What is the role of Transcutaneous Electrical Nerve Stimulation (TENS) for muscle building?

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From the Guidelines

TENS (Transcutaneous Electrical Nerve Stimulation) is not effective for muscle building. While TENS units are useful for pain management by sending electrical impulses through the skin to stimulate nerves, they don't provide sufficient resistance or stimulus to promote significant muscle growth. According to the 2022 American College of Rheumatology guideline for exercise, rehabilitation, diet, and additional integrative interventions for rheumatoid arthritis 1, using electrotherapy, including TENS, is conditionally recommended against due to low certainty evidence of no improvement in pain and physical function. For effective muscle building, you should focus on progressive resistance training, such as weightlifting, resistance bands, or bodyweight exercises, as recommended by the American Heart Association Council on Clinical Cardiology and Council on Nutrition, Physical Activity, and Metabolism 1.

Key Components of Muscle Building

  • Progressive resistance training:
    • 1 set of 8-12 reps for persons 50-60 years of age
    • 10-15 reps at reduced levels of resistance for persons 50-60 years of age
    • Minimum 1 exercise per major muscle group
  • Proper nutrition:
    • Adequate protein intake (1.6-2.2g per kg of bodyweight daily)
  • Sufficient recovery time:
    • 48-72 hours for specific muscle groups

The science behind muscle building involves creating microscopic damage to muscle fibers through resistance training, which then repair and grow stronger during recovery periods when provided with proper nutrition. This process, called hypertrophy, requires mechanical tension, metabolic stress, and muscle damage - stimuli that TENS cannot provide. If you're interested in electrical muscle stimulation for fitness purposes, look into EMS (Electrical Muscle Stimulation) devices instead, though even these should supplement rather than replace traditional resistance training.

From the Research

Transcutaneous Electrical Nerve Stimulation (TENS) for Muscle Building

  • There is no direct evidence to suggest that TENS is used for muscle building. The provided studies focus on the use of TENS for pain management and its potential interactions with implantable cardiac devices 2, 3, 4, 5, 6.
  • TENS is commonly used as an adjunct non-pharmacological treatment for chronic pain, but its effectiveness for this purpose is still uncertain due to the low quality of evidence 2.
  • The use of TENS has been shown to potentially interfere with the function of implantable cardiac devices, such as pacemakers and implantable cardioverter defibrillators (ICDs) 3, 4, 5, 6.
  • Studies have investigated the risk of interference between TENS and ICD function, with results suggesting that TENS can cause disturbance on the sensing function of ICDs, leading to potential misinterpretation of cardiac rhythms 6.
  • The safety of using TENS in patients with implantable cardiac devices is a concern, and some studies recommend against its use in these patients due to the potential risks 4, 6.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Transcutaneous electrical nerve stimulator-induced electrocardiogram artifact. A brief report.

American journal of physical medicine & rehabilitation, 1996

Research

The simultaneous use of a biventricular implantable cardioverter defibrillator (ICD) and transcutaneous electrical nerve stimulation (TENS) unit: implications for device interaction.

Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology, 2003

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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