Which individuals may be at risk when using TENS therapy?

• A. Pregnant, demand-type cardiac pacemaker, bladder stimulator, metal plates or pins, diabetes, or heart disease
• B. Healthy individuals with no implants
• C. Children under 5 only
• D. People with normal nerve function

Answer: (A)

TENS therapy uses electrical impulses applied to the skin to relieve pain, so safety depends on how electricity interacts with the body and any devices or conditions present. Certain situations raise the risk of adverse effects or device interference. Implants or devices that rely on electronics—such as a demand-type cardiac pacemaker or a bladder stimulator—can be affected by external electrical currents, potentially causing malfunction or inappropriate stimulation. Metal hardware like plates or pins at the stimulation site can alter current flow or heat up, increasing the chance of skin burns. Pregnancy is considered a precaution because electrical stimulation near the abdomen or chest could affect maternal or fetal tissues, even though some uses may be supervised in specific settings. Diabetes can bring neuropathy, which blunts sensation and can mask early signs of skin irritation or burns, while heart disease may heighten risk if the stimulation influences cardiovascular function or is applied in a way that affects cardiac status.

Because of these considerations, the group described—pregnant individuals, those with implanted electronic devices, people with metal implants, and individuals with diabetes or heart disease—are the ones who may be at risk when using TENS therapy. The other options describe populations without these risk factors.