Will a TENS unit help for your plantar fasciitis? We can break the answer down into TENS for speeding up the healing process, and using it for pain management. I take a look at what the research says about this, and I give some tips on TENS electrode placement for plantar fasciitis as well as the best TENS settings. Remember, if you need more help with an injury, you're welcome to consult one of our physios online via video call.
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The two ways in which TENS might help for plantar fasciitis is by providing pain relief and by speeding up the healing process. Let’s look at what we can learn from the people in the white lab coats about each of these.
TENS for plantar fasciitis pain relief
There's a substantial body of research into TENS for acute pain – in the case of plantar fasciitis, when its onset has been fairly recent – as well as for chronic pain – when you’ve been suffering from plantar fasciitis for several months or even longer.
In both cases, TENS seems to be effective for pain relief(1,2), but only for in-the-moment pain, i.e. while you’re hooked up to the TENS unit. In some cases, it also alleviates pain for a few hours afterwards, but no longer.
So, yes, TENS is indeed effective if you want to use it to calm down severe plantar fascia pain temporarily, especially if pain medication doesn’t work for you or if you want to avoid taking medication.
TENS for plantar fasciitis healing
I was quite surprised when I couldn’t find a single research study that investigated whether TENS could speed up the healing process when treating plantar fasciitis.
As for TENS being able to heal other things, I was able to find only three studies into TENS for wound healing and another three into TENS for tendon healing. These are of some use to us, because your plantar fascia is mostly made up of collagen, which is also the main building block of your skin and your tendons.
The studies into wound healing show that TENS might help for this, but the evidence is not very strong, and the researchers used quite small samples. So, based on these studies, we cannot really say for sure that TENS will help to heal your plantar fasciitis – we need larger-scale studies to be sure either which way.
The same goes for the three studies into TENS for Achilles tendon healing. Only one was on a small sample of humans; the other two were on rats. Two studies found that TENS helps to speed up healing in injured Achilles tendons, and one found that it actually impeded healing. And again, these were not high-quality studies.
My recommendation on TENS for plantar fasciitis
From my own experience, I have not seen that my plantar fasciitis patients who used TENS on a regular basis recovered any quicker or slower than my other plantar fasciitis patients. So, in the absence of a definitive answer from science, I don't think it influences healing either which way.
However, I have seen that patients benefit from TENS to decrease their pain – and the science backs this up – which enabled them to get on with other, proven plantar fasciitis treatments.
Therefore, I would not recommend that you use TENS as a standalone treatment for plantar fasciitis – your condition won’t improve even if you use TENS day in and day out. But you can use it for pain relief while you work on healing your plantar fasciitis with some of the other tried and tested treatment methods.
What are those treatment methods? Here’s our article with an overview of plantar fasciitis treatments, and here are three more articles with details on three of the most commonly used treatments for plantar fasciitis:
If you would like help with figuring out your rehab plan and what exercises may be best for you, check out the Plantar Fasciitis rehab plan in the Exakt Health app. I've helped to design the app to guide you through the rehab process from the moment your foot becomes painful all the way back to your sport. It uses your feedback after each workout to help you adjust your exercise intensity to the right level.
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How to use your TENS unit for plantar fasciitis
Where to place the electrodes
The research shows that it doesn't really matter where you stick the electrode pads, as long as the current passes through the painful area.
So, for plantar fasciitis you could either:
place one electrode right at the back of the bottom of your heel and the other under the arch of your foot, or
place one electrode to the left and the other to the right of the painful area.
💡Top tip: If you have small feet, look for a TENS unit with small electrode pads – I have found that they stick on easier.
These are two examples of what I’m talking about:
TENS unit settings
What seems to work best, according to the research, is an intensity setting that is as high as you can tolerate without it causing you pain.
Also, the current shouldn’t cause any muscle contractions. So, if you find that the muscles in your foot start contracting or twitching when you’re hooked up to the TENS unit, dial it down.
💡Top tip: Your body will get used to the intensity and frequency of the current if it stays the same for a whole session, and then the TENS treatment will be less effective. It’s like when you’re aware of a noise initially, but if it becomes repetitive, you tune out and no longer notice it. If your TENS unit has a setting that automatically varies the intensity and frequency of the current, use it.
How often and for how long?
According to the research, you can’t really overdo TENS in this regard. So, it’s safe to use it as often and for as long as you feel is necessary.
TENS side effects
The only possible serious side effect of TENS is that it might interfere with the electrical current of another device you might have. For instance, if you have a pacemaker, you don't want to be using the TENS near it.
However, using it on your foot for plantar fasciitis should be fine.
Possible minor side effects are that you may be allergic to the electrode pads and that you may get a rash if you keep the pads stuck to your skin for too long.
How we can help
Need more help with your injury? You’re welcome to consult one of the team at SIP online via video call for an assessment of your injury and a tailored treatment plan.
We're all UK Chartered Physiotherapists with Master’s Degrees related to Sports & Exercise Medicine or at least 10 years' experience in the field. But at Sports Injury Physio we don't just value qualifications; all of us also have a wealth of experience working with athletes across a broad variety of sports, ranging from recreationally active people to professional athletes. You can meet the team here.
About the Author
Maryke Louw is a chartered physiotherapist with more than 20 years' experience and a Master’s Degree in Sports Injury Management. Follow her on LinkedIn and ResearchGate.