worn out, you will notice that the quality of the current is not the same as in the first sessions. In addition, they may gradually lose their ability to stick to the skin, due to the accumulation of dirt and lint, and fall off during the sessions, making it more uncomfortable to apply each therapy.

How do I clean the electrodes pads?

This point also depends on your manufacturer. In our experience, it is best to use distilled water for cleaning, as this guarantees no damage to the tissues or other materials that make up the pad.