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Tendonitis is one of the most common conditions of the tendon. When left untreated, tendonitis can lead to chronic pain, reduced capacity to carry out necessary tasks (e.g., working, exercising), and ongoing restrictions. One way to help relieve pain is through the use of a transcutaneous electrical nerve stimulation (TENS) machine. Through targeted electrical impulses to the injured area, the TENS machine can inhibit pain signals and help the body release natural pain-relieving chemicals. This article will go through how a TENS machine can assist with your tendonitis symptoms.

 

What is Tendonitis and Types of Tendonitis? 

Tendonitis is a condition that refers to inflammation of the tendon. The tendon connects muscle to bone to help store energy and create movement. Tendonitis can become a painful condition that restricts your ability to move and load certain parts of the body [1]. This condition can occur anywhere in the body with a tendon.

However, the most common types of tendonitis include:

  • Achilles tendonitis
  • Patellar tendonitis
  • Tennis elbow (lateral epicondylitis)
  • Golfer’s elbow (medial epicondylitis) 
  • Adductor tendonitis 
  • Biceps tendonitis
  • Rotator cuff tendonitis

 

What Causes Tendonitis? 

Tendonitis is caused by inflammation of the tendon. Symptoms of tendonitis can be similar to other tendon conditions, such as tendinopathy and/or tendinosis. 

Tendonitis is most commonly seen as an overuse injury, caused by repetitive stress and movement [1]. In less frequent situations, direct trauma to the tendon can also lead to this condition (e.g., landing on your patella tendon, etc.). For example, Achilles tendonitis is frequently caused by running more than your tendon is capable of. Over time, this can cause inflammation, microtears, and unravelling of the fibres that make up the tendon.

 

Range of Tendonitis Symptoms and its Complications 

Symptoms of tendonitis can vary in location and severity. However, common signs that are associated with tendonitis can include [2]: 

  • Sharp and localised pain on the tendon
  • Swelling
  • Redness
  • Weakness
  • Difficulty moving and lifting
  • Stiffness 

While tendonitis often does not usually require invasive treatment, such as surgery or injections to improve, it can lead to complications such as: 

  • Reduced ability to move and exercise
  • Increased risk of injury to the tendon and/or muscle
  • Risk of developing chronic or long-term injuries, particularly if the early stages of tendonitis are not cared for. 
  • Being in constant pain.
  • Long-term weakness and stiffness



TENS Machine & Benefits of Using TENS for Tendonitis

A transcutaneous electrical nerve stimulation (TENS) machine is used as a natural way to help relieve tendonitis pain [3]. Electrical pulses can be delivered through the TENS machine to help ease pain to specific parts of the body depending on the placement of the attachments.

The TENS machine can be manually set up in a way where it can help ease pain quickly or over a prolonged period of time. Easing tendonitis pain is crucial as it allows you to be able to perform tasks that would otherwise cause you pain, including the ability to move, work, and/or even household chores.

Additionally, it can be used as a way to complement the rehabilitation required to assist with your recovery from tendonitis. 

 

How to Use a TENS Machine for Tendonitis 

A TENS machine is best used as a way to manage pain or help prevent the onset of pain (i.e., if you’re expecting a movement that might lead to pain, etc.). How you set up the TENS machine helps you achieve the desired effect of the TENS machine [4]. 

Firstly, the placement of the TENS machine is important for tendonitis. The electrode pads need to be positioned around the tendon to deliver the treatment effectively. Unlike the muscle, the tendon is smaller and thinner, requiring specific placement of the pads. 

Secondly, the device has several settings that can be altered to help you achieve the desired effect. For instance, high-frequency settings may assist with a quicker onset of pain relief as opposed to a lower frequency. These settings can be adjusted before or after the treatment. 

Finally, the way that the electrical impulses can be delivered can vary depending on your preference. While most TENS units come with sticky gel pads, separate conductive garments can be purchased for easier application. 



The Best Practices for Using a TENS Unit

The TENS machine is best used when the settings are adjusted to suit your needs. Best practices include positioning the electrode pads and optimising TENS machine settings. These practices will be described below. 



Position of Electrode Pads for Tendonitis 



Achilles Tendonitis



Patellar Tendonitis


Peroneal Tendonitis

Wrist tendonitis




 

Bicep tendonitis



Conductive Garments as an Alternative to Tendonitis 

Electrode pads have traditionally been the way that TENS machines deliver impulses to help treat pain. Conductive garments are an alternative attachment to the electrode pads, which can be purchased separately. The benefit of the conductive garment is that it is an easier way for the TENS machine to deliver treatment. Instead of placing the electrode pads correctly on the body, the conductive garment can be easily worn.

Examples of conductive garments and the type of tendonitis that could benefit from them include:



Setting the TENS Mode for Tendonitis

Depending on the TENS unit purchased, there may be several modes that can be set before treatment, including TENS, massage, and EMS. If the focus is pain relief, it’s important to select the TENS mode. Please refer to your included pamphlet for more information about selecting the appropriate mode. 


Setting the Pulse Rate (Frequency) for Tendonitis

Frequency (Hz) measures the amount of electrical impulses over a given treatment period.

Higher frequency settings (100-200 Hz) have been shown to provide immediate and shorter-lasting pain relief [4]. This can be helpful if you need relief from your symptoms quickly. 

Whereas, low-frequency settings (2–5 Hz) allow for slower acting but prolonged pain relief [4]. This can be helpful in situations where you would like to prevent symptoms or prefer longer-lasting pain relief. 


Setting the Pulse Width for Tendonitis 

Pulse width describes the duration of each electrical impulse during your treatment with the TENS machine. There is inconclusive research [4] about the effect of pulse width for tendonitis. Typically, the conventional pulse width range is between 50 and 250µs but could vary depending on your TENS unit purchased. 


How Often Should You Use Your TENS Machine for Tendonitis? 

How often you should use your TENS machine will vary between people and their experience with tendonitis, accounting for factors such as your symptoms and area of injury. Research has suggested that TENS machines can be effectively used for pain relief for twice a day for 30-60 minute sessions [4]. Please consult a healthcare professional if you are unsure or first time using a TENS machine. 

 

Using Caremax TENS machine for Tendonitis Mangement


We provide a comprehensive packaging solution for Tendonitis Pain Relief. Discover the most sought-after products below essential for effective TENS therapy treatment.

 Caremax 2.0 Classic TENS machine   Caremax 2.0 Pro TENS Machine
 Conductive TENS Knee Sleeve Brace Conductive Sock Garment

 


Where and When to NOT Use TENS Machines 

Using a TENS (transcutaneous electrical nerve stimulation) machine can help alleviate discomfort or pain, but it's vital to adhere to safety guidelines for safe and effective use [5]. Here are important precautions to consider: 

Avoid applying the TENS machine to:

  • Damaged skin, such as wounds or cuts.
  • Areas with reduced sensation or numbness.
  • Swollen areas.
  • Near tumours or blood clots.
  • Areas treated with radiotherapy or radiation.
  • Individuals unable to provide consent should not use TENS machines.

There are special considerations where you must consult a healthcare professional, such as your GP or specialist, before use, including: 

  • Those with cognitive or mental impairments.
  • Individuals unable to provide consent should not use TENS machines.
  • You are pregnant.
  • Those with nerve pain

Additionally, do not use a TENS machine if:

  • You have reduced sensation or numbness in the application area.
  • Severe pins and needles or tingling occur.
  • Symptoms worsen following TENS machine use.


Are There any Risks of Side Effects When Using a TENS Machine?

When used correctly, a TENS machine is generally safe, but it's important to be mindful of possible side effects [5]. Most side effects are mild and can usually be prevented with careful use. If you experience any negative reactions, stop using the machine right away and speak to your doctor. Although serious side effects are uncommon, they should be addressed immediately.

Some typical side effects are:

  • Irritated skin
  • Strange sensations near the area being treated
  • Feelings similar to, or worsening, nerve pain

If you experience any of these, stop using the device and consult a healthcare professional, such as a physiotherapist.

More severe side effects (often from improper use or in people with certain risk factors) may include:

  • Rashes on the skin
  • Intensified pain
  • Seizures
  • Issues with implanted medical devices
  • Strokes
  • Blood clot formation
  • Skin injuries
  • Burns




References

  1. The Royal Australian College of General Practitioners (RACGP). (2013). Tendon injuries. Australian Family Physician, 42(4). 
  2. Healthdirect. (n.d.). Tendinopathy. Healthdirect Australia. 
  3. Johnson MI, Paley CA, Jones G, Mulvey MR, Wittkopf PG. Efficacy and safety of transcutaneous electrical nerve stimulation (TENS) for acute and chronic pain in adults: a systematic review and meta-analysis of 381 studies (the meta-TENS study). BMJ Open. 2022 Feb 10;12(2):e051073.
  4. Vance CGT, Dailey DL, Chimenti RL, Van Gorp BJ, Crofford LJ, Sluka KA. Using TENS for Pain Control: Update on the State of the Evidence. Medicina (Kaunas). 2022 Sep 22;58(10):1332. 
  5. University of Iowa Health Care. (2018). Pain medicine: Contraindications and precautions.