--- title: "TENS unit and pacemaker: what to ask before you start" description: "Is a TENS unit safe with a pacemaker? The NHS and University of Iowa Health Care say do not use TENS. See which implants they list and what to ask." url: https://analgesic.multisites.ai/tens-unit-and-pacemaker publisher: Analgesic Healthcare phone: +1-800-749-1188 contact: https://analgesic.multisites.ai/contact --- TENS and pain relief # TENS unit and pacemaker: what to ask before you start The NHS says do not use TENS if you have a pacemaker. University of Iowa Health Care says the same, and extends the warning to defibrillators, spinal cord stimulators, in-dwelling pumps or monitors, and any implanted metallic or electronic device. Ask your cardiologist or doctor before any TENS use. Published October 26, 20264 min read3 sources ![A doctor talks with an older man across her desk](https://analgesic.multisites.ai/_astro/v3-post-pacemaker.C46b3Mhn_Z1Lk0J9.webp) ## Can you use a TENS unit with a pacemaker? No. The NHS says “Do not use TENS if” you have a pacemaker. University of Iowa Health Care (UIHC) lists “A cardiac pacemaker or defibrillator” under people who should not use TENS. If you have a pacemaker, talk with your doctor before you try any TENS unit. A [TENS unit](https://analgesic.multisites.ai/glossary/tens-unit) sends mild electrical pulses through pads on the skin to relieve pain. A [cardiac pacemaker](https://analgesic.multisites.ai/glossary/cardiac-pacemaker) is an implanted device that regulates the heartbeat. The sources do not explain the mechanism between the two. They simply list the pairing as one to avoid. We do not guess at the reason here. ## Which implants and conditions do the sources list? The lists overlap but are not identical. The table shows what each page says. Source Implants or devices listed Conditions listed NHS Pacemaker Epilepsy; pregnancy unless your doctor or midwife tells you to UIHC Cardiac pacemaker or defibrillator; spinal cord stimulator; in-dwelling pumps or monitors; any implanted metallic or electronic device Talk with your provider if you have cancer, diabetes, cognitive impairment, epilepsy, or are pregnant Cleveland Clinic An implantable device like a pacemaker Pregnancy, cancer, epilepsy, deep vein thrombosis, bleeding disorders, heart disease The UIHC wording is broad: “Any implanted metallic or electronic device.” That covers more than pacemakers. An [implanted medical device](https://analgesic.multisites.ai/glossary/implanted-medical-device) is a device placed inside the body, and it is a reason to ask your doctor before using TENS. ## What do the sources say about heart conditions in general? Cleveland Clinic lists heart disease as a reason to check with your provider before using TENS. It also lists deep vein thrombosis (DVT) and bleeding disorders. The NHS page does not list heart disease by name. It lists only a pacemaker, epilepsy and pregnancy. UIHC lists a cardiac pacemaker or defibrillator. Do not read a missing item as permission. A shorter list on one page does not mean the item is safe. It may only mean that page was written for a shorter purpose. If you have any heart condition, ask your doctor before you use a unit, and ask again if your condition or your devices change. ## Why do the lists differ? The sources are written by different organizations for different readers. The NHS page is a short public guide. UIHC writes patient instructions and also points providers to a longer listing of contraindications. Cleveland Clinic gives a broader list of conditions. We cannot say why each list includes what it does, because the pages do not say. What this means for you: treat the longest list as the starting point for your questions. If any item applies to you, ask. A [contraindication](https://analgesic.multisites.ai/glossary/contraindication) is a reason a treatment should not be used for a person. Your doctor knows which ones apply to you. ## What should you ask your doctor? Bring this list to your cardiologist, primary care doctor or physical therapist: 1. I have a pacemaker, defibrillator or other implant. Is TENS ever safe for me? 2. If not, what other options exist for my pain? 3. I have heart disease, diabetes, epilepsy or another condition. Does that change the answer? 4. Do I need to tell other care teams about my plan to use TENS? Question 4 goes beyond what the three pages say. It is a fair question for a clinician, who can answer it for your situation. ## What about monitors and alarms? UIHC says: “Electronic equipment, such as EKG monitors and EKG alarms, may not work the right way when TENS is in use.” This is listed under “For your protection.” If you use any monitor at home or in a care setting, mention it when you ask about TENS. ## What if you are not sure whether you have an implant? Ask your doctor’s office to check your records. If you cannot confirm, do not start. Ask first. ## What should family members and caregivers know? Caregivers often help with devices at home. UIHC says to use the TENS unit only on yourself, as instructed, and not to share your pads with other people. It also says: “Just as you would not let others take a medicine that was only prescribed for you, you should not let others use your TENS unit.” A person with a pacemaker should not borrow a family member’s unit. Keep units out of the reach of children, as UIHC advises. If you help a relative with a TENS unit, ask their clinician what to check first. Show the clinician the unit and its manual so they can see exactly what it is. ## Where else do the sources say to be careful? Pacemakers are one item on a longer list. The NHS says not to use TENS on irritated, broken, infected or numb skin, or on the neck, mouth or eyes. UIHC adds the head, face and throat. See our checklist on [where not to put TENS pads](https://analgesic.multisites.ai/where-not-to-put-tens-pads) and our [TENS unit safety guide](https://analgesic.multisites.ai/guides/tens-unit-safety). Whatever your health history, follow your clinician’s and your device’s instructions. Cleveland Clinic ends its list with this advice: “Always check with your healthcare provider before using TENS, especially if you have existing health conditions.” ## Does buying a unit change anything? The sources do not say so. The NHS notes that you can buy a TENS machine online or in shops, and still says it is a good idea to check with a GP or other healthcare professional first. For how clinicians order units, see our guide on [how to get a TENS unit](https://analgesic.multisites.ai/guides/how-to-get-a-tens-unit). ## Next step Ask your doctor if TENS is safe for you before you buy or use a unit. Then call Analgesic Healthcare at (800) 749-1188 or use [contact](https://analgesic.multisites.ai/contact) if you have questions about getting a unit. ## Questions people ask ### Can you use a TENS unit with a pacemaker? The NHS says do not use TENS if you have a pacemaker. University of Iowa Health Care says do not use TENS if you have a cardiac pacemaker or defibrillator. Cleveland Clinic lists an implantable device like a pacemaker as a reason not to use it. ### Which other implants are a problem for TENS? University of Iowa Health Care lists a spinal cord stimulator, in-dwelling pumps or monitors, and any implanted metallic or electronic device. Ask your doctor about any implant you have, even if it is not on this list. ### What should I ask my doctor about TENS and my heart? Ask if TENS is safe for you at all, which implants or heart conditions you have that matter, and where pads must never go. Cleveland Clinic also lists heart disease among conditions to check with your provider first. ## Terms on this page - [Implanted medical device](https://analgesic.multisites.ai/glossary/implanted-medical-device) - [Cardiac pacemaker](https://analgesic.multisites.ai/glossary/cardiac-pacemaker) - [Contraindication](https://analgesic.multisites.ai/glossary/contraindication) - [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) 3. [Cleveland Clinic: Transcutaneous Electrical Nerve Stimulation (TENS)](https://my.clevelandclinic.org/health/treatments/15840-transcutaneous-electrical-nerve-stimulation-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 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) - [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) - [How to get a TENS unit through your clinician: prescription, order, and trial stepsTo get a TENS unit through insurance, start with a visit to your clinician. Medicare requires a face-to-face visit and a written order before the supplier delivers the unit. For chronic pain, you first use the unit on a 30-day to two-month rental trial. Your clinician reviews the results. Rules differ for other plans, so check with yours.](https://analgesic.multisites.ai/guides/how-to-get-a-tens-unit) - [TENS unit safety checklist: a printable list for pacemakers, pregnancy, skin and pad placementPrint this list and review it with your clinician before your first TENS session. The NHS says not to use TENS with epilepsy or a pacemaker, or in pregnancy unless your doctor or midwife says so. Do not place pads on broken skin, the head, face or throat. Do not use TENS while you sleep, bathe or drive.](https://analgesic.multisites.ai/guides/tens-safety-checklist) - [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) - [TENS vs EMS, NMES and interferential therapy: how they differA TENS unit is made to treat pain through electrodes on the skin. EMS and NMES units are made to contract muscles. Interferential therapy crosses two medium-frequency currents inside the tissue. Some devices offer more than one mode. Your clinician's written order tells you which one you should use.](https://analgesic.multisites.ai/guides/tens-vs-ems-nmes-interferential) ## 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/)