Lower back pain affects almost everybody, but it’s tricky to treat. For a popular method of at-home pain relief, you can try TENS or transcutaneous electrical nerve stimulation. In this article I’ll explain how and why TENS works, and point out key features to look for. By the end, you’ll know how to find the best TENS unit for lower back pain, starting with 3 well-rated options.
Lower Back Pain: A Plague of Modern Man
An estimated 1 in 5 adults experience back pain every year, while a whopping 80% of adults will likely have back pain at least once in their lifetime. With such staggering statistics, it’s easy to believe that back pain is the leading cause of disability worldwide.
If you’re in the majority of working adults for whom chronic pain is a common occurrence, you may have already tried the usual avenues for relief: resting, applying ice, and taking over-the-counter pain relievers. But for stubborn back pain, you may want to consider TENS, a type of electrical stimulation or e-stim treatment.
What is TENS?
TENS therapy uses electrical impulses to stimulate your nerves and temporarily block pain signals. An electrical current travels from the TENS unit to a few sticky pads, which you place on your skin near the location of your pain. Once it’s powered on, users can toggle the handheld device to adjust the speed and amplitude (intensity) of each pulse. Ideally, the intensity will be just enough to mask the pain without causing excessive discomfort.
Importantly, as good as it can feel, TENS does not eradicate pain. It instead interferes with the body’s pain signals. Therefore, TENS cannot remedy a chronic condition or treat the root cause of low back pain. For many patients, low back pain requires a multitude of treatments to cure. TENS therapy is just one approach that can help support other modalities of pain relief, such as massage, exercise, and acupuncture.
Does TENS actually work?
Although transcutaneous electrical nerve stimulation may sound like a snake oil treatment, as a physical therapist I can assure you that TENS is valid and effective. In fact, we use it often in the clinic to help patients with postoperative pain, muscle spasms, or lower back pain.
TENS works to relieve your perception of pain by drowning out the pain signals in your nerves. It also helps stimulate your body to produce endorphins, which are natural pain relievers.
Besides mitigating chronic pain, TENS can help strengthen muscles, combat muscle atrophy, and reduce inflammation. Because it’s noninvasive, relatively inexpensive, and safe to perform at home, TENS is becoming a popular pain relief option around the world.
How to Find the Best TENS Unit for Lower Back Pain
At the most basic level, a TENS unit consists of a few sticky pads, electrodes, and a handheld device that controls the e-stim treatment. But to better fit your lifestyle, consider the following features when looking for the best TENS machine.
Wireless or wired
For many TENS units, e-stim is transmitted through wires from the machine to the sticky pads. However, more advanced versions use Bluetooth or wifi technology to send the electrical current wirelessly and directly to the pads.
The presence of wires may not bother you if you plan to sit still and relax through your TENS treatment. But to benefit from e-stim while working out or performing yoga, for example, a wireless TENS unit is a game-changer.
Programs and settings
E-stim therapy isn’t all or nothing, so there’s no on/off switch for TENS. Instead, you’ll have a range of speeds and intensities to toggle through, usually starting on low and then gradually increasing intensity as desired.
But in addition to the two parameters of speed and intensity, most TENS units come with several preset programs you can use to achieve a particular kind of TENS therapy. For example, you may be able to emulate a deep tissue massage, cupping, or acupuncture treatment with a particular TENS program. Some units include a timer to help you track your treatment or even a heating element to deliver thermotherapy.
Single, Dual, or Quad Channels
Typically, TENS sticky pads come in pairs, with two sticky pads for each channel. A single electrical current runs through the channel and splits between the pads, which you’d place on either side of your point of pain.
To treat two different areas at once, look for TENS units with dual-channel capability. You may be able to program a different setting for each channel, such as a low massage for your upper back and shoulders but a robust percussion for your lower back. If you really love to multi-task—and you hurt all over—consider a quad-channel TENS unit, which provides targeted e-stim treatment to 4 different parts of the body.
The Best TENS Unit for Lower Back Pain: My Top 3
There are dozens of TENS units on the market, but these 3 provide some of the most consistent results in relieving lower back pain.
1. iReliev TENS + EMS
Quick stats:
- Dual channel (2 pods) or quad channel (4 pods)
- Wireless; uses radio frequency
- Rechargeable lithium-ion battery
- 25 intensity levels: up to 80mA
- 14 preset programs
- Includes timer for up to 60 minutes of therapy
- $190 for dual channel; $250 for quad channel
If untangling wires is too much of a pain, you may prefer a wireless machine like iReliev’s. Their TENS + EMS unit is completely cordless, using radio frequency to sync the remote to the pods. And instead of two pads for each channel, you’ll place a single isolated “pod” on the spot you want to treat. With less bulk and no wires at all, the iReliev is among the most wearable and convenient TENS units on the market.
The iReliev TENS + EMS offers 14 preset programs for comprehensive e-stim treatment, from arthritis therapy to exercise recovery. Each program can be further tweaked across 25 levels of intensity levels, ensuring your therapy meets your needs every time. Upgrade to the quad channel version and you can enjoy wireless TENS therapy on 4 different parts of your body.
Although you won’t need to buy a replacement battery for this one—it comes with a charger for its lithium battery—you will need to buy replacement pods, which, at $30 for 4, are much pricier than conventional TENS sticky pads. With proper care, some users have managed to squeeze 30+ wears out of each pod, thereby reducing reorder frequency.
2. TENS 7000, Second Edition
Quick stats:
- Dual channel; 4 pads
- Wired
- 9-volt battery
- 10 intensity levels: 10-100mA in 10mA increments
- 5 therapy modes
- Includes timer for up to 60 minutes of therapy
- $33 on Amazon
A pioneer of e-stim technology, the TENS 7000 has been around for nearly 15 years. Its simple design offers everything you need in a TENS machine without extra bells and whistles. Besides dual channel capability, the TENS 7000 provides 10 different intensity levels and 5 therapy modes, including Burst, Modulation, and Strength Duration.
Over the years, users have stuck with TENS because it’s easy to operate, powerful, and affordable. The only drawback is that it requires a 9-volt battery instead of a rechargeable one. So in addition to ordering fresh sticky pads, you’ll also need to order replacement batteries throughout the life of the machine.
3. PowerDot 2.0
Quick stats:
- Single channel (2 pads) or Dual channel (4 pads)
- Wired between pads, wireless to phone; uses Bluetooth
- Rechargeable lithium-ion battery
- 100 intensity levels; fully adjustable through the app
- 10 preset programs; customizable through the app
- Includes timer for up to 60 minutes of therapy
- $200 for single channel or $350 for dual channel
These days, we do everything on our phones. Who’s to say you can’t manage TENS therapy from the comfort of your smartphone’s interface?
Not only has PowerDot brought the TENS experience to your familiar handheld screen, it’s also taken full advantage of your phone’s capabilities by developing a feature-rich app. Through the PowerDot app, you’ll control each TENS session, track your progress, receive customized recommendations, and connect with the PowerDot community through a wide range of user resources.
Although the PowerDot is wireless from phone to sticky pads, the pads themselves are hard-wired to the pod, which powers and administers the e-stim. For a single-channel experience, you’ll attach two pads and one pod on your lower back; a dual-channel session requires twice as much hardware for almost twice the cost.
Cost is perhaps the biggest prohibiting factor for getting started with PowerDot. Another factor may be the patience and tech-savviness required to rely on Bluetooth technology. However, many users agree that these drawbacks are more than worthwhile for a powerful, personalized TENS experience they can use for all kinds of physical performance needs, whether that’s to relieve pain, recover muscles, or improve blood circulation on a long-haul flight.
Other Ways to Manage Lower Back Pain
Although TENS can help block your pain, it’s most effective as a short-term solution for quick relief. Even the best TENS machine won’t fix the problem, and you may need an array of methods to break free from chronic lower back pain.
When you’re on the go, consider wearing a compression brace to offload any overworked back muscles and prevent further strain. Physical therapy, including these exercises for back pain, can help you address muscle weakness that may be causing your pain.
Besides these avenues, you may need to make some lifestyle changes. A comprehensive approach to curing chronic back pain is outlined in Back Mechanic by Stuart McGill. Check out my review of that book or skip ahead to these three exercises you can do today to help relieve pain in your lower back.
