How TENS Helps Post-Concussion Pain TENS modulates pain through gate control mechanism. The low-level electrical stimulation activates large-diameter nerve fibers that suppress pain transmission in smaller fibers. The mechanism produces measurable pain reduction during stimulation, with effects continuing 30-60 minutes after treatment ends (Treleaven, 2008). TENS supports cervicogenic headache treatment. Cervicogenic headache responds particularly well to TENS applied to the cervical region. The cervical contribution to PCS headache makes TENS appropriate for many patients. Direct head application is not necessary; treating the neck addresses the head pain. Avoid direct head and face application. TENS to the scalp, temples, or directly across the eyes is contraindicated. Stay below the C2 level (below the base of the skull). The cervical and shoulder regions are appropriate; the head itself is not. Drug-free addresses medication concerns. Patients managing multiple medications for PCS, or those wanting to reduce medication use, benefit from non-pharmacological pain modalities. TENS adds tools without adding medications. Best Overall: TENS 7000 Digital TENS Unit Available at: Amazon, medical supply retailers Price: ~$35-45 The TENS 7000 provides clinical-grade dual-channel stimulation with 7 modes and 25 intensity levels. Used in physical therapy clinics. FDA-cleared. The dual channels allow simultaneous treatment of two areas (both sides of neck, for example). The extensive feature set comes at budget pricing. What makes it stand out: Clinical-grade dual-channel stimulation 7 modes (varied stimulation patterns) 25 intensity levels FDA-cleared Used in clinical settings Includes electrodes, lead wires, battery Budget pricing for capabilities Established reputation Limitations: Wired electrodes (less convenient than wireless). 9V battery operated (not rechargeable). Bulkier than wireless units. The clinical positioning may be more features than needed for typical home use. Electrode pads need replacement periodically. Best for: Patients wanting clinical-grade TENS at budget pricing, particularly those familiar with TENS from PT sessions. Best Wireless: iReliev TENS + EMS Wireless Website: ireliev.com Price: ~$200-250 The iReliev wireless system uses pods that adhere directly to skin without wires. Premium positioning with wireless convenience. Includes EMS (electrical muscle stimulation) in addition to TENS. App control via smartphone. The wireless design supports use during work or activities. Premium price reflects convenience and feature breadth. What makes it stand out: Completely wireless (no wires) Discreet (pods adhere to skin) App control via smartphone TENS + EMS combined Use during activities Rechargeable Premium build quality FDA-cleared Limitations: Premium pricing. App dependency for full features. Pods need adhesive replacement. Less intuitive than button-controlled units. The EMS feature may not be needed by all PCS patients. Smartphone integration adds complexity during cognitive recovery. Best for: Patients wanting wireless convenience for use during work or daily activities, willing to pay premium for the format. Best Pocket-Sized: Omron Max Power Relief TENS Unit Website: omronhealthcare.com Price: ~$45-55 The Omron Max Power provides pocket-sized TENS unit with body-part-specific modes (neck, shoulder, back, etc.). The compact format supports travel and on-the-go use. Established medical device brand with strong reputation. Wide retail availability supports easy purchase. What makes it stand out: Pocket-sized for portability 6 body part modes (neck included) 3 massage-style modes (rub, tap, knead) 15 intensity levels Omron medical device brand Wide retail availability Simple interface FDA-cleared Limitations: Single channel (one area at a time). Less intensity range than TENS 7000. Wired electrodes. The body-part modes are presets that may not match individual preferences. Less customizable than clinical units. Best for: Patients wanting simple, portable TENS from established brand without learning clinical interface. Best for Beginners: AccuRelief Wireless TENS Available at: Amazon, pharmacies Price: ~$80-110 The AccuRelief Wireless provides wireless TENS at lower price than iReliev. Simpler interface suits patients new to TENS. Remote control rather than smartphone app. Reasonable middle option between wired TENS 7000 and premium iReliev wireless. What makes it stand out: Wireless format Remote control (no app required) Mid-range pricing Simple interface Adequate intensity range FDA-cleared Limitations: Less premium than iReliev. Smaller adhesive pad than wired electrodes. Battery life shorter than wired units. Less established than TENS 7000 or Omron. Best for: Patients wanting wireless format without premium iReliev pricing, particularly those preferring remote over app control. Best Athletic-Grade: Compex Wired Muscle Stimulator Website: compex.com Price: ~$300-450 Compex provides athletic-grade muscle stimulator with TENS function. Used by professional athletes for both recovery and training. Premium quality and durability. May exceed typical PCS needs but appropriate for patients wanting professional-grade equipment for ongoing use. The investment supports long-term use beyond recovery. What makes it stand out: Professional athletic grade Premium durability Multiple stimulation programs Used by professional athletes Strong customer support Long product lifespan Both TENS and muscle stimulation Limitations: Premium pricing exceeds typical PCS needs. The athletic features may overwhelm. Less intuitive than simple TENS units. Better positioned for athletes than typical patients. Best for: Athletes recovering from concussion who want professional-grade equipment for both PCS recovery and ongoing athletic use. How to Choose the Right TENS Unit Clinical features at budget: TENS 7000 ($35-45) Wireless premium: iReliev TENS + EMS ($200-250) Pocket portability: Omron Max Power ($45-55) Wireless without premium: AccuRelief Wireless ($80-110) Professional athletic-grade: Compex ($300-450) How to Use TENS for PCS Pain Safely Get PT or provider guidance first. Initial use with physical therapist supervision ensures correct electrode placement and intensity. Self-application with proper technique becomes safe; without guidance, ineffective placement reduces benefit. Never apply to head or face. Stay below the base of the skull (below C2). Cervical, shoulder, and upper back placement is safe. Direct head application can be problematic. Start at lowest intensity. Build to comfortable strong-but-not-painful tingling sensation. Pain intensity is not therapeutic; comfortable stimulation is. 20-30 minute sessions. Optimal therapeutic duration. Longer produces diminishing returns. Maintain 2+ hour breaks between sessions. Avoid during pregnancy without provider guidance. Standard TENS contraindication. Discuss with provider before use. Don't use with pacemakers or other electrical implants. Standard contraindication. Discuss with cardiology before considering TENS. Avoid on irritated or broken skin. Skin damage prevents electrode contact and can become infected. Apply to healthy skin only. Supporting Mobility Routine JME 155 Diaphragmatic breathing supports the parasympathetic activation that pain relief tools can only partially provide. 10 breaths every 60-90 minutes, plus longer sessions during symptom flares. JME 14 Chin tucks address the cervical contribution that drives much PCS headache. 10 repetitions with 5-second holds, multiple times daily. JME 3 Lateral cervical flexion releases the upper trapezius tension that contributes to cervicogenic headache. 8 repetitions per side with 15-second holds. JME 151 Lateral side bends with breathing combine mobility and parasympathetic activation. 8 repetitions per side. Start your 3-day free trial for cervical mobility programs that complement pain relief tools during concussion recovery. References Treleaven, J. (2008). Sensorimotor disturbances in neck disorders affecting postural stability, head and eye movement control. Manual Therapy, 13(1), 2-11. PubMed Patricios, J. S., et al. (2023). Consensus statement on concussion in sport: the 6th International Conference on Concussion in Sport, Amsterdam, October 2022. British Journal of Sports Medicine, 57(11), 695-711. PubMed