How Pulsed Shortwave Therapy (PSWT) Differs from TENS

Transcutaneous Electrical Nerve Stimulation (TENS) and Pulsed Shortwave Therapy (PSWT) are both non-invasive technologies used in pain management and recovery support, but they operate through fundamentally different mechanisms and delivery models.

TENS systems deliver low voltage electrical current directly through electrodes attached to the skin. PSWT systems instead emit pulsed electromagnetic fields without conductive skin electrodes or direct electrical stimulation.

Modern wearable PSWT devices such as ActiPatch® operate at a carrier frequency of 27.12 MHz, an internationally allocated Industrial, Scientific, and Medical (ISM) radiofrequency band commonly used in regulated medical technologies.

Published literature exploring PSWT and related bioelectric therapies spans chronic musculoskeletal pain, postoperative recovery, osteoarthritis, plantar fasciitis, and additional pain related applications.

Quick Comparison

Property	PAINKILLER (PSWT)	TENS
Mechanism	Pulsed electromagnetic field	Electrical current
Skin contact	Not required directly on skin	Adhesive electrodes required
Sensation	Typically subsensory	Tingling or buzzing sensation
Session model	Extended wearable use possible	Typically session based
Frequency type	27.12 MHz radiofrequency carrier	Low frequency electrical pulses
Therapy delivery	Electromagnetic field exposure	Conductive electrical stimulation

Technology characteristics vary between manufacturers, indications, and regulatory classifications.

What is TENS?

Transcutaneous Electrical Nerve Stimulation has been used for decades as a non-invasive pain management modality. TENS devices generally work by delivering low voltage electrical current through electrodes placed on the skin surface.

The electrical stimulation is intended to modulate sensory signaling and is commonly associated with a tingling, tapping, or buzzing sensation during treatment. Session duration may vary from minutes to over an hour depending on the device configuration and intended use.

TENS systems are commonly used in:

• musculoskeletal pain
• rehabilitation programs
• physical therapy
• home pain management
• short duration therapy sessions

Because TENS relies on direct conductive stimulation, electrode placement and skin contact are central to therapy delivery.

What is Pulsed Shortwave Therapy (PSWT)?

Pulsed Shortwave Therapy uses pulsed electromagnetic energy rather than conductive electrical stimulation.

Wearable PSWT devices emit low power pulsed electromagnetic fields without requiring conductive gels or direct electrical current to pass through the skin. Many PSWT systems are designed to operate without perceptible sensation during use.

ActiPatch®, the foundational technology behind PAINKILLER™, received FDA 510(k) clearance as an over the counter pulsed shortwave therapy device for pain management. FDA documentation identifies the device as operating at 27.12 MHz.

Unlike many TENS systems, wearable PSWT devices are often designed for prolonged intermittent or continuous use models, including ambulatory wear.

Published PSWT literature includes investigations involving:

• osteoarthritis
• chronic musculoskeletal pain
• postoperative recovery
• plantar fasciitis
• temporomandibular disorders
• fibromyalgia related investigations

Mechanism Differences

One of the primary distinctions between TENS and PSWT is the form of energy used to interact with tissue.

TENS systems apply electrical current directly through electrodes attached to the skin. Treatment intensity is typically adjusted according to user sensation and comfort thresholds.

PSWT systems instead generate pulsed electromagnetic fields. In wearable PSWT systems, therapy is generally subsensory and does not require the user to feel electrical stimulation during treatment.

Because these technologies differ in waveform structure, carrier frequency, delivery method, tissue interaction, and duration of exposure, clinical findings from one category should not automatically be generalized across all electrotherapy or electromagnetic therapy devices.

Why Continuous Wear Matters

Many traditional TENS workflows are session based, where therapy is delivered for shorter intervals during active use periods.

Some wearable PSWT systems are instead designed around prolonged wearability and low burden recovery support. This has contributed to interest in postoperative recovery workflows, ambulatory recovery support, wearable musculoskeletal recovery, and continuous use recovery pathways.

Treatment protocols and outcomes vary significantly depending on device architecture, waveform parameters, indication, duration of exposure, and patient population.

Clinical Literature and Evidence

Published literature exploring pulsed shortwave and related electromagnetic therapies has produced mixed but growing evidence across multiple pain and recovery related applications.

Some studies have reported improvements in pain and functional outcomes in selected patient populations, while others demonstrated modest or placebo level differences, highlighting the importance of careful interpretation and device specific evaluation.

A study published in Clinical Rehabilitation evaluating pulsed shortwave therapy for osteoarthritis reported improvements in pain and function measures within the treatment population.

Conversely, a placebo controlled trial published in Pain evaluating pulsed shortwave therapy in osteoarthritis did not demonstrate statistically significant differences between active and placebo groups within that study population.

A 2022 publication in Scientific Reports comparing focused low intensity pulsed ultrasound with pulsed shortwave diathermy reported that both modalities were considered safe within the evaluated study population while demonstrating differing outcome patterns across measured endpoints.

This variability underscores an important principle in bioelectric medicine. Outcomes may depend heavily on signal parameters, treatment duration, waveform architecture, delivery methodology, patient selection, and indication specificity.

Regulatory Context

In the United States, many electrotherapy and electromagnetic devices are regulated through the FDA 510(k) pathway.

FDA clearance through 510(k) is based on substantial equivalence to legally marketed predicate devices and differs from pharmaceutical approval pathways.

For this reason, Electrome uses language such as "supported by published clinical evidence" rather than broad efficacy claims.

ActiPatch® received FDA clearance as an over the counter pulsed shortwave therapy device under 510(k) K192234.

Clinical Context

Bioelectric medicine remains an evolving field that includes multiple distinct therapeutic modalities, device architectures, and signal delivery systems.

TENS and PSWT represent different technological approaches within that broader category.

Electrome's long term platform vision focuses on understanding how programmable bioelectric signaling may support future recovery, pain management, and therapeutic workflows through combinations of wearable therapeutics, AI enabled systems, clinical deployment infrastructure, signal response research, and bioelectric mapping.

"Bioelectric signaling represents one of the most underexplored layers in medicine," said Erik Nilson, PhD, CTO of Electrome. "As computational biology and electrophysiology continue advancing, we believe signal based therapeutics may become an increasingly important component of modern recovery and treatment pathways."

Related Research

• FDA 510(k), ActiPatch® K192234
• Osteoarthritis PSWT Clinical Trial
• Chronic Pain PSWT Observational Study
• Scientific Reports, FLIPUS vs PSWD Study
• Electrome Clinical Evidence Library

Sources and References

• FDA 510(k) Database, ActiPatch® K192234
• PubMed, Effect of pulsed short wave diathermy on osteoarthritis of the knee
• PubMed, Placebo controlled double blind trial of pulsed short wave therapy
• Scientific Reports, FLIPUS vs PSWD Study
• PMC, Pulsed Shortwave Therapy Observational Study