TENS Unit for Restless Legs: Benefits and Risks

Kristen Gasnick, PT, DPT, is a medical writer and a physical therapist at Holy Name Medical Center in New Jersey.

Laura Campedelli, PT, DPT, is a physical therapist currently working in New York at Morgan Stanley Children's Hospital, an affiliate of New York Presbyterian.

Restless leg syndrome (RLS) is a condition characterized by unpleasant sensations in the legs, causing an urge to move to alleviate symptoms. Sensations of restless leg syndrome occur or worsen at rest and happen mainly at night. TENS, or transcutaneous electrical nerve stimulation, is a treatment that delivers a gentle electrical current through the skin and muscles and may reduce these unpleasant symptoms. This article will review the potential benefits and risks of using a TENS unit to treat restless legs syndrome.

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TENS, or transcutaneous electrical nerve stimulation, is a treatment method that utilizes electrode pads that are applied to the skin over muscles. These electrode pads connect to a device via wires that carry an electrical current through the pads.

The electrical current sent from the TENS unit stimulates nerves in the skin and underlying muscle. It is often used to treat pain and muscle spasms. Because restless leg syndrome causes pain and muscle spasms in the legs, electrical stimulation via TENS is beneficial for alleviating symptoms.

The TENS unit treats pain and overstimulation of sensory nerves by delivering a low-level, non-painful electric current that disrupts overstimulated nerves from sending signals to the brain.

Limited research exists on the benefit of using TENS for managing symptoms of restless leg syndrome. One study suggests that the placement of electrode pads over the posterior tibial nerve of the lower legs may help to decrease overall levels of discomfort, but further research may be needed.

TENS is generally a safe treatment, but patients should take certain precautions. Though TENS electrodes for restless leg syndrome should only be placed on the legs, the electrode pads should be placed on areas of soft tissue only and not directly on top of bones, joints, or areas of blood clots or bleeding.

Electrodes for TENS, in general, should also never be placed on the head, neck, eyes, mouth, chest, or areas of broken skin.

TENS should not be used if a person:

If you notice any rash or skin irritation after the electrodes are removed, talk with your healthcare provider because you may be allergic to the electrode adhesive or have another skin condition.

When using a TENS unit, electrode pads are applied to the skin overlying your leg muscles. These pads will be very sticky but will not leave a residue when removed.

When the machine is on and the electrode pads are connected to the TENS unit, you should start to feel a light vibrating or tingling sensation through the pads. The TENS unit should ramp up slowly to increase the intensity to your desired level.

The sensation should be strong but not painful. If the stimulation is too strong, it will cause the underlying muscles to uncomfortably spasm and contract. TENS treatment typically takes 10–30 minutes.

Medication is the recommended treatment for restless leg syndrome. The main types of medications that treat restless leg syndrome include:

Restless leg syndrome is a condition that causes unpleasant sensations in the legs that increase at night and with inactivity. TENS, or transcutaneous electrical nerve stimulation, is a treatment by which an electrical current reaches the skin and muscles via wires connected to electrode pads that are placed on the skin.

Though there is not enough evidence to suggest that TENS is effective for reducing the symptoms of restless leg syndrome, it often helps decrease chronic pain and nerve overstimulation. Avoid using TENS if you also have a pacemaker, epilepsy, or cancer, are pregnant, or have a blood clot in your leg.

Restless leg syndrome can be uncomfortable and interfere with your ability to sleep at night. If you notice symptoms of restless leg syndrome have been recurring and affecting your quality of life, talk with your healthcare provider about potential treatment options.

TENS units are generally safe to use. Electrodes should never be placed on the head, neck, eyes, mouth, chest, or areas of broken skin. If you have a pacemaker, epilepsy, or cancer, are pregnant, or have hemorrhaging or a blood clot in your leg, you should not use one at all.

Overuse of a TENS unit can cause nerve irritation and muscle spasm. Use of TENS should be limited to 10–30 minutes.

How long the effects of using a TENS unit last is highly variable depending on your individual response to treatment, ranging from just a few minutes to over a day or more.

Rozeman AD, Ottolini T, Grootendorst DC, Vogels OJM, Rijsman RM. Effect of sensory stimuli on restless legs syndrome: a randomized crossover study. J Clin Sleep Med. 2014;10(8):893-896. doi:10.5664/jcsm.3964

Vance CG, Dailey DL, Rakel BA, Sluka KA. Using TENS for pain control: the state of the evidence. Pain Manag. 2014;4(3):197-209. doi:10.2217/pmt.14.13

National Health Service (UK). TENS (transcutaneous electrical nerve stimulation).

Winkelman JW, Armstrong MJ, Allen RP, et al. Practice guideline summary: Treatment of restless legs syndrome in adults: Report of the guideline development, dissemination, and implementation subcommittee of the American academy of neurology. Neurology. 2016;87(24):2585-2593. doi:10.1212/WNL.0000000000003388

By Kristen Gasnick, PT, DPTKristen Gasnick, PT, DPT, is a medical writer and a physical therapist at Holy Name Medical Center in New Jersey.