Shockwave Therapy Vs. TENS

If you have been looking into non-invasive technologies to support your healing process, you have likely come across both shockwave therapy and TENS.

Occasionally we get asked by people who have tried TENS whether shockwave therapy works similarly.

Shockwave therapy and TENS are both common treatments used in patients with pain. Both are widely available in the UK and are carried out by healthcare professionals.

In just about every other respect the two treatments are different.

Below we explain each treatment and what they are used for.

What is TENS?

TENS (Transcutaneous Electrical Nerve Stimulation) is often used by clinicians treating patients with pain.

A TENS machine is a small battery powered device that is connected to the patient’s skin by two sticky electrode pads. Small electrical impulses are passed between the electrodes, along the area of the body affected by pain. Pain signals are also small electrical impulses that are passed along nerves up the spine and to the brain. What TENS is thought to do is disrupt this pain signalling, relieving pain sensations and relaxing muscles around it.

Pain is an important function of your body to detect danger and damage, but for some patients with chronic pain it can be little help and a significant barrier to everyday life.

The effectiveness of TENS is not definite, as it does not have the same level of supporting research that other pain treatments do. Many clinicians who use it regularly report improvements in reported pain for their patients, but it does not work for everyone. There are large-scale clinical studies currently ongoing so we may have a more conclusive answer in coming years.

TENS is also not a treatment for the source of pain, and will not treat a condition directly, but rather reduce the amount of pain felt.

What conditions is TENS used to treat?

TENS is used to treat pain caused by:

  • Arthritis

  • Period pain

  • Pelvic pain caused by endometriosis

  • Knee pain

  • Sports injuries

  • Labour

Who can administer TENS treatment?

TENS machines are freely available online or from high street pharmacists. It doesn’t require any medical training to use and is simple enough to figure out from in-the-box instructions.

What is Shockwave therapy?

Shockwave therapy involves passing high-frequency acoustic pulses through the soft tissue or bone in the damaged area. These pulses create microtrauma in the cells around it, triggering an inflammatory response. The therapeutic effect mostly comes from increases in blood circulation in the tissue, meaning more substances involved in repair can be delivered to the affected site, as well as enhanced metabolic activity, leading to the onset of the healing process.

The shockwaves also overstimulate nerves, which can reduce sensitivity and pain in chronic conditions. In this respect shockwave affects pain in a similar way to TENS, but TENS does not have the primary healing effect that shockwave provides.

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What conditions can shockwave therapy treat?

Shockwave therapy delivered by qualified therapists is largely risk and side-effect-free, making it a safe treatment choice for musculoskeletal conditions and chronic pain.

Shockwave can effectively treat symptoms and improve function of:

  • Jumper’s knee 2

  • Calcifications 1

  • Painful shoulder 3

  • Tennis elbow 4 5

  • Heel spur 5

  • Plantar fasciitis 1 5

  • Chronic tendinopathy/chronic pain 5

  • Medial tibial stress syndrome 6

  • Hip pain 7

  • Achilles tendinitis 5 10

  • Myofascial Pain Syndromes 8

  • Calcific tendonitis 1 10

  • Hamstring tendinopathy 9

  • Non healing wounds 11 12 13

  • Union/non-union fractures 19

  • Erectile dysfunction 14 15

  • Chronic Pelvic Pain Syndrome 16 17 18

The conditions and research listed here represent only the tip of the iceberg. Over 3000 papers have so far been published on shockwave therapy and new treatments are being investigated regularly.

Unlike TENS, shockwave therapy treats the condition causing the pain rather than just the symptom of the pain itself.

Who can administer shockwave therapy?

Shockwave therapy is administered in clinics or hospitals by healthcare professionals. Some areas of the body and conditions are contraindicated for shockwave therapy, so it is important that it is delivered by someone who has been trained in how to use it.

You may come across some cheap shockwave machines online that are available for purchase by anyone, however these devices will be ineffective and a waste of money.

When considering a new treatment for your condition it is always important that you speak with your GP or relevant health professional to ensure that you have the correct advice moving forward.

Shockwave therapy

  • Promotes repair and analgesia

  • Treats the root cause of the pain, meaning long term freedom from pain
  • Delivered by medical professional
  • Supported by over 3000 papers

  • Produces high-frequency acoustic waves


  • Only promotes analgesia

  • Covers up pain in the short term, meaning further treatments are needed for the cause
  • Delivered by anyone

  • Disputed efficacy and further research needed

  • Produces low-level electrical impulses