Electrotherapy for Chronic Pain

Electrotherapy has been used to treat a range of chronic pain conditions, including chronic neck pain, low back pain, and diabetic nerve pain.1,2,3 It uses mild electric current transmitted through the skin and is believed to block pain signals.

Transcutaneous Electric Nerve Stimulation (TENS) Therapy

Generally, TENS therapy delivers current through electrodes on small, sticky pads attached via wires to a battery-operated device. When the electrodes are placed over the area in pain, a tingly feeling is created that lessens the intensity of pain. It does this by stimulating sensory nerves. TENS therapy is self-controlled through a hand-held device that can adjust the level of current.

Recently, many TENS products have been marketed as wearable, meaning the device can be strapped to a part of the body, such as the leg, back, shoulder, or knee. These devices work similarly to a larger TENS unit and are typically not visible under clothing.


Percutaneous Electric Nerve Stimulation (PENS) Therapy

PENS therapy uses thin needle electrodes that pierce the skin and get closer to nerve endings or muscle than TENS therapy. It is often recommended if TENS therapy has not been successful.

PENS therapy is likely to be used first by a doctor or health care practitioner but can also be done at home. While some people see improvements immediately, others may require multiple sessions.

PENS therapy is often advised to help with diabetic peripheral neuropathy.4

Pulse Electromagnetic Field Stimulation (PEMF) Therapy

PEMF therapy uses short bursts of low-level electromagnetic fields to promote bone healing and fusion, and can relieve continuing leg or back pain following back surgery.5 PEMF has also shown promising results in the treatment of fibromyalgia and osteoarthritis.5

PEMF therapy can be accessed through a professional, such as a physical therapist or chiropractor, or the devices can be purchased for at-home use. Most devices on the market are FDA-approved wellness devices, although it is recommended to speak with a doctor before use.


The extent of pain relief achieved with electrotherapy varies widely, depending on the person and injury. Electrotherapy generally has minor side effects, such as bruising or soreness in the area being treated.


  • 1.Kroeling P, Gross A, Graham N, et al. Electrotherapy for neck pain. Cochrane Database Syst Rev. 2013;(8):CD004251.
  • 2.Johnson M, Martinson M. Efficacy of electrical nerve stimulation for chronic musculoskeletal pain: a meta-analysis of randomized controlled trials. Pain. 2007;130:157-165.
  • 3.Jin DM, Yun X, Deng-Feng G, Tie-bin Y. Effect of transcutaneous electrical nerve stimulation on symptomatic diabetic peripheral neuropathy: a meta-analysis of randomized controlled trials. Diabetes Res Clin Pract. 2010;89:10-15 as cited in AAN Summary of Evidence-based Guideline for patients and their families: Therapies for Treating Diabetic Nerve Pain. American Academy of Neurology, 2011.
  • 4.Bril V, England JD, Franklin GM, et al. Evidence-based guideline: treatment of painful diabetic neuropathy--report of the American Association of Neuromuscular and Electrodiagnostic Medicine, the American Academy of Neurology, and the American Academy of Physical Medicine & Rehabilitation. Muscle Nerve. 2011;43(6):910-7.
  • 5.Thomas AW, Graham K, Prato FS, et al. A randomized, double-blind, placebo-controlled clinical trial using a low-frequency magnetic field in the treatment of musculoskeletal chronic pain. Pain Research & Management : The Journal of the Canadian Pain Society. 2007;12(4):249-258.