NMES vs TENS: Which is better for back pain relief?

There are many different electrotherapies to help with back pain and muscle recovery, but which is better NMES or TENS?

Electrotherapy has been around for years. And within that time frame, the use of electrotherapy has evolved into various therapies. Two therapies  that seem to get intertwined most are NeuroMuscular Electrical Stimulation (NMES) and Transcutaneous electrical nerve stimulation (TENS). Yes, both are electrotherapy and use similar waveforms, but, each targets different nerves. Let’s take a look at the uses and differences between NMES and TENS.

Below are parameters used in electrotherapy. 

    • Frequency – dictates the nerves recruited motor nerves vs sensory nerves and elicits a strong muscular contraction without excessive muscular fatigue. If you use too high a frequency, the muscles can become over fatigued and possibly weaken. 
    • Waveform – improves patient comfort while delivering efficient muscle recruitment/contraction. 
    • Pulse Duration – targets deep, secondary spinal stabilizing muscles. 
    • Amplitude – Increases intensity of the stimulation. 
    • On:OFF ratio (Duty Cycle) – A ratio of the ON time of each cycle to the OFF time (e.g., ON:OFF 10:30 s=1:3 ratio). Higher ratios (1:5) have more rest time between muscle contractions and cause less muscle fatigue.



NeuroMuscular Electrical Stimulation, or NMES, uses electrotherapy to target motor nerves. This typically happens through electrodes, which attach to a device which powers electrical stimulation from the device and into the electrodes. The electrodes have an adhesive gel that transfer electrical impulses deep into the muscles, thus causing the muscles to contract. NMES helps to increase muscle strength, blood circulation, and range of motion and to lessen muscle spasms.

Uses for NMES  vary and have been used In sports medicine for muscle strengthening, maintenance of muscle mass and strength during prolonged periods of immobilisation, selective muscle retraining, and the control of oedema. Another use for NMES has been in  total knee arthroplasty (TKA) and have shown improvements in strength and function. NMES has also  provided  positive results for dysphagia. Recent studies reported significantly greater improvement for stroke patients in the NMES group compared with other therapeutic methods. Back pain is another ailment NMES can assist with and can greatly improve the back. NMES training results in enhanced activation of spinal stabilizing muscles during spinal loading and improvements in pain ratings. Other uses include sciatica, si joint pain, arthritis, muscle spasms, fatigue or weakness in muscles, stroke rehabilitation, and musculoskeletal conditions.

NeuroMD has released the NeuroMD Corrective Therapy Device, with clinically researched parameters designed to relieve back pain as well as other ailments listed previously. So far, the results have been positive for many verified customers where their pain has diminished or is no longer existent. 


TENS units work very similar to that of NMES. Both therapies use electrodes with adhesive gel that send electrical impulses. Only difference is the types of nerves they target. Previously, we mentioned NMES targets motor nerves with impulses that travel deep into the muscle tissue. TENS units use electrical impulses that target sensory nerves, which floods the nervous system, reducing its ability to transmit pain signals to the spinal cord and brain. This type of electrotherapy is only temporary and simply masks the pain as it tricks the brain into believing there is no pain at all.

Uses for TENS units help to temporarily relieve pain from period pain, labor pain, postoperative pain, joint pain, neck and back pain, sports injuries, osteoarthritis, postoperative pain, painful diabetic neuropathy and some acute pain conditions

Although TENS has been used to treat osteoarthritis and still is, studies have shown that “osteoarthritis pain similar to the reviews of acute pain and low back pain, a recent Cochrane systematic review showed that TENS was not effective for knee osteoarthritis(OA) pain”. However, some patients still prefer to use TENS units regardless. 

Electrotherapy has come a long way where clinical studies continue to test the various methods and benefits it has on our health and in the treatments of various ailments. Benefits are tenfold and are used in alternatives to surgery and the use of opioids. Now that you know the differences between NMES and TENS, make an informed decision and check out the NeuroMD Corrective Therapy Device to correct the source of the pain, not just mask the symptoms.