By MaryAnn DePietro CRT
Acute and chronic pain are very common complaints among adults. According to the CDC, about 23% of people experience chronic pain at some point in their lifetime.
Treating pain sometimes takes a multifaceted approach. One excellent non-pharmaceutical option for pain management involves using electrical stimulation (e-stim).
Various forms of e-stim, such as TENS, EMS, and e-stim for massage (E-massage), are popular noninvasive pain relief methods. The risks are typically minimal, reducing the necessity of potentially harmful drugs.
The article below provides an overview of TENS vs EMS vs massage, including:
The differences
The benefits
And when to use each.
On the surface, these devices may appear the same. However, the type of stimulation they deliver is different. Knowing the differences between these three can help determine which is ideal for your pain and overall goals.
TENS works by sending low-voltage electrical currents through the skin to the nerves. Nerve stimulation causes physiological changes, which reduce pain. Users can adjust various settings, such as the mode, to target their treatment.
TENS mechanism of action includes:
Gate Control Theory: This theory suggests that pain signals can be blocked from being sent to the brain by stimulating non-painful nerve fibers. Experts refer to this as "closing the gate." TENS restricts or limits pain signals from traveling to the brain, decreasing pain perception.
Endorphin Release: TENS may also stimulate the release of certain neurotransmitters, such as endorphins, in the brain and nervous system. Endorphins act as natural painkillers in the body.
Scientific research supports the use of TENS for pain reduction. A study in the Journal of Clinical Medicine examined TENS therapy. It focused on how safe and effective TENS therapy is for managing pain after surgery.
The review included an analysis of 40 articles involving controlled clinical trials. The results indicated a decrease in morphine requirement for those utilizing TENS therapy. This suggests that TENS has the potential for pain control and improved postoperative recovery.
Some key features of TENS include:
Focus: The primary focus of TENS is pain relief, both acute and chronic.
Sensation: People often describe the sensation of TENS as buzzing or tingling, but not painful.
Current: The current is usually a lower intensity, targeting superficial nerves.
Chronic pain, including back pain, neck pain, arthritis, fibromyalgia, sciatica
Acute pain, such as postoperative, labor pain, and sports injuries
Nerve pain, such as that associated with spinal cord injuries and neuropathy
Migraines and tension headaches
Menstrual pain
Electrical muscle stimulation delivers electrical impulses to the targeted muscle, causing muscle contraction, strengthening the muscle, or preventing atrophy.
As the electrical impulse stimulates the motor neurons, it mimics signals from the brain. This causes muscle contraction and effectively exercises the muscle. EMS is commonly used in physical therapy for various reasons. For example, it can help improve weak muscles not functioning correctly and decrease pain and muscle spasms.
Some of the key features of electrical muscle stimulation include:
Focus: EMS can improve muscle strength, aid recovery and rehabilitation, and possibly enhance athletic performance.
Sensation: The sensation involves visible muscle contractions, and the intensity level may vary.
Current: The intensity is usually stronger than TENS since it is intended to target muscle fibers.
EMS is commonly used in physical therapy settings and rehabilitation. It can treat various conditions and may be helpful in the situations below.
Muscle atrophy prevention (e.g., after injury or surgery)
Muscle re-education and rehabilitation
Increasing muscle strength and endurance (for athletes)
Reducing muscle spasms and stiffness
Improving local blood circulation
E-Massage also uses electrical impulses similar to EMS and TENS. However, the impulses utilize different waveforms and frequencies to mimic the sensation of a traditional massage. Settings such as intensity, duration, and frequency are variables that feel like other forms of massage.
Some advanced units feature various pre-programmed modes that simulate different massage styles, such as:
Deep tissue
Tapping
And kneading.
On two-in-one TENS and EMS units, this is often called massage mode.
E-Massage delivers gentle, rhythmic electrical pulses that stimulate nerve endings and muscle fibers. This "massage-like" effect reduces muscle soreness and tension and promotes relaxation. E-Massage may also help dilate blood vessels, which improves circulation and helps in recovery.
The E-Massage setting provides a "massage sensation" without causing strong contractions like EMS. It is often comfortable and well-tolerated by people with pain.
Focus: The focus of E-Massage is relaxation, reducing muscle tension, improving circulation, and reducing pain through muscle relaxation.
Sensation: The sensation may vary but may feel like gentle tapping, kneading, rubbing, or pulsing, designed to replicate massage strokes.
Current: The current varies but typically aims for a comfortable, non-fatiguing sensation.
General muscle soreness and stiffness
Stress reduction and relaxation
Post-exercise recovery (aiding in lactic acid removal)
Improving local blood flow
Relieving mild aches and pains by promoting muscle relaxation
| TENS | EMS | E-Massage (Electrical Massage) | |
|---|---|---|---|
| Primary Goal | Pain Relief | Muscle Contraction/Strengthening | Muscle Relaxation, Tension Relief, Circulation |
| Target | Nerves (sensory) | Muscles (motor nerves) | Muscles & Nerves (for soothing effect) |
| Sensation | Tingling, Buzzing | Visible Contraction, Pulsing | Gentle tapping, kneading, rubbing, pulsing |
| Intensity | Low to Moderate | Moderate to High | Low to Moderate (comfort-focused) |
| Typical Use Cases | Chronic/Acute Pain, Nerve Pain | Muscle Atrophy, Rehab, Strength Training | Sore Muscles, Stiffness, Relaxation, Stress |
| Muscle Contraction | Minimal to none | Strong, noticeable contractions | Gentle, rhythmic, non-fatiguing |
Before choosing which form of e-stim is right for you, it's helpful to identify your primary goal to get the best results.
If your main goal is pain relief, TENS is often the go-to, especially for nerve-related or persistent pain. However, EMS can also reduce pain associated with muscle spasms.
If your main goal is muscle strengthening, rehabilitation, or preventing atrophy, EMS is the best option.
If your main goal is muscle relaxation, reducing tension, or soothing soreness, E-Massage can provide significant relief.
Many devices, such as the TENS 7000 Sport Recovery TENS Unit, offer TENS, EMS, and E-Massage modes. Choosing a device that offers various modes provides you with options for comprehensive treatment. For example, you may utilize all three to:
Instantly block pain to ease discomfort (TENS)
Rehabilitate the injury by strengthening muscles and promoting blood flow (EMS)
And promote relaxation and ease soreness (E-Massage)
Combination therapy may provide a comprehensive approach to address various aspects of recovery and pain management from injuries, surgery, and medical conditions.
Understanding the key differences between TENS, EMS, and E-Massage can help you maximize your recovery. To recap:
TENS focuses on pain relief
EMS helps strengthen muscles
And E-Massage promotes relaxation and recovery.
Since 2008, TENS 7000 has been a leader in safe, effective, and cost-efficient e-stim devices. Our TENS 7000 Sports Recovery TENS Unit and TENS 7000 3-in-1 Combo Unit deliver effective e-stim. Both feature adjustable intensity, various modes, and dual-channel capabilities for tailored treatment.
If you're uncertain which e-stim type is right for you, we recommend taking our product quiz. It walks you through key questions to recommend the ideal device based on your needs and preferences.
MaryAnn DePietro CRT is a licensed respiratory therapist with over 15 years of clinical experience in critical care, emergency medicine, and pulmonary rehabilitation. She is also an American Council on Exercise certified personal trainer and holds specialty certifications in orthopedics, senior fitness, and weight management. MaryAnn has a degree in Rehabilitation from Penn State University and a degree in respiratory therapy.
In addition to her clinical experience, she has written extensively about all things medical, as well as health, fitness, and aging for various websites, magazines, and newspapers.
Pain sucks. It affects millions of people each year with adverse physical and mental side effects. TENS 7000 provides tools to combat pain and let people live life on their terms, pain-free. Our TENS 7000 TENS Unit is one of the top-rated over-the-counter TENS units, having sold over two million since 2008. Stop letting aches and pain hold you back — live life on your terms.
