Last updated: November 3, 2026
Electrical muscle stimulation sends gentle pulses through pads on the skin to make a muscle contract. A second setting, TENS, calms the nerves carrying pain signals. Dr. Don Bolt, D.C., uses the Compex stimulator for both at his Oxnard office, as part of care for back pain, knee arthritis, muscle spasm and weakness after injury.
Patients from Oxnard, Camarillo, Ventura and Port Hueneme use stimulation in two stages of care: early, to settle pain and spasm, and later, to rebuild muscle the injury switched off.
EMS and TENS: two settings, two jobs
| EMS (muscle stimulation) | TENS (nerve stimulation) | |
|---|---|---|
| Targets | Motor nerves, the ones driving muscle | Sensory nerves, the ones carrying pain |
| What you feel | A firm, visible muscle contraction | Tingling or buzzing, no contraction |
| Main use | Strength, spasm release, muscle re-education | Short-term pain relief |
| Stage of care | Recovery and strengthening | Early pain control and flare-ups |
TENS is thought to work two ways. The tingling competes with pain signals at the spinal cord, known as the gate theory. Stimulation also prompts the release of the body’s own pain-relieving chemicals.
What the research shows
The evidence favors EMS for strength and gives TENS a weaker grade for long-term pain relief.
- EMS for knee arthritis. A 2021 systematic review covering 571 patients found EMS combined with exercise increased thigh muscle strength more than exercise programs without stimulation. Pain and function scores did not differ. A 2026 meta-analysis in Orthopedic Reviews reached a similar conclusion: stimulation works best as an add-on to exercise.
- TENS for chronic pain. A 2019 Cochrane overview of nine reviews rated the evidence for TENS in chronic pain at the lowest quality grade. The authors were unable to say with confidence whether TENS helps or harms over the long term.
Dr. Bolt uses these findings in two ways. EMS goes with exercise, not in place of exercise. TENS is a short-term tool for flare-ups and painful early visits, not a long-term plan.
Who benefits from electrical muscle stimulation
- Patients with knee arthritis and weak thigh muscles
- Patients with low back or neck muscle spasm after an injury
- Auto injury patients in the first weeks of care
- Seniors losing leg strength who struggle with standard exercise
- Patients rebuilding muscle after surgery, once their surgeon clears them
- Patients with chronic back pain whose core muscles stopped firing well
Who should not receive stimulation
Dr. Bolt screens every patient first. He does not use electrical stimulation:
- On patients with a pacemaker, implanted defibrillator or other implanted electronic device
- On the front or sides of the neck, over the carotid artery
- Across the chest or head
- Over the abdomen or low back during pregnancy
- On patients with epilepsy
- On patients with a known or suspected blood clot
- Over broken skin, infection or a tumor
- For pain without a diagnosis
EMS also stays off a torn muscle or tendon until the tissue heals enough to contract safely.
What a stimulation session looks like
- Exam. Dr. Bolt identifies whether you need pain control, muscle activation or both.
- Pad placement. Self-adhesive pads go on the skin over the target muscle or around the painful area.
- Setting. Intensity rises until you feel a strong, comfortable contraction for EMS, or steady tingling for TENS.
- Active work. For strength goals, you tighten the muscle along with the stimulation or perform a simple exercise during each pulse.
Expect red skin under the pads for an hour or two after the session, and mild muscle soreness the next day after EMS.
How stimulation fits with the rest of your care
Stimulation is one of the physiotherapy modalities in the office. Dr. Bolt pairs EMS with corrective exercises and pairs TENS with spinal decompression and therapeutic laser therapy for patients with disc and nerve pain. Seniors working on balance often combine EMS with whole body vibration.
Why patients choose Dr. Bolt
Dr. Bolt graduated from Cleveland Chiropractic College, Los Angeles, in 1988 and holds California chiropractic license #19387. He has practiced in Oxnard for more than 35 years and treats patients from across Ventura County, including veterans through VA Community Care.
Request a Muscle Weakness Evaluation
Electrical muscle stimulation FAQs
Does electrical muscle stimulation hurt?
No. EMS feels like a strong squeeze. TENS feels like tingling. Dr. Bolt adjusts the intensity to your comfort.
Will EMS build muscle without exercise?
Research shows the best results when stimulation goes with exercise. Dr. Bolt pairs the two.
Is TENS safe with a pacemaker?
No. Patients with a pacemaker or implanted defibrillator do not receive electrical stimulation.
Should I buy a Compex for home?
Ask Dr. Bolt first. Pad placement and settings matter, and some conditions rule out home use.
Is the Compex the same as a TENS unit?
The Compex delivers both EMS and TENS programs. Many drugstore units deliver TENS only.
Ready to Get Started?
Call the Oxnard office or request an appointment online to schedule your visit with Dr. Bolt.