--- title: "TENS Unit Pad Placement: Where to Put Electrode Pads" description: "TENS unit pad placement in plain steps: how to prepare skin, space the pads, and where never to put them. Based on NHS and University of Iowa guidance." url: https://analgesic.multisites.ai/guides/tens-pad-placement-guide publisher: Analgesic Healthcare phone: +1-800-749-1188 contact: https://analgesic.multisites.ai/contact --- Guide # TENS pad placement guide: where to put your electrode pads Put TENS electrode pads on clean, dry skin near the painful area, with a gap between them, and turn the unit off first. Never place pads on broken or numb skin, the head, face, throat, or over the spine. Your clinician can show you the exact spots for your pain. Updated October 26, 20267 min read2 sources ## Skin first Pads stick well to clean, dry skin. University of Iowa Health Care says to clean off oil and lotion first. ## Near the pain, with a gap The NHS says to place pads near the painful part of your body and to leave a gap between them. ## Some places are off limits Do not place pads on the head, face, throat, broken skin, or directly on the backbone. ## Ask for a map Written sources do not give exact spots for every pain. Ask your doctor or physical therapist to mark yours. Never place pads on - Broken, irritated, infected or numb skin - Your head, face, eyes or mouth - Your neck or throat - Your chest and back at the same time - Directly on your backbone Place pads safely - On clean, dry skin near the pain - On fleshy areas, not over bony sites - With a gap between them, never touching each other or metal - Only with the unit turned off, and off again before you move them Sources: [NHS](https://www.nhs.uk/conditions/transcutaneous-electrical-nerve-stimulation-tens/), [University of Iowa Health Care](https://uihc.org/health-topics/transcutaneous-electrical-nerve-stimulator-tens). Your clinician and your device's instructions decide your exact placement. ## How should I get ready before I place TENS pads? Turn the TENS unit off and clean your skin. Dry skin lets the [electrode pads](https://analgesic.multisites.ai/glossary/electrode-pad) make firm contact. The NHS says: “Make sure the TENS machine is turned off before you start.” University of Iowa Health Care (UI Health Care) says it is “very important” to put pads on clean, dry skin. If a pad is not secure, the stimulation can change and cause discomfort. Clean off oil and lotion first. Follow these steps for any placement: 1. Turn the [TENS unit](https://analgesic.multisites.ai/glossary/tens-unit) off. 2. Clean the skin where the pads will go. Let it dry. 3. Plug the [lead wires](https://analgesic.multisites.ai/glossary/lead-wire) all the way into the pads. UI Health Care says no bare metal pins should show. 4. Plug the lead wire plugs into the unit. 5. Peel the pads off the plastic liner. Save the liner for storage. 6. Press the pads onto your skin. 7. Turn the unit on. Turn the dial slowly until you feel tingling. The NHS says it should not be painful. Read your device’s leaflet for the full list of rules. Follow your clinician’s and your device’s instructions. For the full safety list, see the [TENS unit safety guide](https://analgesic.multisites.ai/guides/tens-unit-safety). ## What are the basic rules for pad spacing and position? Place pads near the pain, on fleshy areas, with a gap between them. These are the rules the two sources agree on. Rule What the source says Source Near the pain Place pads “near the painful parts of your body” NHS Leave a gap “Leave a gap between the pads” NHS Surround the pain “Try to surround the painful area” UI Health Care Fleshy areas Place pads on fleshy areas, not over bony sites UI Health Care No contact Pads should not touch each other or any metal object, such as a belt buckle or metal jewelry UI Health Care Neither page gives a distance in inches or centimeters. Do not guess one. Ask your clinician to show you. UI Health Care says two sets of pads go on the body, and you may try any placement shown on its pages. Your own plan may differ, so use the one your clinician gave you. ## Where do TENS pads go for low back pain? Place them on the muscle beside the painful area. Do not place them on the backbone. UI Health Care says not to use TENS “directly on your backbone.” The NHS says not to use TENS on your chest and back at the same time. Pad placement for the [lumbar spine](https://analgesic.multisites.ai/glossary/lumbar-spine) depends on the person. Ask your doctor or physical therapist to mark the spots on your skin or draw them on paper. Then follow that plan. One coverage fact matters here. Medicare’s local policy (LCD L33802) says TENS for chronic low back pain “will be denied as not reasonable and necessary.” That is a payment rule, not a statement about what a clinician may suggest. Read more in the [TENS for lower back pain guide](https://analgesic.multisites.ai/guides/tens-for-lower-back-pain) and on the [back pain page](https://analgesic.multisites.ai/pain-areas/back-pain). ## Where do pads go for the neck and shoulder? Ask your clinician first. The two sources give different wording, so this area needs a person who knows your case. - The NHS says: “Do not use TENS on your neck, mouth or eyes.” - UI Health Care says not to use TENS on “any part of your head or face” or “any part of your throat.” Both list places to avoid. There is no safe pad map for the neck. Do not place a pad on the neck, front of the throat, head or face unless your clinician tells you to. If your clinician does, follow that plan and your device’s instructions. Headache is also a coverage topic. LCD L33802 lists headache as an example of a condition where TENS therapy “is not considered to be reasonable and necessary.” ## Where do pads go for the knee and foot? Use the same rules: clean skin, near the pain, fleshy areas, and a gap between pads. UI Health Care says to avoid bony sites. A knee or foot has many bony spots, so a clinician’s guidance matters more here. Pad placement for the knee or foot depends on the person. Ask your doctor or physical therapist for one. For a place to start reading about foot pain, see our posts on [causes of foot pain](https://analgesic.multisites.ai/causes-for-foot-pain-and-how-to-fix) and [morning foot pain](https://analgesic.multisites.ai/whats-causing-my-morning-foot-pain). ## Where should I never place TENS pads? Never place pads on skin that is damaged or numb, or on the head, face or throat. These lists come from the NHS and UI Health Care. They list the same kinds of places to avoid, in different words. Do not place pads on NHS UI Health Care Irritated, broken, infected or numb skin Yes Yes (open wounds, rashes, swollen, red, infected or inflamed skin, skin without normal feeling) Neck, mouth or eyes Yes Not listed in this form Any part of the head or face Not listed in this form Yes Any part of the throat Not listed in this form Yes Chest and back at the same time Yes Not listed in this form Both sides of the chest or trunk at the same time Not listed in this form Yes Directly on the backbone Not listed in this form Yes Cancerous lesions, or close to them Not listed in this form Yes If a source does not list a place, that does not make the place safe. Use the stricter rule. People with a [cardiac pacemaker](https://analgesic.multisites.ai/glossary/cardiac-pacemaker) or another [implanted medical device](https://analgesic.multisites.ai/glossary/implanted-medical-device) should not use TENS. Both the NHS and UI Health Care say so. The NHS also says not to use TENS if you have epilepsy, or if you are pregnant unless your doctor or midwife tells you to. ## What should the pads feel like once they are on? You should feel tingling, and it should not hurt. The NHS says to turn the dial slowly until you feel a tingling sensation and says “It should not be painful.” UI Health Care adds that you may feel tingling, tapping, buzzing or muscle twitching. It says the feeling can seem weaker after a few minutes as your body gets used to it. It then says to turn up the [stimulation intensity](https://analgesic.multisites.ai/glossary/stimulation-intensity) to keep it “strong but comfortable.” Your device and your clinician decide the rest. The [settings guide](https://analgesic.multisites.ai/guides/tens-unit-settings-explained) covers intensity in more detail. If one pad feels much stronger than the others, turn the unit off. Check that every pad is flat against the skin and every wire is plugged in. A loose pad can change the feeling. ## What should I do if the pads will not stay in place? Check the skin first, then the pad. UI Health Care gives these steps for pads that slip or lift: 1. Turn the unit off and unplug the wire from the pad. 2. Clean the skin and let it dry. 3. Wet your fingertip with water and gently rub the pad surface. Let it dry for 60 seconds. Then try again. 4. If that does not work, use a new pad. Sweat can move pads. UI Health Care says a skin prep product can help the pads stick, and that medical tape can hold them if sweating is a problem. Ask your health care team for instructions before you use tape. Never pull on the wires to remove a pad. UI Health Care says pulling or yanking on the wires could damage the electrodes. Unplug the wire from the pad first, then peel the pad off gently. ## How do I take pads off and store them? Turn the unit off first. UI Health Care says to turn it off before you put on, move or take off the pads. Then follow these steps: 1. Pull the wires out of the pads with care. 2. Peel the pads off your skin gently. 3. Place the pads back on the plastic liner. 4. Put the liner and pads in the plastic storage bag. 5. Keep the bag in a cool, dry place. UI Health Care says pads can be used over and over until the adhesive wears out. It also says not to share your pads with other people. Check your device’s manual for how to order new pads. The [electrode pads and supplies guide](https://analgesic.multisites.ai/guides/tens-electrode-pads-supplies-guide) explains supplies in more detail. ## When should I stop using the pads? Stop at the first sign of a problem. Turn the unit off before you move or remove pads. The NHS says: “If your skin becomes itchy, irritated or red (redness may be harder to see on brown or black skin), turn off the machine and remove the pads.” UI Health Care says to stop and talk with your doctor or health care team if you have skin irritation, headache, dizziness or nausea. [Skin irritation](https://analgesic.multisites.ai/glossary/skin-irritation) in the first 24 hours is a reason to call your health care team, according to UI Health Care. People who are allergic to nickel or adhesives may react to the pads. Other stop rules from both sources: - Do not use TENS in the bath or shower. - Do not use TENS while you sleep. - Do not use TENS while driving or using tools or machinery. ## Next step Ask your doctor or physical therapist to mark your pad spots, then follow the plan and your device’s instructions. If you have questions about getting a TENS unit, call Analgesic Healthcare at (800) 749-1188 or use the [contact page](https://analgesic.multisites.ai/contact). ## Questions people ask ### Where do I put TENS pads for lower back pain? Place pads on the fleshy muscle beside the painful area, not on the backbone itself. University of Iowa Health Care says to surround the painful area and avoid bony sites. Ask your doctor or physical therapist to show you the spots that fit your pain. ### How far apart should TENS pads be? The NHS says to leave a gap between the pads. University of Iowa Health Care says the pads should not touch each other or any metal object. No distance in inches is given, so follow your clinician's and your device's instructions. ### Can I put TENS pads on my neck? The NHS says not to use TENS on your neck, mouth or eyes. University of Iowa Health Care says not to use it on any part of your head, face or throat. Ask your doctor or physical therapist before you place pads anywhere near the neck. ### Can I put a pad on each side of my chest or trunk? No. University of Iowa Health Care says not to use TENS on both sides of the chest or trunk at the same time. The NHS says not to use TENS on your chest and back at the same time. ### What if the pads will not stay on? University of Iowa Health Care suggests cleaning the skin, then wetting a fingertip and gently rubbing the pad surface. Let it dry for 60 seconds before you try again. If that fails, use new pads. A skin prep product or medical tape may help; ask your care team. ### When should I stop and call my clinician? Turn the unit off and remove the pads if your skin becomes itchy, red or irritated. University of Iowa Health Care also says to stop and talk with your doctor if you have a headache, dizziness or nausea. ## Terms on this page - [Implanted medical device](https://analgesic.multisites.ai/glossary/implanted-medical-device) - [Chronic low back pain](https://analgesic.multisites.ai/glossary/chronic-low-back-pain) - [Stimulation intensity](https://analgesic.multisites.ai/glossary/stimulation-intensity) - [Cardiac pacemaker](https://analgesic.multisites.ai/glossary/cardiac-pacemaker) - [Skin irritation](https://analgesic.multisites.ai/glossary/skin-irritation) - [Lumbar spine](https://analgesic.multisites.ai/glossary/lumbar-spine) - [Lead wire](https://analgesic.multisites.ai/glossary/lead-wire) - [TENS unit](https://analgesic.multisites.ai/glossary/tens-unit) ## Sources 1. [NHS: TENS (transcutaneous electrical nerve stimulation)](https://www.nhs.uk/conditions/transcutaneous-electrical-nerve-stimulation-tens/) 2. [University of Iowa Health Care: Transcutaneous electrical nerve stimulator (TENS)](https://uihc.org/health-topics/transcutaneous-electrical-nerve-stimulator-tens) Checked against the sources above on October 26, 2026. Coverage rules change, so check the linked page or your plan before you act. This page gives general information, not medical advice. Talk with your doctor or physical therapist about your own care, and follow your clinician's and your device's instructions. In an emergency, call 911. ## Keep reading - [TENS for lower back pain: what the evidence and Medicare coverage sayMedicare does not cover TENS for chronic low back pain. CMS decided on June 8, 2012 that the evidence was inadequate to support coverage. The current policy, LCD L33802, says it will be denied as not reasonable and necessary. A 2022 review calls the wider TENS evidence uncertain. Ask your clinician about options.](https://analgesic.multisites.ai/guides/tens-for-lower-back-pain) - [TENS unit electrode pads, lead wires and supplies: what you need and what Medicare saysA TENS kit has the unit, lead wires, electrode pads and a power source. Pads wear out as the adhesive fades. For covered use, Medicare's LCD L33802 sets a usual maximum of one unit of A4595 per month for 2 leads and two units for 4 leads. Lead wires, A4557, rarely need replacing more often than every 12 months.](https://analgesic.multisites.ai/guides/tens-electrode-pads-supplies-guide) - [Back pain and TENS units: what Medicare says and what to askA TENS unit sends mild pulses through pads near the painful area. Medicare can cover one for pain after surgery when its criteria are met, but its policy (L33802) denies TENS for chronic low back pain. Other plans set their own rules. Your clinician decides if a unit fits your back pain and where the pads go.](https://analgesic.multisites.ai/pain-areas/back-pain) - [TENS unit safety: who should not use one, where pads must not go, and when to stopTENS units are not safe for everyone. The NHS says not to use TENS if you have epilepsy, have a pacemaker, or are pregnant unless your doctor or midwife tells you to. University of Iowa Health Care says not to use it with any implanted device. Never use TENS while you sleep, bathe, or drive.](https://analgesic.multisites.ai/guides/tens-unit-safety) - [TENS unit settings explained: intensity, frequency and pulse widthA TENS unit has three main settings: intensity (how strong), frequency (how many pulses each second) and pulse width (how long each pulse lasts). Sources say intensity should feel strong but comfortable, not painful. Your clinician and your device's manual set the rest. Follow your clinician's and your device's instructions.](https://analgesic.multisites.ai/guides/tens-unit-settings-explained) - [Where not to put TENS pads: a plain-language checklistHealth sources list areas to avoid with TENS pads: broken, irritated, infected or numb skin; the head, face and throat; the eyes and mouth; and both sides of the chest or trunk at once. The lists differ a little by source. Follow your clinician's and your device's instructions.](https://analgesic.multisites.ai/where-not-to-put-tens-pads) ## Questions about your unit or a bill? Call toll free. For customer care, ask for extension 508. [Call (800) 749-1188](tel:+1-800-749-1188)[Pay invoice](https://ahcpatientservices.com/)