Understanding TENS electrode placement for maximising pain relief

Tuesday December 20, 2011

Today I wanted to talk a little about the correct placements for TENS electrodes. For TENS pain management, there really are no "right or wrong" locations for the placement of the two electrodes.

Everyone has their own individual experience of pain, so we always recommend you try a number of options to discover what's most effective electrode placement for your needs. Also remember, over time, your needs may change.

Later, I'll outline some principles governing TENS electrode placement and a number of different recommended options for you to try.

For now I want to expand on my earlier comments with regards to "right or wrong" and experimentation.

Just to give a little background and set this up

I've been a user of our TENS products since almost the day I began working for physiotherapist and TENS creator, Jim Lamers, almost 16 years ago at the young age of 17 (they say sport is good for you!! Haha).

I'm 33 now and have a bad back, neck, shoulders and knees... Yeah, I know, complain complain. ;)

So being the good son, a few weeks back on a sunny Saturday afternoon I helped my Dad move 9 cubic metres of soil. Can you see where this is going?

Needless to say I was sore on Sunday. Monday I woke up unable to move with pain all over, but none compared to the excruciating pain in my lower back.

My lovely wife was kind enough get to my SportsMed and put it on. It oddly took quite a few hours but I slowly regained some movement - but it just wasn't helping as much as I knew it could.

So I decided, as I debated earlier and declined (!!), to move the electrodes down. I'd say they came down the spine around 1 inch. That's all. In half an hour I had far more movement and less pain than I'd had all day, just by finding what was in this situation, the "right" spot.

TENS is not a miracle cure but it sometimes feels like one. So the moral of the story here is, if you don't find you're getting relief after an hour or two using an ActivLife TENS machine, you probably need to try another position for the electrodes. It could be slightly up, down, left right, etc..

The honest truth is, its not complicated - no matter how much some would like to convice you otherwise. You just need to find the right spot for you.

Now on to the 'principles'.

First - in case you may not have seen them (they're new), we have pages devoted to each of the most common causes of chronic pain. Each page has photographs, diagrams and/or further explanations of recommended TENS electrode locations. We hope to add video in 2012 to really help our customers out.

Here's an example - one of my 'favourites' - the very enjoyable sciatica. Anyone who experiences sciatic pain knows what I mean. So this is how to place TENS electrodes for sciatica. Enjoy.

Principles of TENS Electrode Placement

I'll dot point this first part.

Its always best to maintain a gap of at least 2 cm between electrodes to avoid any possible damage to your control unit
Choose either the site of the pain for stimulation of specific targeted sensory nerves; OR
Choose locations that will provide the best access to major sensory nerve gatherings such as ankles, wrists, the sacroiliac joint or the nape of the neck. This will result in many sensory nerves being stimulated simultaneously and ensure you gain the maximum therapeutic benefit.
Where possible, choose locations that aren't directly over major muscles. Otherwise you may trigger the moterpoint of the muscle causing unnecessary muscle twitching and possible discomfort.

Option 1

Place electrodes at the site of the pain; for example:

For neck pain, place an electrode either side of the spine, at the level of the nape (or base) of the neck and approximately 2cm from the spinal column. The Butterfly Dual Electrode is excellent for this application. I'm in love with these new electrodes.

Option 2

Stimulate areas of maximum sensory feeling such as limb extremities or acupoints;

For example:

For lower leg pain, place an electrode on each ankle
For tension headache, place an electrode on each earlobe

Combination 1 and 2

Some people like to combine options 1 and 2 by placing one electrode at the site of the pain and the other electrode at a sensory point on the same side of the body;

For example:

For pain in the buttocks or upper leg, place one electrode horizontally across the spine and the other electrode on the back of the leg, just above the knee. This is one option for treating sciatica.