E-Stim: What It Is, How It Works, and Why It May Help You (2023)

Whether you’re recovering from an injury or stroke or dealing with the pain of fibromyalgia or another condition, you may benefit from a physical therapy procedure called electrical stimulation, or e-stim.

E-stim sends mild electrical pulses through the skin to help stimulate injured muscles or manipulate nerves to reduce pain.

E-stim may not be appropriate for everyone, but for many people this painless procedure is accelerating recovery and providing relief from painful or uncomfortable symptoms.

E-stim uses electrical pulses to mimic the action of signals coming from neurons (cells in your nervous system). These mild electrical currents target either muscles or nerves.

E-stim therapy for muscle recovery sends signals to targeted muscles to make them contract. (Flexing your biceps is a form of muscle contraction.) By causing repeated muscle contractions, blood flow improves, helping repair injured muscles.

Those muscles also improve their strength through repeated cycles of contraction and relaxation. E-stim can also “train” muscles to respond to the body’s natural signals to contract. This is an especially helpful benefit for stroke survivors who must essentially relearn basic motor functions.

The type of e-stim that focuses on pain relief sends signals on a different wavelength so they reach the nerves, rather than the muscles. Electrical stimulation can block pain receptors from being sent from nerves to the brain.

The two main types of e-stim are transcutaneous electrical nerve stimulation (TENS) and electrical muscle stimulation (EMS).

(Video) Muscle Stimulators: 5 Fast Facts


TENS may be used for chronic (long-term) pain as well as for acute (short-term) pain. Electrodes are placed on the skin near the source of the pain. Signals are sent through nerve fibers to block or at least reduce the pain signals traveling to the brain.


EMS uses a slightly stronger current than TENS to get muscles to contract. The unit’s electrodes (also placed on the skin near the affected muscles) cause rhythmic contractions. This can improve muscle strength if the user attempts to contract the muscle simultaneously.

Other e-stim types

In addition to EMS and TENS, your doctor or physical therapist may recommend other e-stim treatments.

other types of e-stim

One of the following similar e-stim treatments may help you, depending on your condition:

  • Electrical stimulation for tissue repair (ESTR) helps reduce swelling, increase circulation, and speed up wound healing.
  • Interferential current (IFC) stimulates nerves to reduce pain.
  • Neuromuscular electrical stimulation (NMES) stimulates the nerves in muscles to restore function and strength, prevent muscle atrophy, and reduce muscle spasms.
  • Functional electrical stimulation (FES) involves a unit implanted in the body to provide long-term muscle stimulation aimed at preserving function and motor skills.
  • Spinal cord stimulation (SCS) uses an implantable device to relieve pain.
  • Iontophoresis helps deliver ionically charged medication to tissue to help speed up healing.

You may have seen TV and online advertisements for home e-stim systems. If you’re interested in one of these products, talk with your doctor or a physical therapist. Be sure to get proper instruction on its use before trying it out.

As part of a physical therapy program, you may be provided a battery-powered unit to use at home. Make sure the unit’s settings are correct before using it on your own.

E-stim uses small electrodes placed on the skin. The electrodes are small, sticky pads that should come off with little discomfort at the end of the session.

Several electrodes are placed around the area receiving treatment. Wires from the e-stim device are attached to the pads.

Steady streams of electrical pulses are delivered through the wires from the e-stim unit. The unit may be small enough to fit in your hand or larger, like a landline phone and answering machine.

For muscular stimulation, the pulses will reach the muscles, signaling them to contract.

Pulses aimed at the nervous system block the transmission of pain signals from reaching the spinal cord and brain. The pulses also stimulate the body to produce more natural pain-relieving chemicals called endorphins.

(Video) Introduction to Electrical Stimulation

What to expect during e-stim
  • Electrodes are placed around the site receiving therapy.
  • The electrical current will begin on a low setting and increased gradually.
  • You’ll get a tingly, “pins and needles” feeling at the site.
  • Depending on the type of e-stim, you may feel a muscle twitch or contract repeatedly.
  • Each e-stim therapy session may last 5 to 15 minutes, depending on the condition being treated.

When e-stim is part of an overall physical therapy program, your insurance may cover it like other physical therapy treatments.

Check with your insurance provider first, however. The nature of your condition will often determine coverage. For example, an insurance provider may cover e-stim for scoliosis in serious cases, but not if the curvature is less than 20 degrees.

Home TENS or EMS systems can start at $20 for simple, starter units. Higher-end systems that are more durable and offer more features can cost several hundred dollars.

E-stim may be appropriate for the following conditions:

  • back pain
  • cancer-related pain
  • dysphagia (trouble swallowing)
  • fibromyalgia
  • joint pain
  • arthritis
  • muscle conditioning (mostly for athletes, such as long-distance runners)
  • muscle injury from trauma or disease
  • nerve inflammation
  • poor muscle strength
  • urinary incontinence
  • spinal cord injury
  • stroke
  • surgery recovery

Researchers are also working on ways to use e-stim to help people with advanced multiple sclerosis walk again.

Risks of e-stim

(Video) Does Neuromuscular Electrical Stimulation Work for Training and Recovery?

The most common risk of e-stim is skin irritation where the electrodes are placed.

However, there’s a much more serious risk to heart health. For people with a pacemaker or other implantable heart device, e-stim may be dangerous and isn’t recommended.

E-stim is also not recommended for those who are pregnant. But in some supervised circumstances, e-stim has been used to help relieve labor pains.

E-stim targeting the nerves for pain relief can be effective in treating a range of conditions causing nerve and musculoskeletal pain as well as pain that doesn’t respond to traditional treatments, according to 2019 research.

However, the researchers note e-stim isn’t always a first-line treatment. Rather, it’s part of a broader set of options available to physical therapists.

Depending on your condition, you could start to feel better after one e-stim session. You may need multiple sessions, depending on the severity of your condition and symptoms.

In a small 2019 study, researchers found that 36 NMES sessions over a 16-week period improved muscle function in people with rheumatoid arthritis.

E-stim is still considered an alternative therapy. There are some health experts who are skeptical of its long-term effectiveness.

There’s also some disagreement about which conditions are best suited for e-stim treatment.

Generally speaking, e-stim is most effective at working weakened or atrophied muscles and healing muscles after an injury or surgery.

As a pain reliever, e-stim (especially TENS therapy) can be effective in treating many conditions, though typically as part of a broader pain-management program.

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While e-stim can be an effective tool in physical therapy and rehabilitation, it’s just one of many strategies employed by physical therapists, sports medicine physicians, and orthopedists.

Other forms of therapy include:

  • muscle-strengthening exercises using weights, resistance bands, machines, and a person’s own body weight
  • massage
  • range-of-motion exercises
  • stretching and flexibility exercises
  • ice and heat treatments

E-stim treatments have become standard parts of physical therapy for many conditions.

When used as part of injury or surgery recovery, e-stim should be used as a prescribed, supervised treatment, though home use may be appropriate in many cases.

Just be sure to tell your healthcare provider if you have a heart condition or are pregnant.

Sharing your medical history and a list of medications and supplements you take is always a smart and safe approach, too.

If you’re interested in e-stim as a tool for muscle conditioning or pain relief, talk with your doctor about your options and how to proceed safely.


How does electro stim work? ›

E-stim uses electrical pulses to mimic the action of signals coming from neurons (cells in your nervous system). These mild electrical currents target either muscles or nerves. E-stim therapy for muscle recovery sends signals to targeted muscles to make them contract.

What are the 3 main reasons we use electrical stimulation? ›

Electrical stimulation is a type of physical therapy modality or treatment used to accomplish various tasks in physical therapy (PT). The idea is that applying an electrical current helps strengthen muscles, block pain signals, and improve blood circulation.

What are the benefits of electric stim? ›

Electric muscle stimulation can also help reduce chronic pain. Other benefits include: May improve joint pain and swelling.
Benefits of Electric Muscle Stimulation
  • Relieve discomfort and pain.
  • Reduce muscle spasms.
  • Restore muscle tone.
  • Rehabilitate parts of the body.

How does e-stim promote healing? ›

ELECTRICAL STIMULATION can help speed wound healing by increasing capillary density and perfusion, improving wound oxygenation, and encouraging granulation and fibroblast activity.

How does stim help tight muscles? ›

Electrical muscle stimulation, sometimes called e-stim or muscle stim, delivers light electrical pulses to the muscles surrounding the site of back or neck pain. This relaxes the muscles which can relieve pain, reduce inflammation, and decrease muscle spasms.

Does electrical stimulation help nerve damage? ›

Several studies have shown that direct electrical stimulation of the injured nerves can enhance sensory and motor axon regeneration, hasten functional recovery, and facilitate reinnervation [2, 5–11].

What are the four types of electric stimulation? ›

Russian electrical stimulation. Neuromuscular electrical stimulation (NMES) Functional electrical stimulation (FES) Transcutaneous electrical nerve stimulation (TENS)

Is Stim good for pinched nerve? ›

Muscle Stimulation

A pinched nerve can be caused by a muscle that places pressure upon the nerve. When this occurs, electrical muscle stimulation can work to relieve the muscle contraction that caused the pinched nerve.

Does a TENS unit help with inflammation? ›

Reduced inflammation

Research has shown that a TENS unit can also reduce chronic hyperalgesia induced by muscle inflammation. The units can help reduce swelling and increase circulation, which may also enhance tissue healing and inflammation control.

What are the side effects of estim? ›

Side effects
  • pain.
  • headaches.
  • muscle spasms.
  • pain in lower back.
  • uncomfortable.
  • dizziness.

Does electrical stimulation help with inflammation? ›

Electrical stimulation helps to prevent atrophy and build or maintain muscular strength, reduces inflammation, and improves range of motion. Different types of electrical stimulation are used in treating sprains, arthritis, chronic pain, and sciatica.

What promotes nerve healing? ›

Magnesium promotes the regeneration of the peripheral nerve.

Can electricity heal nerves? ›

Findings: Electrical stimulation applied to injured peripheral nerves during surgical repair can greatly enhance nerve recovery—both sensory and motor functions. This effective modality is not being used in the clinic or hospital sitting due to challenges in translation.

What is an example of electrical stimulation? ›

Neuroprosthetics/Functional Electrical Stimulation refers to the use of electrical stimulation during a task. This can include walking or using an arm to reach. For example, “foot drop” is a common problem for a child with a neurological injury. The child has difficulty picking up his or her toes when walking.

Does electrical stimulation help back pain? ›

Transcutaneous electrical nerve stimulation is also known as TENS or TNS. It is a passive, non-invasive, non-addictive modality with no known side effects. TENS works to decrease perception of back pain or neck pain. The treatment can help patients control acute and chronic pain.

How long should you use electrical muscle stimulation? ›

You should feel your muscles twitching or contract during treatment. Finally, the average muscular stimulation therapy sessions last about 10 minutes. However, your treatment may range between 5 and 15 minutes, depending on the area and condition of your muscles.

How often should you do electro stim? ›

You can safely use a TENS machine as often as you like. Usually for 30-60 minutes up to 4 times daily. TENS can provide relief for up to four hours.

What is the difference between TENS and E Stim? ›

The main difference

Transcutaneous Electrical Nerve Stimulation (TENS) machines stimulate the nerves exclusively for the purpose of relieving pain, whereas Electrical Muscle Stimulation (EMS) machines are designed to stimulate the muscles for the purposes of strengthening and rehabilitating them.

When should you not use E Stim? ›

If there is an area known peripheral vascular disease, thrombophlebitis, a known DVT or suspected DVT, you want to avoid Estim in that area. You will also want to avoid the obvious places like over the phrenic nerve, the gonads, the eyes, over areas of active osteomyelitis, and areas of hemorrhage.

Can you use E Stim too much? ›

TENS is safe, so you can use it as much as you like, although it's good practice to take regular 10-minute breaks every hour or so. Some people use TENS for more than five hours a day.

Can you overuse a muscle stimulator? ›

Short-term electrical stimulation is not damaging.

But chronic electrical stimulation can damage the structure of the nerves. For stimulation longer than 30 minutes, remember to pause for at least 20 minutes to prevent skin irritation.

When is the best time to use Stim? ›

Post-Workout. Finally, when used after working out, e-stim can help bring fresh oxygen and blood into your muscles, facilitating toxin removal and helping to speed up recovery.

Can E Stim cause nerve damage? ›

Electrical stimulation to the nerve root may trigger a series of pathophysiological processes that lead to secondary injury. Apoptosis is an important mechanism of cell death following spinal cord injury and a very complex pathophysiological process involving Bcl-2, Bax, P53, C-myc, and Caspase-3 proteins.

Does TENS reduce inflammation? ›

Reduced inflammation

Research has shown that a TENS unit can also reduce chronic hyperalgesia induced by muscle inflammation. The units can help reduce swelling and increase circulation, which may also enhance tissue healing and inflammation control.

Does E Stim increase circulation? ›

Physiological changes caused by electrical stimulation include an increase in blood flow and an effect on the peripheral circulation [7]. The appropriate dose and duration of electrical stimulation can achieve various physiological responses [10].

How long should you use electrical stimulation? ›

Research has shown that TENS is most helpful for chronic pain when used for at least 30 minutes while you are active. It is less effective when you are sitting still, lying down, or resting.

Are there any negative side effects of TENS unit? ›

Are there any risks of side effects? For most people, TENS is a safe treatment with no side effects. Some people may be allergic to the pads and their skin may become red and irritated. Speak to your GP, physiotherapist or pharmacist if you have concerns.

Can estim cause damage? ›

Researchers speculate that too much stimulation may actually cause more pain or damage the muscle. Due to the potential risks involved with electrical stimulation, it is important to discuss treatment with your doctor before implementing it into your recovery program.

Does Stim burn fat? ›

It also gives the muscle more resistance, helps it burn fat, and convert it into muscle fibers, toning the muscle. For all these reasons, electrostimulation is the best way to tone muscles and lose weight. While the muscles are toned, at the same time, you lose fat.


1. Principles of Electrical Stimulation
(Ryan Krzyzanowicz)
2. How to Use a TENS Unit for Pain Relief - Ask Doctor Jo
3. The Most Powerful E-Stim Device for Higher Performance and Recovering Faster From Injuries
(Ben Greenfield Life)
4. Stroke Rehabilitation: Use of electrical stimulation to help the fingers be able to open and close
(Legacy Health)
5. E-Stim for Beginners :: A simple electroplay demonstration with the E-Stim Systems ElectroHelix
(E-Stim Systems Ltd)
6. Guide to electrical stimulation therapy for stroke patients
(Rehab HQ)
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