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How to use a TENS units & EMS machines for bursitis? Placement of electrode pads

The human body has a specialized design that allows it to have a fairly wide mobility, which can be increased with the appropriate exercises. For this purpose, the joints possess a certain cushioning property provided by certain membranes, which are called synovial bursae. However, these membranes can become damaged causing a condition known as bursitis.

This condition can lead to a series of symptoms that can be disabling, requiring a series of treatments to deal with both the disease itself and the ailments it causes. For the latter, one of the best options is electrotherapy in its TENS and EMS modalities, and below, we will show you how to apply these physiotherapy techniques for the relief of bursitis symptoms.

How to use TENS machines to relieve bursitis pain?

TENS electrotherapy is one of the most effective methods for treating the most painful symptoms of bursitis, so learning how to apply it correctly is crucial to be able to run an effective TENS session.

Below, we will teach you the correct positioning for the TENS electrode pads, and how to set up the TENS unit to apply the therapy correctly.

Where to place the electrodes?

The optimal positioning of the pads for bursitis treatment will depend largely on the type of ailment and the area affected. So the ideal locations can be summarized in the following list.

  • Shoulder: over the trapezius muscle and the deltoids, to maximize the interaction of the impulses with the circumflex and supraclavicular nerve.
  • Elbow: in this area, the electrodes are placed on the medial head of the triceps brachii and the anterior brachialis muscle, allowing a direct effect on the ulnar nerve.
  • Hip: on the tensor fascia lata muscle, in position to interact with the obturator and lesser abdominogenital nerves.
  • Wrist: the electrodes will be positioned over the anterior brachial muscle and the palmaris minor, exerting their effect on the extension of the median nerve.
  • Knee: bursitis ailments can be treated by positioning the electrodes over the rectus femoris and tibialis anterior muscles, to interact with the vastus medialis nerve.

Which current to use?

The level of pain that can be caused by bursitis can be highly variable, so the intensity should be adjusted to the level of pain and the type of ailment present in the joint. This adjustment is mainly due to the difference between acute bursitis and chronic bursitis.

Bursitis responds better to higher frequencies, in the range of 90 and 120 Hz, which leads to a faster release of endorphins and a more aggressive interaction with the nerve endings in the affected regions, thus providing a sense of relief for the patient that makes the treatment of the disorder more tolerant.

On the other hand, chronic bursitis requires a much lower frequency and for longer periods of time. The ideal frequency ranges from 2 to 10 Hz, and is applied for periods long enough to stimulate a more controlled release of endorphins and to ensure that the nerve endings are not overstimulated. This promotes a sense of relief in chronic patients that can last for hours after the session.

Best TENS units to treat bursal inflammation

The effectiveness of TENS electrotherapy for the treatment of ailments associated with bursitis is so high that it is possible to purchase a wide variety of equipment with different configurations that can relieve the painful symptoms of this disorder. Among the most effective TENS units for this purpose, we can highlight the following:

iReliev - Rechargeable TENS and EMS unit with 24 modes large display and 6 electrode pads
  • Type: Combo
  • Channels: Dual
  • Modes/Programs: 14 Modes
  • Intensity: 25 Levels
  • Wireless: Yes
  • Heat Therapy: No
  • Battery: Rechargeable Lithium
  • Electrodes: 6 Pads
  • Display: Digital
  • Size: Not specified
  • Portable and small size
  • Includes carrying bag
  • Rechargeable battery
  • Includes user manual
  • Accelerates recovery from sports injuries
  • Does not specify measurements and weight
  • Battery life not specified
  • Does not include touch screen
The iReliev electrostimulator is one of the most practical and complete options for the treatment of ailments and physical conditioning, since it combines in its compact size the most advanced TENS and EMS technology, making it the number one option for the relief of ailments of any kind, thanks to the 14 predefined treatment programs available.

The compact size of the device makes it incredibly practical and easy to carry, so you can use it anywhere you like quickly and discreetly. It is FDA approved, so it is completely safe to use, and its LCD screen gives you a full display of all settings so you can easily adjust your requirements.

Belifu - Dual channel electromuscular stimulator with 24 modes and 10 electrode pads
  • Type: TENS
  • Channels: Dual
  • Modes/Programs: 24 Modes
  • Intensity: 20 Levels
  • Wireless: Yes
  • Heat Therapy: No
  • Battery: Rechargeable Lithium (up to 20 hours)
  • Electrodes: 10 Pads
  • Display: Touch
  • Size: 5.12" x 2.56" x 0.39" - 0.35 lbs
  • Portable and small size
  • Includes carrying bag
  • Long battery life (up to 20 hours)
  • Accelerates recovery from sports injuries
  • Reduces pain symptoms
  • Not for muscle hypertrophy
  • Does not include user manual
  • No heat therapy
The Belifu muscle stimulator is the perfect combination of TENS and EMS electrostimulation modalities, through which you can apply massages to relieve pain in a natural way, as well as generate muscle contractions that increase the size, strength and tone of the muscle, all in a completely safe and natural way, stimulating the body's natural processes.

It has 24 modes of use and 20 intensity levels that can be applied in isolation to each of the device's channels thanks to its dual channel function, allowing different therapies to be applied to separate areas of the body. In addition, it has a session timer mode and automatic shut-off that will allow you to give greater efficiency to your sessions and make better use of the energy of its high-capacity lithium battery.

Med-Fit - 4 channels stimulator with 8 electrodes pads for pain relief fully rechargeable
  • Type: TENS
  • Channels: 4
  • Modes: 24 Programs
  • Intensity: Not specified
  • Wireless: No
  • Heat therapy: No
  • Battery: Rechargeable
  • Electrodes: 8 Pads
  • Display: LCD
  • Size: Not specified
  • 4 independent channels
  • Provides cramp relief
  • Portable Device
  • Promotes tissue healing
  • 24 programs
  • Few electrodes
  • Does not specify battery life
  • Does not specify intensity and size
The Med-Fit model BAL-906ª is a very complete rechargeable electrostimulation device of premium quality that has an incredible function of 4 individual channels that will give you a great coverage and a perfect effectiveness when applying different electrical massages simultaneously. It also has a large LCD screen that makes it especially easy to operate, so you can program your sessions with great ease.

It has 24 clinically proven massage programs, which are divided into 12 TENS therapy programs and 12 muscle stimulation training modes. It has a long-life rechargeable lithium battery that will give you a great autonomy of several hours of continuous use, eliminating the extra cost of buying replacement cylindrical batteries.

SPACEREST - 4-channel rechargeable Tens unit with 24 modes and 24 reusable electrode pads
  • Type: TENS
  • Channels: 4
  • Modes: 24 Modes
  • Intensity: 20 Levels
  • Wireless: No
  • Heat therapy: No
  • Battery: Rechargeable (10 hours of use)
  • Electrodes: 24 Pads
  • Display: Digital
  • Size: Not specified
  • 4 outputs with 2 separate channel configurations
  • Includes 24 different pads
  • Rechargeable battery
  • Large display
  • 24 massage modes with 20 intensity levels
  • No adapter for non-US plugs
  • No size specified
Spacerest offers its users its newest model of electro stimulator that combines TENS and EMS technologies in a dynamic and compact device that includes 24 reusable electrodes of excellent quality and an incredible 4-channel function that will allow you to apply different modes of use to 4 different areas of the body, or even to 4 different people.

It has an incredibly portable size that will allow you to take it anywhere, and a high-powered rechargeable battery that will give you up to 20 hours of continuous use. It can be connected to AC power through its AC adapter, or to an external battery or laptop through its USB charging port.

Irest Classic - Mini massager dual channel TENS unit with 6 massage modes and timer
  • Type: TENS
  • Channels: 2
  • Modes/Programs: 6 Programs
  • Intensity: Not specified
  • Wireless: No
  • Heat Therapy: No
  • Battery: Rechargeable Lithium (up to 20 hours)
  • Electrodes: 8 electrodes
  • Display: Digital
  • Size: Not specified
  • Includes user manual
  • Accelerates recovery from sports injuries
  • Portable and small size
  • Long battery life (up to 20 hours)
  • Includes carrying bag
  • No intensity levels specified
  • No heat therapy
  • Does not specify dimensions and weight
The compact electrostimulator of the iRest brand offers a combination of electrostimulation modalities, combining the benefits of TENS and EMS therapy, providing its users with a safe and drug-free method to treat ailments caused by different injuries or diseases, through the application of low-intensity electrical impulses.

It has 6 modes of use that emulate different types of massages to achieve different objectives, along with 10 levels of intensity that provides greater effectiveness. The package includes 1 control, 2 large electrodes, 2 small electrodes, 2 guide cables, 1 user's manual, 1 cable case and 1 treatment guide.

How to use EMS electrostimulators to strengthen muscles and prevent bursitis?

Although the shocks applied by EMS devices are not effective in treating the symptoms of bursitis, their use can be quite helpful in strengthening the muscles of the joints.

To this end, we will show you below the most effective electrode positioning, along with the proper configuration for muscle training.

Where to place the electrodes?

To obtain the best results in the prevention of bursitis, muscle strengthening of the joints is crucial, since it allows to reduce to a certain extent the direct stress on the synovial bursae, preventing their inflammation. For this purpose, the correct locations of the electrodes are as follows.

  • Shoulders: the trapezius muscle, the anterior, lateral and posterior deltoids, and the infraspinatus muscle.
  • Elbows: in this case, the electrodes are placed on the biceps brachii, the anterior brachialis muscle and the biceps brachii muscle.
  • Wrist: the ideal positions are the brachioradialis muscle and the deep flexor.
  • Knees: in the case of the knees, the electrodes will be positioned on the vastus medialis, rectus femoris and tibialis anterior muscle.
  • Hip: tensor fascia lata, gluteus maximus muscle and gluteus medius muscle

What intensity to use?

The best way to achieve a progressive development in the strength of the muscle groups that are responsible for stabilizing the joints is through the application of a medium intensity electric current that activates the muscles without putting stress on the joints themselves.

To achieve this, the ideal frequency ranges between 65 and 85 Hz in periods of between 40 and 70 minutes, with the variables established by the specialist to ensure that the joints receive less stress when they are being used, thus preventing injuries and joint diseases.

Best EMS machines to prevent synovial bursa inflammation

The use of EMS training therapy for muscles can bring a number of indirect benefits for the prevention of disorders such as bursitis, thanks to the reinforcement of muscle support of the joints. For this purpose, we can make use of the following models of EMS devices:

TechCare - Dual channel TENS & EMS device includes 24 modes and 8 electrodes with touchscreen display
  • Type: Combo
  • Channels: Dual
  • Modes/Programs: 24 Modes
  • Intensity: Not specified
  • Wireless: Yes
  • Heat Therapy: No
  • Battery: Rechargeable Lithium (up to 20 hours)
  • Electrodes: 8 Pads
  • Display: Touch
  • Size: Not specified
  • Includes user manual
  • Long battery life (up to 20 hours)
  • Portable and small size
  • TENS+EMS Combo
  • Reduces pain symptoms
  • Does not specify intensity levels
  • Does not specify measurements and weight
  • Does not include carrying bag
This multifunction electrotherapy device is one of the most complete and versatile electro stimulators you will find. Brought to light by TechCare Massage, this device combines the most commonly used electrostimulation technologies to treat different types of ailments. The TENS and EMS technologies allow you to relieve acute and chronic ailments, deep muscle pain and promote the rehabilitation and regeneration of muscle fibers.

It includes 24 massage programs in total, which are designed to treat a wide variety of ailments. Each of the modes has 4 different options to choose from, and comes with all the accessories you may need, from electrodes and guide wires to a user guide and an electrode positioning guide.

Conree - Dual Channel TENS & EMS Combo for Pain Relief Therapy with Hard Travel Case
  • Type: Combo
  • Channels: Dual
  • Modes/Programs: 12 Modes
  • Intensity: 30 Levels
  • Wireless: Yes
  • Heat Therapy: No
  • Battery: Batteries
  • Electrodes: 16 Pads
  • Display: Digital
  • Size: Not specified
  • Includes carrying bag
  • Improves blood circulation
  • Portable and small size
  • Improves joint mobility
  • TENS+EMS Combo
  • No battery type specified
  • No heat therapy
  • Does not specify size and weight
The Conree electrostimulation machine was created for one specific use: symptomatic relief of chronic pain and temporary relief of aches and pains associated with exhaustion and muscle injuries in the arms, shoulders, neck, back, waist and legs due to strain caused by exercise or heavy work.

It offers a professional solution through its 12 massage modalities with 30 intensity levels, which you can easily adjust to adapt the therapy to your needs. Additionally, its dual channel function allows you to apply different modalities on the A and B channels of the stimulator, allowing you to treat two different areas of the body, or even two different people, simultaneously.

StimChoice - 4-channel TENS machine for back and neck pain relief and muscle recovery
  • Type: Combo
  • Channels: 4
  • Modes: 4 Programs
  • Intensity: Not specified
  • Wireless: No
  • Heat therapy: No
  • Battery: 3 AA
  • Electrodes: 8 Pads
  • Display: LCD
  • Size: 6.25 x 2.25 x 0.80 inches
  • Offers relief from cramps
  • TENS + EMS
  • Portable Device
  • Easy to use
  • Includes carrying bag
  • Few modes/programs
  • No rechargeable battery
  • No intensity specified
The StimChoice 4000 is a powerful portable electrostimulation unit that will help you provide immediate relief for various types of ailments thanks to its multiple TENS therapy modes. In addition, it includes an EMS training program, through which you can get more out of your exercise routines, while facilitating muscle recovery.

It has a versatile 4-channel function that allows you to apply individual massage programs to different areas of the body simultaneously, includes 4 modes of professional massage therapy, divided into TENS, EMS, Rehabilitation and Fitness, making it the ideal complement to maximize the results of your workouts.

Compex Performance 2.0 - Combo TENS/EMS muscle stimulation machine with 12 electrodes pads & 6 programs
  • Type: Combo
  • Channels: 4
  • Modes/Programs: 6 Programs
  • Intensity: Not specified
  • Wireless: No
  • Heat Therapy: No
  • Battery: Rechargeable
  • Electrodes: 12 electrodes
  • Display: Digital
  • Size: 5.38" x 3.75" x 1"
  • Improves blood circulation
  • Prevents muscle atrophy
  • Rechargeable battery
  • Good quality
  • Reduces pain symptoms
  • Does not specify intensity levels
  • No heat therapy
  • No weight specified
The Compex brand has one of the best electrostimulation machines available on the market. It is the versatile Compex Performance, which comes in a very complete kit with all the complements you may need to apply an efficient electrostimulation therapy. It includes 12 clip-type electrodes pads, guide wires, battery, 1 carrying bag and 1 user's guide.

It also has 5 programs of use focused on different branches of physical conditioning: endurance, resistance, strength, active recovery and warm-up. Proper use of this device will allow you to reach your maximum performance with very little cardiovascular fatigue, and is highly recommended for fitness enthusiasts who frequently engage in competitions.

PowerDot 2.0 - App-controlled wireless TENS & EMS smart device (black model)
  • Type: Combo
  • Channels: -
  • Modes/Programs: 15 Programs
  • Intensity: Not specified
  • Wireless: Yes
  • Heat Therapy: No
  • Battery: Rechargeable Lithium
  • Electrodes: 4 Pads
  • Display: No display
  • Size: Not specified
  • TENS+EMS Combo
  • Control from mobile app
  • Reduces pain symptoms
  • Includes user manual
  • Rechargeable battery
  • Does not specify dimensions and weight
  • Battery life not specified
  • Does not specify intensity levels
This surprising and revolutionary electro stimulator from PowerDot presents one of the most comfortable and complete designs on the market. It is the PowerDot 2.0, an electrostimulation device designed to work by means of a convenient and simple mobile application, available for Android and iPhone mobiles. Its design and functionality is aimed at muscle recovery and pain relief through the application of electrical impulses to the nerves in the affected area.

With more than 400 modes of use and a variety of intensity levels, the PowerDot 2.0 is one of the most complete electro stimulators available, as its functions focus on muscle recovery, improved physical performance, and pain relief. All these features make it the leading choice for the immediate treatment of any pain, whether caused by injury or illness.

Video: How to place electrodes pads for bursitis?

Electrodes for shoulder

Electrodes for shoulder
Electrodes for shoulder
Electrodes for shoulder

Electrodes for elbow

Electrodes for elbow
Electrodes for elbow

Electrodes for wrist

Electrodes for wrist

Electrodes for knee

Electrodes for knee
Electrodes for knee
Electrodes for knee

Electrodes for ankle

Electrodes for ankle
Electrodes for ankle

More types of EMS electrostimulators and TENS machines you should know about

What is bursitis and what are the causes?

It is a particularly painful disorder that consists of inflammation of the synovial bursae, which are small fluid-filled sacs that provide cushioning to the joints at the bone and muscle level. It is a very common ailment in areas such as the shoulder, elbow and hip, although the knee is also particularly vulnerable, as is the base of the big toe.

There is a considerable list of causes for bursitis, among which we can highlight the following:

  • Previous diseases such as arthritis or gout.
  • Repetitive movements that put stress on the joint.
  • Excessive pressure on the joints for long periods of time.
  • Injuries and trauma to the joint.
  • Different types of infections can affect the joints and lead to cases of bursitis.

In addition to the direct causes, there are certain risk factors that play an important role in the likelihood of developing bursitis. Among these, we can highlight the following:

  • Age: people over 45 years old have a higher risk of suffering bursitis.
  • Works or hobbies: especially those that require repetitive and demanding movements in elbows and knees.
  • Medical history: since certain disorders such as diabetes may increase the risk of developing bursitis.

What are the most common types of bursitis?

There are two main ways in which bursitis can be classified. The first is governed by the length of time the condition lasts, while the second is based on its location.

In the first classification we can find:

  • Acute bursitis, where pain and inflammation manifest suddenly and abruptly. This classification lasts for a maximum period of three weeks.
  • Chronic bursitis, in which the pain has persisted for a period of more than three weeks.

The second classification, for its part, is organized as follows:

  • Shoulder
  • Hip
  • Knee
  • Elbow
  • Wrist

Differences between TENS and EMS: Which is better for treating bursitis?

One of the most prominent symptoms of bursitis is the pain it can cause in the patient's joints. This is one of the first problems that must be addressed when dealing with this disease. For this, one of the best options is electrotherapy, however, it is necessary to take into account the distinctions between TENS and EMS therapy in order to be able to obtain the desired effects.

Transcutaneous Electrical Nerve Stimulation, or TENS for its initials in English, is a physiotherapy technique focused on the relief of ailments, which can be identified by the following characteristics:

  • Interacts directly with the nerve endings of the affected area.
  • It applies low intensity electrical currents, in the range of 1 to 250 Hz.
  • It is a therapy for the treatment of symptoms, so it does not replace the treatment for the disorder that causes the symptoms.
  • Its usefulness for the treatment of bursitis lies in its ability to numb the nerves that cause the sensation of pain in the joint.

EMS, or Electro Muscle Stimulation, is a physical training method aimed at improving muscle condition, distinguishable by the following properties:

  • It applies electrical impulses with varying intensity between 70 and 150 Hz.
  • It focuses on physical conditioning through muscle contractions.
  • It is a widely applied method for muscular rehabilitation in highly competitive sports.
  • It is not a treatment for painful injuries.

With this said, the best option for the relief of pain caused by bursitis in any of its forms is Transcutaneous Electrical Nerve Stimulation. Thanks to its direct effect on the nociceptors in the nerve branches of the different joints, which blocks the pain impulses preventing them from reaching the brain, thus numbing the sensation for the patient, generating relief of variable duration.

On the other hand, EMS is not a recommended therapy for the treatment of bursitis, because its electrical discharges are designed to interact with muscle tissue. This effect is foreign to the internal structure of the joints, so muscle contractions will not have a favorable effect in relieving pain caused by bursitis.

Contraindications to the use of electrodes and electrotherapy

Contraindications for electrode placement

The placement of the electrodes is of utmost importance in electrotherapy, whether TENS or EMS, so here are some things to keep in mind before starting a session:

  • Symmetrical placement: the negative and positive poles of each electrode should be connected symmetrically. That is to say, if we use two pads, we should use one positive and one negative pole in each one, while if we use four, the equivalence should be two positive and two negative.
  • Do not cross the electrodes: you cannot use one electrode in the lower train and another in the upper train and more importantly, never cross the electrodes from the left side to the right side of the body and vice versa, since the current path can negatively affect the patient's health. For this reason it is always recommended to use the electrodes in a localized way.
  • Motor point: at least one of the electrodes, whether positive or negative, must be positioned over the motor point, which is the point where the greatest force is achieved in the muscle in question.
  • Control the intensity: the size of the muscle must be taken into account when choosing the intensity of the current, since the less volume and size the muscle has, the lower the tolerated intensity will be.
  • Be careful with the skin: EMS or TENS should not be used on recently depilated areas since the pores will be open and this could generate skin sensitivity. Do not use on irritated or reddened areas, open wounds or recent scars.

Contraindications for the use of electrostimulation

Being a therapy that applies currents to the body, it cannot be used for all conditions, therefore its use should be avoided in cases where the user suffers from the following conditions:

  • Epilepsy.
  • Cardiac pacemakers.
  • Circulation disorders and problems.
  • Abdominal or inguinal hernias.
  • Neurological disturbances.
  • Tendency to bleed.
  • Skin irritation, burns or wounds.
  • Diseases that affect muscle metabolism, such as diabetes.
  • Metabolic syndrome (diabetes, hypertension and obesity).
  • High uric acid levels.
  • Metabolic disorders and metabolic pathologies.
  • Inflammatory pathologies.

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