TENS Vs EMS Devices: What’s The Difference & Best For You?

TENS Vs EMS Devices: What’s The Difference & Best For You?

TENS Vs EMS Devices: What’s The Difference & Best For You?

TENS Vs EMS Devices: What’s The Difference & Best For You?

I’ve been writing extensively about the benefits and uses for both TENS and EMS therapy.

And from the feedback I’ve received, many of my readers still don’t know the difference.

So if you fall into this group, this article is for you.

In this post, we’re going to delve into the details of both devices, describe the benefits and downsides of each, and then discuss which would be better for you.

The reason people think TENS and EMS are the same is because, on the surface, they look exactly the same.

Sometimes, depending on the product you purchase, both units may be available on a single device.

However, there are some subtle as well as drastic differences that we need to address.

The Similarities.

  • Both TENS (transcutaneous electrical nerve stimulation) and EMS (electrical muscle stimulation) transmit electrical impulses through electrode pads placed on the skin.
  • We can use both systems as pain relief methods.

The Differences.

  • TENS relieves pain by using the principles of gate control theory. It delivers gentle electrical impulses to nerves, replacing the pain input to the brain with a non-painful input.  This allows for endorphins to be released, which causes overall pain relief in the affected area(s).
  • EMS is primarily used for actual muscle strengthening and recovery. The impulses are used to passively contract muscles and increase blood flow, which builds muscle.  This is the reason EMS is more popular amongst athletes as well as patients with paraplegic muscle groups.

TENS units can be used on multiple aspects of the body, depending on where the pain resides.

Here are just a few of the many examples:

Back Pain.

Although research is limited, there have been some studies noting the positive effects of TENS units for back pain, particularly lower back pain.

A study conducted in 2014 revealed that patients who used TENS units for lower back pain reported less frequent visits to the hospital and required fewer back surgeries (Pivec et al. 2013).

Additionally, some studies have examined how TENS acts as an effective placebo for pain relief (Deyo et al. 1990).


Inflammation has many root causes, but accurate electrode placement can temporarily relieve pain that comes with inflammation.  This includes both inflamed joints and muscle tissue.

Carpal Tunnel Syndrome.

Carpal tunnel is very commonly treated with TENS devices.

A study by Kara et al. (2010) showed that TENS treatment significantly reduced pain amongst test subjects with carpal tunnel syndrome by stimulating fingers innervated by the median nerve (which is the nerve that’s compressed in carpal tunnel).

Period Pain.

Surprisingly, period pain or primary dysmenorrhea can be treated with TENS therapy.

Bai et al. (2017) found that the majority of their study participants experienced pain relief associated with menstrual pain while using TENS intervention.


TENS has shown to be effective in minimizing sciatic-related pain.

Hashmi et al (2014) found that patients with sciatica benefited equally, if not more, from using TENS for sciatic pain as compared to a traditional Indian treatment called Kati Basti (use of heated medicated oil).

Pain clinics commonly address sciatica using TENS and choose to further educate patients on appropriate pad placement for home use.


Research findings are relatively inconclusive when it comes to treating arthritis with TENS therapy, particularly because arthritis is so widespread and comes in many types.

For example, clinicians can carefully place electrodes to numb nerve endings in the spine which reduces osteoarthritis-related pain.

Multiple Sclerosis.

Depending on the type, TENS therapy is an effective tool for MS-associated pain (joint pain, muscle fatigue, muscle stiffness, muscle atrophy and paralysis, etc.).

Because of the complexity of the disease, it’s wise to rely on clinicians to locate the source(s) of pain and for pad placement.

There are some incidences in which using a TENS machine is inappropriate or even dangerous.

Some of these situations are quite obvious, while some are unbeknownst to new and regular users. Here are a couple of times you should not use a TENS machine:

  • Don’t use it in your first trimester of pregnancy.
  • Don’t use it over broken or infected
  • Don’t use it if you have a
  • Don’t use it on your face, especially over your eyes and the front/sides of your
  • Don’t use it in the shower or
  • Don’t place electrodes over your
  • Don’t place electrodes directly over surgical hardware (i.e. back fusions, pins, joint replacements)

One of the greatest benefits of using a TENS machine is that it is a non-invasive and non-addictive pain relief tool.

So in other words, there is no set limitation on how often you can use a TENS machine.

As long as you are following clinical guidelines, such as using up to 30 minutes at a time while giving your skin a break from the electrodes (because prolonged pad placement can cause skin irritation), you are welcome and safe to use a TENS machine as often and as long as you need.

Now let’s switch gears and explore a few of the ailments EMS is used for:

Muscle Relaxation

Although EMS is used to strengthen muscle via active contractions, it can also produce a relaxing effect which is especially useful after an extreme workout.

Muscle Strengthening

Research has shown that accurate EMS intervention can strengthen muscles just as much as voluntary training.

However, clinicians and coaches suggest that using both produces better results versus using one over the other.

Relieve Muscle Fatigue

Athletes commonly use EMS after finishing a workout in order to safely address muscle fatigue.

Muscle contractions promote healing and recovery after tearing up muscle tissue from a decent workout.

Increase Blood Circulation

Because EMS produces muscle contractions, the body will automatically increase blood flow to the muscle tissue.

This will expose the muscle tissue to much needed oxygen to promote quick healing and recovery.

Prevents Muscle Atrophy

Muscle atrophy is an actual physical breakdown in muscle tissue, which is commonly seen in patients who have little voluntary ability to work out muscle groups (i.e. paralysis, hemiplegia).

EMS performs the contractions for you to prevent muscle breakdown.

Combines TENS & EMS Devices

As mentioned previously, you don’t have to settle for one device over another.

There are several products available on the market today that combine the TENS and EMS units into one device!

Here’s a starting point for devices available online:

TENS Unit + EMS Muscle Stimulator

This in-home device comes with 8 TENS modes and 6 EMS modes for pain relief and muscle recovery.

The display screen is large, which makes it easier to navigate the settings you prefer, and the unit is small and compact for travel purposes.

Compex Edge 2.0 Muscle Stimulator with TENS Bundle Kit

The Compex Edge is also a combination device that comes with 4 programs in total (1 Recovery, 1 TENS, and 2 Strengthening programs).

This device advertises programs that are effective for both muscle recovery and explosive strength, or power and force of muscle tissue.

Not every device will universally fit all users.  In order to find and purchase the best product, do some research while assessing your own unique needs:

Choosing The Right Device

When you’re ready to buy a device, don’t get so overwhelmed that you panic and buy one that you’ll never use.

Take your time and research each device thoroughly to determine whether you need a single system or a combined EMS/TENS device.

Your Condition

What are you seeking treatment for? Pain? Muscle weakness? Muscle damage? Inflammation? Or a little bit of everything?

The best step to take would be to talk to your doctor and assess your body before making your final decision on a device.


How much are you willing to spend?  Keep in mind, there are many insurance companies that will not pay for or supplement the cost of a TENS device or an EMS device.

The devices that are more expensive tend to offer more features, so prioritize what you need financially.


The cheaper the device, the less available modes there are.

Sometimes, you don’t need more than 3 or 4 modes for treatment.

For others, having more modes available means you’re less likely going to be stuck with the same, and potentially ineffective, settings.

Power Level

This refers to the intensity put off through the electrodes.

Some users with a higher pain tolerance will prefer having a device that has a relatively high power level.

For others, they might stay within a certain power level range indefinitely.


These days, most in-home devices are small, compact, and battery-operated.  That way, you are not limited to completing treatment by your plug outlet in your bedroom.

Before buying and actively using a TENS device or an EMS device (or both), consult with your doctor.

This is an especially important step for those who have never used either device before or who are unfamiliar with their current medical conditions.

So be sure to clear up any confusion and contraindications with your primary physician before regularly using either device.