How does it work?
The effectiveness of TENS can be explained by two principles: “Gate Control” and “Endorphins”.
It is possible to use either of these mechanisms or a combination of the two.
Luna Memo
TENS stands for Transcutaneous Electrical Nerve-Stimulation.
It is a non-medicinal, non-invasive, scientifically validated pain treatment that is reimbursed by social security when prescribed by an algologist (pain doctor).
TENS is listed as a non-medicinal therapeutic option in the recommendations for managing endometriosis, published by the HAS (High Authority for Health) in December 2017.
The basis of the treatment is the stimulation of peripheral nerve fibres using electrodes glued to the skin and connected to an external box that generates an electric current.

Gate Control: The gate
This is a defence mechanism that exists naturally in our body. Sensory information transmitted by the peripheral nerves passes through the spinal cord before travelling up to our brain.
Peripheral nerves are like electrical cables. They come in different sizes and have different conduction speeds. The cables that carry non-painful information are fast, and those that carry painful information are slower.
The spinal cord has a kind of door that closes as soon as information is received.
For example, when we burn ourselves, we blow on the burn and feel relief, even though the burn is still there: the “breath” information wins and closes the door to the pain information. First come, first served!
The TENS device activates large electrical cables, and you feel a pleasant tingling sensation which during the session closes the door to pain information. The pain-relieving effect is rapid but does not last when stimulation is stopped.
Endorphin stimulation: "acupuncture like"
Endorphins are painkillers naturally produced by our brain.
The electrical stimulation generated by the device will increase the production of endorphins by the brain. During the session, you will feel small beats. The painkilling effect is not immediate, as our brain needs time to produce the endorphins, but the effect after the session will be longer.
What are the benefits of TENS?
TENS is a medication-free, non-invasive, pain-free treatment with no side effects.
It reduces the use of pain medication and therefore the side effects, as well as the overall cost of the treatment.
TENS can be used to treat several types of pain: pelvic pain, perineal pain, migraines, neck pain, lumbar pain, joint pain, fibromyalgia, etc. It can therefore be perfectly integrated into a multidisciplinary approach.
It is a very easy to use technique. The device is personal, available and can be used at any time of the day, in response to painful episodes. The patient can benefit from TENS at home, at work or in their free time. Their daily activities become easier, their general state of health improves, their social life and their active life become more normal.
Patients take an active role in managing their pain. The success of the treatment depends on the patient’s diligence, which in turn requires good quality information at the time of prescription and regular supervision during the first few months of use.
Finally, TENS, when prescribed by an algologist, is reimbursed by social security: device (rental and purchase) and electrodes.
The devices recommended for pain management are in no way related to those sold in supermarkets or on the internet. Devices that can be reimbursed by social security must meet strict safety standards and be prescribed by a doctor.
When is TENS not suitable?
The device is not recommended for patients with severe psychiatric disorders or for patients with an implantable medical device (pacemaker).
The positioning of the electrodes is not recommended on certain parts of the body: neck, thorax, the abdomen in pregnant women, or an injured or numb skin area.
TENS is also not suitable in the case of venous or arterial thrombosis or during the recording of an examination that uses electricity, such as an electrocardiogram or an electroencephalogram.
The presence of a prosthesis or osteosynthesis material does not mean that it should not be used.
In practice
TENS is prescribed during a consultation with a pain doctor.
The patient learns to use TENS during a “test session” with the pain doctor or nurse.
During the “test session”, the patient is shown how to use the device to treat their pain: operating instructions, choice of programme, regulation of stimulation intensities, number of sessions per day, positioning of the electrodes, etc.
The effectiveness of the treatment is tested over the first 6 months, on a rental basis.
If the treatment is effective and if the patient agrees, the doctor writes a prescription for the purchase of the device after the 6-month rental period. The purchase of the device is renewable every 5 years.
The self-adhesive electrodes are reusable. They are prescribed and reimbursed, at the rate of 1 bag of 4 electrodes, every 15 days during the rental period and after purchase. Hypoallergenic electrodes are available for those who are allergic to conventional electrodes.
Conclusion
TENS is a non-medicinal, non-invasive pain treatment with no side effects, scientifically validated and reimbursed by social security.
It is a very easy to use technique which allows patients to take an active role in the management of their pain.
TENS is an integral part of the therapeutic arsenal and must be offered at an early stage as part of a multidisciplinary approach.
Co-authored and scientifically validated by Dr Nathalie Choucroun,
Anaesthetist and Algologist, Bouchard Clinic, Marseille