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Behind the Keynote: Why TENS Still Matters
Recently, I had the privilege of delivering a keynote at the 2nd International Electronic Conference on Medicine, a virtual gathering of neurologists, researchers, and clinicians exploring cutting-edge discoveries. My talk? “Transcutaneous Electrical Nerve Stimulation to Alleviate Pain: What the Evidence Really Says.”
Why this topic? Because TENS has been around for decades, yet it still sparks debate. Some swear by it, others dismiss it as placebo. So, I wanted to cut through the noise and share what the evidence—especially our Meta-TENS study published a few years ago—actually tells us.
Here’s the headline: TENS is beneficial and safe, but it’s not magic. Think of it as a helpful sidekick, not the superhero. Use it as an adjunct to core treatments to soothe pain in the moment. The evidence shows moderate certainty that strong-but-comfortable TENS reduces pain during or immediately after treatment—regardless of diagnosis. That’s big, because it means TENS isn’t just for one type of pain.
And those endless debates about pulse frequency, duration, or pattern? The data says they don’t make much difference. What matters most is adequate intensity and patient comfort. That’s liberating because it simplifies protocols and makes TENS easier to use.
The Meta-TENS study systematically reviewed 381 randomized controlled trials, confirming that TENS offers rapid relief across various painful conditions such as musculoskeletal, neuropathic, and postoperative pain [available here]. TENS is portable, inexpensive, and empowers self-management—qualities that align perfectly with modern pain care principles. In an era of opioid stewardship and polypharmacy, that autonomy is not just practical; it’s therapeutic.
Of course, TENS isn’t a cure. Its effects are transient, and it works best as part of a multimodal plan—alongside physical activity, education, and psychological support. At the moment I am developing an integral approach to pain care, using TENS as an exemplar. This it matters because an integral vision for pain represents something bigger: a shift toward whole-person, whole-system care, where technology serves empowerment, not dependency [previous blog here]. And in a world grappling with chronic pain, that’s a message worth amplifying.
Professor Mark Johnson
Mark Johnson is Professor of Pain and Analgesia. Mark is an international expert on the science of pain and its management and the world leader on transcutaneous electrical nerve stimulation (TENS). He has published over 300 peer reviewed articles.
