TENS Therapy 101: How It Works and Where to Place the Pads

TENS (transcutaneous electrical nerve stimulation) is one of the most popular drug-free options for managing everyday muscle and joint pain — and one of the most under-explained. Here's what it actually does and how to use it well.

How TENS works

A TENS device like the Path Pharm PPG-104T sends gentle electrical pulses through adhesive pads on your skin. Two things happen: the pulses stimulate nerves in a way that helps “close the gate” on pain signals travelling to the brain, and they encourage the release of endorphins — your body's own pain relievers. The PPG-104T also includes EMS (muscle stimulation) modes, which cause gentle muscle contractions used for recovery and tired muscles.

Pad placement basics

The golden rule: place pads around the pain, not on top of bones or joints.

• Lower back: two pads either side of the spine at the sore level — never directly on the spine itself.
• Shoulder: one pad above and one below the sore area, on muscle.
• Knee: pads on the muscle above and below the knee — not on the kneecap.
• Keep pads at least 2–3 cm apart, on clean dry skin.

Sensible settings

Start low. Increase intensity until you feel a strong but comfortable tingling — never pain or sharp muscle jolts (in TENS modes). Sessions of 15–30 minutes are typical; give skin a break between sessions.

Pad care = better therapy

Pads lose their grip and conduct unevenly as the gel wears. Clean skin before use, press pads back onto their plastic film after, and replace them when they stop sticking firmly — PPG-100R replacement pads fit the PPG-104T.

Who should check first

Skip TENS — or talk to a provider first — if you have a pacemaker or implanted device, are pregnant, have epilepsy, or would be placing pads over broken skin, numb areas, or the front of the neck. And if pain is new, severe, or getting worse, get it assessed rather than masking it.

This article is for general education only and is not medical advice. Consult a healthcare professional about persistent pain.