Knee pain is a common problem we see, with causes ranging from acute injuries to long-term issues like arthritis or overuse problems.
While there are many treatments available for knee pain, transcutaneous electrical nerve stimulation (TENS) can provide instant relief when you’re at home.
Tens therapy units work by sending small electrical pulses through the skin to the nerves, giving you a much-needed break.
In this guide, we’ll show you the best TENS placements for knee pain to improve your quality of life right now!
Where should I place the TENS Pads?
Above and below the knee cap (patella)
Placing one TENS pad just above the kneecap and the other below the patella allows for targeted pain relief and muscle stimulation around the knee joint. This arrangement targets nerves supplying the front of the knee, calming the pain of:
- Patellofemoral Pain Syndrome (Runner’s Knee or Hiker’s Knee): Pain around or behind the kneecap, especially during activities like running.
- Patellar Tendinitis (Jumper’s Knee): Inflammation of the patellar tendon, often experienced by athletes engaged in repetitive jumping sports or knee extension.
Above and either side of the knee cap (patella)
Often with sports injuries or overuse, the quadriceps tendon attachment becomes inflamed, leading to knee pain. The rule of thumb placement for the tens pads is the upper part of your kneecap, where the quads attach.
Medial and Lateral sides of the knee
Placing TENS pads on the medial and lateral sides of the knee targets deep knee pain in your knee joint, from structures like the meniscus and joint cartilage. This arrangement helps with the discomfort of:
- Osteoarthritis (Bone-on-bone knee pain): A degenerative joint disease causing knee cartilage deterioration, leading to pain and stiffness.
- Medial Collateral Ligament (MCL) Sprain: Damage to the MCL due to sudden twisting or direct impact to the outer knee. The most commonly injured knee ligament.
- Lateral Collateral Ligament (LCL) Sprain: Damage to the LCL due to sudden impact or force on the inner side of the knee.
- Medial Plica Syndrome: Irritation of the plica, a fold in the synovial lining of the knee joint, causing pain on the inside of the knee.
Front and back of the knee
For conditions like ACL sprains or PCL sprains (or tears in these vital structures), a front and back tens pad arrangement is the go.
These structures lie deepest in our knee, so work the pads around until you get a result.
TENS pad positions we have had success with for deep knee pain are:
- Two pads at the lower third and either side of the kneecap, along with:
- A pad directly behind the knee.
Popliteal Fossa and Calf Muscles
Placing one TENS pad on the back of the knee (within the popliteal fossa, see below) and the other on the calf, allows for targeted pain relief with back-of-the-knee pain. Give this arrangement a try for:
- Baker’s Cyst: A fluid-filled swelling (cyst) in the popliteal fossa, causing discomfort and pain at the back of the knee.
- Gastrocnemius (calf) Strain: Injury to the calf muscle (gastrocnemius), which can contribute to knee pain and stiffness.
How TENS Works for Knee Pain Relief
TENS therapy works on the “gate control theory” of pain modulation. When the TENS machine delivers electrical impulses through the knee electrode pads, it stimulates sensory nerves in the area.
These electrical signals travel faster than pain signals, essentially closing the “pain gate” in the spinal cord. As a result, the brain receives fewer pain signals, leading to a reduction in perceived knee pain.
Moreover, TENS therapy can also promote the release of endorphins, the body’s natural painkillers, further enhancing pain relief and promoting a sense of well-being.
The versatility of TENS therapy allows users to incorporate it into their overall pain management plan, either as a standalone treatment or in combination with other therapies.
To make the most of TENS therapy for knee pain, proper electrode pad placement, appropriate settings, and consistent usage according to a healthcare professional’s guidance are essential.
Consult with a healthcare provider or physical therapist to determine the most suitable TENS settings and usage frequency based on your knee condition and individual needs.
TENS pad placement for Sciatica
Components of a TENS Machine
A typical TENS machine consists of several essential components:
- TENS Device: The main control unit of the TENS machine, which houses the settings, display, and power source. Some devices may be battery-operated, while others have rechargeable batteries or use mains power.
- Knee Electrode Pads: These are adhesive pads with conductive surfaces that adhere to the skin around the knee. The electrode pads are responsible for delivering the electrical impulses to the nerves beneath the skin.
- Lead Wires: These wires connect the electrode pads to the TENS device, facilitating the transfer of electrical impulses.
- Power Source: The power source provides the necessary electrical energy to operate the TENS machine. Battery-powered devices offer greater portability, allowing users to use TENS therapy on the go.
TENS machines offer different stimulation modes, each with distinct effects on pain relief. The most common TENS modes include:
- Continuous Mode: In this mode, the TENS machine delivers a continuous stream of low-voltage electrical pulses. Continuous TENS is ideal for managing ongoing, chronic knee pain.
- Burst Mode: Burst TENS delivers bursts of electrical pulses followed by short breaks. It is suitable for acute knee pain or when rapid pain relief is desired.
- Modulation Mode: Modulation TENS varies the intensity, frequency, or pulse width of the electrical impulses, preventing nerve adaptation and enhancing pain relief effectiveness.
TENS machines also come with adjustable settings, allowing users to customize the frequency, pulse width, and intensity according to their comfort level and the specific knee pain condition.
When not to use TENS machines for knee pain
TENS therapy is generally safe and well-tolerated for managing knee pain. However, there are certain medical conditions and situations where using a TENS machine for knee pain may not be advisable or should be done under medical supervision.
It’s crucial to be aware of these considerations to ensure safe and effective use of TENS therapy.
- Pregnancy: Pregnant individuals should exercise caution when using a TENS machine for knee pain or any other purpose. Although TENS therapy is considered safe for many people, pregnant individuals should consult with their healthcare provider before using TENS during pregnancy.
- Pacemaker or Implanted Medical Devices: Individuals with implanted medical devices, such as pacemakers or defibrillators, should avoid using TENS without medical approval. The electrical impulses from the TENS machine may interfere with the proper functioning of these devices.
- Epilepsy or Seizure Disorders: TENS therapy involves electrical stimulation, which can trigger seizures in individuals with epilepsy or a history of seizure disorders. If you have a seizure disorder, consult with a healthcare professional before using TENS for knee pain.
- Undiagnosed Knee Pain: If you are experiencing knee pain without a clear diagnosis or understanding of the underlying cause, consult with a healthcare provider before using TENS therapy. Proper diagnosis is essential to ensure appropriate and targeted pain management.
Precautions for knee pain TENS use
- Avoid Open Wounds or Broken Skin: When applying the knee electrode pads, ensure that they are placed on intact, healthy skin. Avoid placing the pads over open wounds, cuts, or broken skin to prevent potential infection or discomfort.
- Avoid Placement Over Surgical Incisions: If you have recently undergone knee surgery, avoid placing the TENS electrode pads directly over the surgical incisions. Consult with your surgeon or healthcare provider regarding the appropriate timing and placement of TENS therapy after surgery.
- Skin Irritation or Allergic Reactions: Some individuals may experience skin irritation or allergic reactions to the adhesive used on the electrode pads. If you notice redness, itching, or any skin discomfort, discontinue TENS use and consult with a healthcare professional.
- Individual Sensitivity: Individuals may vary in their response to TENS therapy. It is essential to start with low-intensity settings and gradually increase as tolerated. Discontinue use if you experience excessive discomfort or adverse reactions.
Why Do I have knee Pain?
Here are some common reasons why we develop knee pain:
Osteoarthritis: Osteoarthritis is one of the leading causes of knee pain, especially in older adults. This degenerative joint disease results from the wear and tear of cartilage, leading to inflammation, pain, and reduced joint flexibility.
Statistics: Osteoarthritis affects millions of people worldwide, with knee osteoarthritis being particularly common. According to the World Health Organization (WHO), around 10% to 15% of adults aged 60 years and older have some degree of knee osteoarthritis.
Ligament Injuries: Injuries to the ligaments supporting the knee joint can cause significant pain and instability.
MCL (Medial Collateral Ligament) Injuries: The MCL is located on the inner side of the knee and is commonly injured during sports or activities involving sudden changes in direction. According to the American Academy of Orthopaedic Surgeons (AAOS), MCL injuries account for about 42% of all knee ligament injuries.
ACL (Anterior Cruciate Ligament) Injuries: The ACL is located in the center of the knee and is often injured during sports that involve twisting or pivoting movements. ACL injuries make up approximately 25% of all knee ligament injuries.
Meniscus Tears: The menisci are cartilage discs that act as shock absorbers in the knee joint. Tears in the meniscus can occur due to sudden twisting or degenerative changes with age.
Tendonitis: Tendonitis refers to inflammation of the tendons that connect muscles to bones around the knee joint. Overuse or repetitive movements can lead to tendonitis and subsequent knee pain.
Bursitis: Bursae are small, fluid-filled sacs that cushion and reduce friction in the knee joint. Inflammation of these bursae can cause pain and swelling.
Patellofemoral Pain Syndrome: Also known as “runner’s knee”, or hiker’s knee, this condition involves pain around or behind the kneecap, often caused by improper alignment or overuse.
Medical Conditions That Can Cause Knee Pain
In addition to injuries and degenerative conditions, knee pain can also be associated with various medical conditions, including:
- Rheumatoid Arthritis: An autoimmune disease that causes joint inflammation, including the knee joint.
- Gout: A type of arthritis caused by the buildup of uric acid crystals in the joint, leading to sudden and severe knee pain.
- Baker’s Cyst: A fluid-filled swelling at the back of the knee, often resulting from underlying conditions like arthritis or meniscus tears.
- Infections: Infections in the knee joint or surrounding tissues can cause significant pain and inflammation.
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