If you know about electrotherapy, then you’ve probably heard of the EMS vs TENS debate, too. Both use electrical stimulation for pain alleviation or muscle recovery. But is one better than the other?

Well, that depends on your specific needs. While both use a natural, drug-free method for body relief, knowing their differences will optimise results.

This guide then highlights the difference between EMS and TENS units, so you’ll get the best possible treatment.

EMS vs TENS Unit: Definition

First, let’s define the two. Electrical muscle stimulation (EMS) sends low-voltage electrical signals to the muscles via adhesive pads or electrodes.

These impulses encourage repeated muscle contractions, which can be short, long, frequent or sustained, depending on the settings.

The goal of these muscular contractions varies. It can be to relieve inflammation or strengthen your muscles without pain or fatigue.

TENS or transcutaneous electrical nerve stimulation also transmits electrical impulses via adhesive pads. The target, however, this time is your nerves, not the muscles.

The purpose of nerve stimulation is mainly to intercept the neurons from sending pain signals to the brain. It results in temporary pain relief but not an absolute cure.

Both EMS and TENS units cause a slight tingling sensation to the body when used. Also, treatment duration can last from a few minutes to less than an hour.

EMS vs TENS Units

EMS vs TENS Unit: Difference

I’ve identified a few factors to make it easier to differentiate one from the other.

Stimulation Effects

We now know that EMS targets the muscles, while TENS aims for the nerves. But how do these two forms of electronic stimulation differ?

EMS improves blood circulation. Increased blood flow through muscle stimulation, in turn, brings a lot of benefits. For instance, it relaxes your muscles, protecting you from inflammation or pain.

Active people and athletes also need this effect to speed up muscle growth or recovery. It’s also helpful for people with injury or mobility issues as muscle stimulation can protect them from atrophy.

TENS relieves acute and chronic pain. Electrical nerve stimulation can do this by improving your blood circulation. Pain-free impulses from a TENS unit also take over pain signals, resulting in instant relief.

Science further explains this reaction through the gate control theory of pain. And lastly, stimulating the nerve endings encourages the release of endorphins, our body’s natural painkillers.


One way to settle the EMS vs TENS discussion is to understand their use. People in fitness centres and rehabilitation clinics, for instance, use EMS units for treating patients who need:

  • enhanced blood circulation
  • strain-free muscle rebuilding
  • muscle cramp or spasm relief
  • faster injury or illness recovery
  • muscle strengthening or toning
  • athletic performance improvement
  • muscular relaxation or rehabilitation
  • venous thrombosis and muscle atrophy prevention

TENS units are available for home, hospital or pain clinic use to provide relief from a range of conditions like:

  • arthritis
  • sciatica
  • tendonitis
  • fibromyalgia
  • sports injury
  • multiple sclerosis
  • headaches or migraines
  • carpal tunnel syndrome
  • wounds, incisions or surgery
  • menstrual, labour or delivery pain
  • back, foot, cancer or neuropathic pain

EMS vs TENS Machines


Does EMS or TENS work? Which is more effective? Well, experts are yet to resolve the EMS vs TENS debate in terms of effectiveness.

Researchers need to do more high-quality studies to prove their efficacy. Still, previous results are promising.

Research in 2012, for example, shows that athletes can use EMS devices as an alternative to traditional strength training. Authors of a 2018 study also concluded that EMS is effective for patients who went through orthopaedic surgeries.

As for TENS, one interesting finding is the relation of pain relief to stimulation intensity. Specifically, a 2014 review found that patients develop pain treatment tolerance when using the same stimulation level daily.

Thus, researchers from the same study concluded that applying TENS with higher intensity is more effective.

Side Effects and Safety

Both EMS and TENS machines are generally safe for home use. However, they may also cause adverse effects. Some people, for instance, may experience skin irritation from the electrode pads due to nickel or adhesive allergy.

Others also report shock or burning sensations. These are more common in EMS unit users as this device transmits a stronger current than TENS.

There are contraindications as well. For example, EMS and TENS machines may interfere with pacemakers and defibrillators. Patients with these medical device implants should then consult their doctors first.

It is still unclear how EMS and TENS can affect unborn babies, too. So, mums-to-be need to talk with their physicians or midwives before using electrotherapy for labour pains.

EMS vs TENS Devices

EMS vs TENS Unit: Verdict

To sum up, both devices share similarities when it comes to stimulation delivery, safety and contraindications.

The main difference between EMS and TENS units, however, is their stimulation target. And so, it’s vital that we identify our electrotherapy goal first, then match it with the correct device to get optimum results.

While you can purchase either EMS or TENS machines in the market, some offer both in one device. These are ideal for people who need the benefits of both electrotherapy methods.

If you are this type of user, you can check out my EMS TENS machine buying guide and review and learn more.