Injury type: Acute/ Chronic

Category: Allied Health Options

Rating: Not effective 

What is it?

An alternating electrical current (AC) or modulated direct current (DC) underpins all stimulating forms of electrotherapy. The electrical current, rectified to a safe, low-voltage level is applied to the body via electrodes placed on the skin. Transcutaneous electrical nerve stimulation (TENS) is one form of electrical nerve stimulation. TENS machines come in various sizes but most are small enough to clip onto your belt and wear whilst walking around.

How does it work?

The current may inhibit pain in the tissues surrounding the electrodes by inhibiting pain impulses (the so-called ‘pain gate theory’). It works by distracting your nerves and brain from the pain sensations.

Is it effective?

There is mixed evidence on the effectiveness of TENS following whiplash. A systematic review of existing whiplash related clinical practice guidelines1 found conflicting recommendations relevant to the use of TENS, ranging from ‘recommended for consideration’ (for acute/ subacute whiplash) to ‘no evidence’ or ‘recommended against’ (for chronic whiplash). Another systematic review2 which updated evidence on passive physical modalities suggested that TENS is ‘likely not helpful/ not worth considering’ as a management option for persistent grade I-II whiplash. More recently, a revised clinical practice guideline underpinned by a systematic review of literature3 revealed a weak level of evidence, suggesting that health care professionals may provide TENS to patients with acute and chronic whiplash.

Are there any disadvantages?

There has been no research on the disadvantages associated with electrical nerve stimulation. TENS machines are available to purchase however they may be costly, and may not be suitable for everyone.

Where do you get it?

TENS units are available to purchase from various sources (i.e. internet, medical suppliers, pharmacies/chemists) or through your treating therapist.


The use of TENS for whiplash is not recommended due to limited current research evidence. More research is required.