Brian Cannon
8 Min Read

When shopping for electronic pain relief devices, you will run across different types of electronic pulse stimulator such as TENS, EMS and EPM, which stand for Transcutaneous Electrical Nerve Stimulation, Electric Muscle Stimulator and Electronic Pulse Massager, respectively.

On the surface, the descriptions of each sound similar. The fact that some devices may provide two or all these functions further clouds the distinctions. However, each differ in the types of signals they produce and in their applications.

Read on and we guarantee to dissipate the confusion and make an expert of you with regard to each technology and how they are used.

Similarities of TENS vs. EMS vs. EPM

All three of these devices provide electrical stimulation via electrode pads placed on the skin near the area to be treated. The intensity, frequency and width of the signals are digitally controlled by the device’s microcontroller. All such devices appear superficially similar on the outside and in fact, some devices can provide more than two or all three of these stimulation types. Thought their applications seem to overlap, there are important difference between them.

TENS uses high and low frequency current pulses in a small range around 100ma. An EMS unit utilizes cycles that induce muscle contraction and relaxation at various intensities from one to 130Mh. These cycles improve muscle blood flow while decreasing inflammation. Whereas TENS units are primarily for pain management, an EMS unit reverses muscle atrophy and retrains previously paralyzed muscles.

The Differences between TENS, EMS and EPM

The biggest difference between TENS and EMS is that TENS is designed to stimulate nerves and EMS devices stimulate muscle cells. Strictly speaking, there is no such thing as a TENS muscle stimulator.

The electrical muscle stimulation of an EMS device induces muscle contraction, whereas TENS nerve stimulation acts to block pain and relax muscles as a consequence. An EPM device is designed to mimic manual massage, which may involve muscle contraction, but not to the degree that an EMS device induces.

Another important difference is that TENS provides immediate pain relief, whereas the application of EMS and EPM is aimed at conditioning muscle groups as part of a longer-range treatment for muscle development. EMS and EPM are not nearly as effective in blocking pain as is TENS.

Furthermore, while many TENS devices provide a wider range of signals in terms of frequency, pulses and intensities, EMS and EPM devices offer narrower functions in this regard.

The uses of EPM, EMS and TENS

TENS units treat a single part of the body, whereas EMS devices are used on whole muscle groups. An EPM typically works on a single muscle. Popular applications of TENS are relieving pain due to osteoarthritis, back pain, carpal tunnel syndrome, sciatica, muscular sclerosis, and so on.

EMS units find their biggest application among athletes for physical and rehabilitation therapy. They are important for strengthening muscles, tendons, and ligaments, but any pain relief is a side effect.

EPM devices are typically used in the home as muscle relaxation devices as they do not provide the signal strength or patterns of an EMS unit.

Which One Is Right for You?

Thus, your choice between getting an EPM, TENS or EMS device should be based on the application to which you intend to apply it.

An EPM unit is a safe and effective way to achieve muscle relaxation where little or no pain is involved. An EMS unit would be appropriate before and after workout sessions or on the advice of a physiotherapist if you are rebuilding atrophied muscles.

A TENS unit is the correct choice if immediate relief of pain is you primary goal. Naturally, there are situations in which two or all three devices can be used together. Fortunately, many OTC electro-therapy units provide TENS EMS capabilities and some include EPM modes as well.

Combination TENS/EMS Devices

Buying a single device that can provide TENS and EMS functions saves money and provides the most versatility. Two examples are the economical PurePulse Electronic Pulse Massager – Portable, Handheld TENS Unit Muscle Stimulator for Pain Management and the iReliev TENS + EMS Combination Unit Muscle Stimulator for Pain Relief & Arthritis & Muscle Strength.

The PurePulse offers settings for EMS, TENS and EPM with independent settings for stimulation patterns and intensity for each of two channels. It has six pre-set programs and three massage modes for a total of 18 combinations.

Because of the name, it often shows up in electronic pulse massager reviews as the best electronic pulse massager. It will introduce you all three types of electronic pulse stimulation for under $30.


The iReliev unit provides seven TENS modes and six EMS modes with 25 intensity levels for each mode. Since it is dual channel, you can tailor treatments to different body areas.


Large, single-unit, butterfly pads are for small areas, whereas smaller, individual pads are used on larger areas. The iReliev unit costs more, but provides plenty of value. It is the best TENS EMS machine we recommend.


Where to Buy Your TENS EMS Unit

When looking for the best rated TENS unit or EMS machine, we recommend shopping on Amazon. None of the TENS EMS units we review or recommend require a prescription and are FDA approved for OTC sale. Amazon always has the best prices and discounts and backs up all products with an industry-leading return policy. Check out the real buyer TENS EMS unit reviews there too.


You should now have a clear idea of the differences between TENS, EMS and EPM units. In brief, TENS units are for immediate pain relief via nerve stimulation, whereas EMS and EPM units stimulate muscle contractions and relieve pain as a side effect. EMS units are for serious muscle conditioning, whereas EPM units are designed for muscle relaxation.

Armed with this new knowledge, you are ready for further research or you can simply buy one of the two recommended TENS/EMS/EPM units above. The sooner you make the decision, the sooner you can enjoy the relaxation and relief these devices are providing for thousands of others.

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