Feedback
We appreciate and encourage feedback. If you need advice or
are concerned about any aspect of care or treatment please
speak to a member of staff or contact the Patient Advice and
Liaison Service (PALS):
Freephone: 0800 183 0204
From a mobile or abroad: 0115 924 9924 ext 65412 or 62301
E-mail: [email protected]
Letter: NUH NHS Trust, c/o PALS, Freepost NEA 14614,
Nottingham NG7 1BR
www.nuh.nhs.uk
T.E.N.S.
(Transcutaneous Electrical
Nerve Stimulation)
for pain relief
Children’s Pain Management
Information for patients
This document can be provided in different languages and
formats. For more information please contact:
Children’s Pain Team
Nottingham Children’s Hospital
Queen’s Medical Centre campus
E Floor, East Block
The Trust endeavours to ensure that the information given here
is accurate and impartial.
Michelle Bennett, Hannah King, Sharon Douglass, Children’s Pain Team © May 2016 All rights
reserved. Nottingham University Hospitals NHS Trust. Review May 2018. Ref: 0420/v6/0516/AS.
Tel:0115 9249924 ext 64551 / 66236
Troubleshooting (continued)
What is TENS?
The benefit of TENS is that it is safe, ‘drug free’ method of pain
management. It acts through pads placed on the skin, sending
small electrical impulses to the underlying nerve fibres
(transcutaneous means ‘through the skin’).
How does TENS work?
Problem
Action to take
4) One of the plugs or leads is 
loose or broken.

Switch off machine.
Contact the Pain Team to
replace Leads.


Remove electrode pads.
Certain skin types can be
sensitive to the adhesive
on the electrode pads.
If skin irritation continues,
please contact the
Children’s Pain Team.
Nerve fibres carry sensations such as touch, warmth, pressure
and pain.
TENS can work in two ways:
 It can “block” the arrival of painful messages from reaching
areas of the brain that interpret pain.
 It stimulates nerves to release endorphins, which are your
own natural painkillers. These act a bit like morphine to block
pain signals.
5) My child seems to be
allergic to the electrode
pads and has developed a
rash in that area.

How long should I use it for?
We recommend that at first you try TENS for at least one hour,
three times a day. You can use the TENS for as long as you
need, as long as you take some breaks. After each treatment
check your skin when you remove the pads. Your skin may
appear red, this is normal. This redness should fade within an
hour. If you have any problems, contact the pain nurse.
Does it work for everyone?
Many children and young people using a TENS machine report
that it has helped to relieve their pain, however, this varies from
person to person. Unfortunately using TENS will not benefit
every child. Generally it takes a couple of hours of using TENS
for the first time, before the effect is felt. You should still give
your child his or her regular pain medicines while using the
TENS machine. Over time, if the TENS machine is helpful; your
child may not need pain relief as frequently as before.
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Troubleshooting
How should I feel during the treatment?
Problem
Action to take
1) There is no or low
sensation under the
electrodes.

The sensation of TENS depends on the settings used. The
feeling is often described as tingling, buzzing and pulsing. To
gain maximum benefit, the sensation should be strong but not
painful.
How do I use the TENS machine?

2) The electrode pads do not 
seem sticky anymore (if

stored correctly on the
plastic sheet between
use, they should last for
up to 30 applications).



3) My child feels burning
under the electrode.
Try replacing the battery.




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Switch off the machine.
Moisten the pads -place one
drop of cold water on the
pad and gently spread
UNTIL there is no visible
moisture.
Place pad onto plastic sheet
and place in the fridge.
Try reapplying to the skin.
If still no good, replace
electrode pad.
Check the skin under the
pads for redness and
sensitivity. If red, do not
reapply.
The electrode pads may
have lost their stickiness and
only be partially attached to
skin - see action 2
The electrode pads may be
worn - therefore replace.
The intensity may be too
high - try reducing until only
mild tingling is felt.









Always make sure the machine is switched off before
starting.
Make sure the selected skin area is clean and dry and the
skin is not broken or numb. You should also refrain from
using any body lotions, creams or talc on the selected area
as these will stop the pads sticking to your skin.
Firstly, connect the pads to the pins on the electrode wires.
The nurse will show you where the pads can be placed, but
usually they are placed on or around the painful area and at
least one pad width apart.
Always apply the pads before switching the machine on.
Connect the electrode wires to the TENS machine, then
switch on the TENS machine.
Slowly increase the intensity (by turning the dials) until you
feel a ‘strong but comfortable’ tingling sensation. This should
not be painful.
When turning the machine off, turn the intensity down slowly.
Switch off the TENS machine, disconnect the electrode
wires and then remove the pads.
Store the pads in their original packaging when not in use.
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When should you NOT use the TENS machine?
What side effects might I experience?
Most people can use a TENS machine, but there are some
exceptions:
 TENS is not recommended if you have certain heart
conditions or have a pacemaker.
 TENS is not recommended during pregnancy.
 TENS is not recommended if you have epilepsy.
 The source of pain is over the site of any previous surgery
where internal metalwork, such as screws, wires, implants or
metal plates have been inserted.
 If you have poor sensation in the area where the electrodes
are to be applied.
 The source of pain is over the site of any malignant disease.
There is a risk of skin irritation from the electrode gel. This can
be minimised by changing the electrode position slightly with
each use. If irritation does occur stop using the electrode pads.
Specially formulated electrode pads for sensitive skin can be
purchased.
What precautions should I take when using TENS?







Stop using the machine if your pain becomes worse or you have
any concerns about using TENS. You can seek advice by
contacting the Children’s Pain Team.
Care of the TENS machine and electrodes



The machine can be cleaned with a soft, slightly damp cloth.
Please replace alkaline battery correctly
Always replace the pads onto the original square backing
and store in the sealed pocket when not in use.
Do NOT place electrodes on the front of the neck or over the
carotid pulse (the main pulse on your neck under your jaw).
Do not place electrodes pads over your eyes, forehead, in
the mouth or anywhere internally.
Do not apply pads over an area of reduced skin sensation or
broken/damaged skin
Do not use when driving or using machinery (a sudden
change in stimulation may cause you to lose concentration).
Do not use when sleeping.
Do not get the TENS machine or leads wet.
Do not let the TENS pads touch each other.
The TENS machine is for the sole use of the person
to whom it has been issued.
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