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Should You Use E-Stim Devices At Home?

E-stim machines are now available for in-home use—but is it a good idea to diy here's what you need to know before you do..

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If you’ve ever been hooked up with electrodes that make your muscles twitch, chances are the treatment occurred in a physical therapist’s office. But recently, small stimulation machines that deliver an electrical current, often called e-stim for short, are becoming commonplace at event expos, health fairs and sporting goods retailers—with home use as the goal.

We’ve seen a proliferation of these devices, but we were curious…do they really work? If so, how does a runner know if she needs one? We turned to a couple of experts: NYC-based pain specialist Dr. Febin Melepura and San Diego physical therapist Chelsea Best to get some answers.

How do e-stim machines work and how effective are they?

They deliver electrical stimulation , which can reduce pain and increase blood flow, but how much of a difference they make varies based on the situation. There are two ways they tend to work: You may see NMES (neuromuscular electrical stimulation) or EMS (electrical muscle stimulation), which means the therapy is designed to stimulate motor neurons—“the nerves that control the muscle,” Dr. Melepura explains. Whereas TENS (transcutaneous electrical nerve stimulation) units are designed to stimulate sensory neurons, aka “the nerves that transmit the pain.” Physical therapist Best explains the former (NMES/EMS) is intended for “someone having trouble contracting the muscle itself.” For example, after a knee injury, it could help prevent atrophy in your quad muscle. TENS, on the other hand, is used only to reduce pain.

How do home ones differ from what pros use?

“While there are many electrotherapy devices available, their basic function is the same,” Dr. Melepura says, as is their efficacy. “Some stimulators are simplified and have preset stimulation settings (frequency, amplitude and duration) for different body parts. The user just pushes a button that corresponds to the part of the body that they want treatment for.” Best says the in-office machines may have more potential settings—but a simple device, even one that only offers TENS, is suitable for most people for home use.

Should a runner who has recurring issues, like lower back pain or Achilles tendinitis, use this therapy?

“People do tend to self-medicate,” Best says. “If you read the directions and you understand what’s going on, they can definitely be very beneficial. In our practice, it’s commonly used as a modality at the end of [one day’s] treatment, because a lot of times people have increased pain, and it calms everything down so that they feel better.” For in-office patients who say e-stim is particularly beneficial, she has recommended a home unit.

If a runner tweaks a muscle or has some acute pain, does it make sense to use e-stim without seeing a doctor first?

It’s up to the individual, but Dr. Melepura says, “The best initial treatment is rest, applying ice or cold compresses and elevating the injured body part. Some injuries will need additional treatment, so if the pain persists for a week to 10 days, individuals should seek the care of a physician who will be able to recommend if electrotherapy is appropriate.”

Should a home treatment feel the same as with a professional?

Yes. Since you can crank up the electrical stimulation on your own, Best says, “You want it to be a moderate feeling but not painful or uncomfortable.” She also suggests treatment for 15 to 20 minutes at a time, and you can use ice with it to help reduce inflammation.

Going Shopping

We found a lot of different machines, so here are three questions to ponder:

• Do I want both the option for EMS (for acute injuries) and TENS (to reduce pain)?
• How important is ease of use and would I be apt to try this without professional advice?
• How much do I want to pay? We found a simple TENS unit as low as $17 and a combo EMS/TENS unit around $70 through TENS Pros .

Warning Signs

Dr. Melepura offers these tips.

• TENS and EMS should not be used on vital parts, such as across the neck, chest or brain (and not at all if you have a pacemaker).
• Electrical stimulation should be used with caution during pregnancy or when trying to conceive.
• There is a potential of skin irritations and possibly burns if used excessively.

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How Often Should You Replace Your Pillows?

As with mattresses , pillows don’t have a hard-and-fast expiration date, so the only truly honest answer for when to replace them is a resounding “It depends.” The basic rule of thumb — and what I’ve heard over and over from experts — is to replace your pillows every two years, especially if you have asthma, a dust-mite allergy, or sensitive skin. But a well-maintained pillow can certainly last longer if it’s still supportive enough that you aren’t waking up with aches and pains. Whether it has been two years or not, here are the main things to consider before buying a new pillow .

Above all, make sure your pillow is supporting your head and neck

Beyond comfort, the main reason for sleeping with a pillow at all is to keep your head and neck in a neutral alignment with your spine. And because you sleep on it for hours every night, your pillow will inevitably wear out over time. If you’re dealing with any kind of neck pain , it may be a sign that your pillow isn’t doing its job, especially if it has gotten too flat or compressed after years of use, says chiropractor Dr. Jordan Duncan .

To test the supportiveness of your pillow, you can try what Dr. Joshua Tal , a psychologist who specializes in sleep disorders, calls the “shoe test,” which was created by Dr. Michael Breus , a clinical psychologist and founder of the Sleep Doctor wellness company. “What you do is you fold your pillow in half, put a shoe on the back side of the pillow, and then let go of the pillow,” explains Tal. “If the pillow folds back into shape and flings the shoe off of it, you’re good. If it doesn’t, it’s kind of lost its ability to hold your head up properly.” (Be sure to use a substantial shoe and not, say, a flip-flop.)

Tal also mentioned another test he uses with his patients: “I advise clients to stand up against the wall as if you were sleeping — so a back sleeper would stand with their back to the wall; a side sleeper would stand with their side to the wall — and then rest your head on the wall and notice how far it has to move to do that,” he says. “Then put your pillow in between where you’re resting your head and see if you’re standing up straight. That’s the key: You should be standing up straight if you have a good pillow.”

If your pillow looks or feels very lumpy — a possibility for down , down-alternative, or shredded-foam pillows — that may also be a sign it’s losing some of its structural integrity.

Pillows can get pretty gross over time

Because you’re essentially smashing your face and hair into them every night, and because they’re not always washing machine–friendly, pillows tend to need replacing more often than other bedding, solely from a hygiene perspective. The main concerns are asthma , allergies, and skin: According to Melanie Carver, chief mission officer of the Asthma and Allergy Foundation of America (AAFA), the fabric of a pillow is permeable to dust mites, and after two years of use, your pillow can be 10 percent dead dust mites and their droppings. Icky, yes, as well as particularly bad for people with dust-mite allergies . Other potential allergy triggers like pet dander and mold can also be absorbed by your pillow and cause symptoms to flare. If you have asthma, allergens in your pillow can make your symptoms worse.

Pillows can also trap dirt, oil, and dead skin cells, and according to board-certified dermatologist Dr. Annie Chiu , all of these can be irritants for your skin — even if you are diligently washing your pillowcase . Chiu explains that a pillowcase won’t act as a complete barrier, so irritants in your pillow can still cause trouble, especially if you have sensitive skin or persistent acne .

Yellowing or stains can be an indicator that your pillow has absorbed lots of moisture — from sweat, drool, skin-care or hair-care products, or going to sleep with wet hair — and needs to be replaced.

How important is the “every two years” rule, really?

If you’re balking at the idea of replacing your pillow every two years, you’re not alone. Two years is what AAFA officially recommends — and just about every expert I spoke to echoed it. But my own informal polling of friends and colleagues and a deep dive into Reddit discussions on how often to replace pillows suggest many people aren’t replacing their pillows as frequently as every two years, no matter what the experts say. Ultimately, while you may need to replace basic fiber pillows even sooner than two years because they may flatten more quickly, pillows made of sturdier materials can last much longer. You should mainly be mindful of whether issues like asthma, allergies, or neck pain are getting worse the longer you have your pillow.

Keeping your pillow as clean as possible will help it last as long as possible

Carver told me that washing your pillow once a month in hot water (130 degrees Fahrenheit) can help remove allergens like dust mites. However, this advice only really applies to pillows that are totally washable — and in my experience, the majority of them are not. Synthetic-fill down-alternative pillows and down pillows are the most likely to be washing machine–friendly, so if you have allergies or asthma and want to follow Carver’s guidance, you may want to seek out those fill types.

Most memory-foam and latex pillows have only a washable cover since the foam itself usually cannot be washed. And a 2013 paper from the American Academy of Allergy, Asthma & Immunology (AAAAI) found that foam pillows are just as susceptible to dust mites as feather pillows, so it’s still important to wash your pillow covers regularly. Memory-foam pillows are often recommended as allergy-safe since the foam itself isn’t a food source to dust mites the way natural materials like feathers are, but like other types of synthetic pillows, foam can still collect your dead skin, which feeds the mites.

You can sometimes clean memory foam by sprinkling it with baking soda and vacuuming it, as recommended by cleaning expert Jolie Kerr, to help remove dust mites or dead-skin buildup. And while some experts (including Kerr) say it’s possible to clean memory foam in water as long as you hand-wash it, I have attempted this and forewarn you that it will take a long time for the foam to dry. (This means you may be risking mold or mildew, so proceed with caution and make sure you’ve got a well-ventilated space and a fan to speed up the process.) For latex pillows, you can follow a similar process as with memory foam. Latex manufacturer Turmerry recommends vacuuming the latex and then spot-cleaning with a damp cloth and mild detergent.

Consider a pillow protector

In addition to cleaning, Carver also recommends using an Asthma & Allergy Friendly–certified pillow protector to keep out dust mites and other allergens in the first place — they’re like mattress protectors for your pillow that go around the pillow before you add your actual pillowcase. But even with these precautions, AAFA still recommends replacing your pillow every two years.

Additional reporting by Hilary Reid and Chloe Anello .

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'ZDNET Recommends': What exactly does it mean?

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ZDNET's editorial team writes on behalf of you, our reader. Our goal is to deliver the most accurate information and the most knowledgeable advice possible in order to help you make smarter buying decisions on tech gear and a wide array of products and services. Our editors thoroughly review and fact-check every article to ensure that our content meets the highest standards. If we have made an error or published misleading information, we will correct or clarify the article. If you see inaccuracies in our content, please report the mistake via this form .

This ultra-thin power bank I tested is a must-have travel gadget (and it's surprisingly cheap)

ZDNET's key takeaways

• The Auskang 5,000 mAh power bank is available on Amazon for $21.
• It's small and thin, yet robust, and delivers on all its promises.
• I wish it could be recharged using the built-in USB-C port.

I've got a thing for chunky power banks: there's something about bigger devices that feels reassuring with all the power they can hold. That said, I'm acutely aware that the bigger the power bank, the more likely it is to be left behind, leaving my devices without those sweet electrons.

Also:  The best power banks you can buy: Expert tested

I've tested portable chargers of all sizes, but recently I had the chance to get my hands on the Auskang 5,000 mAh power bank , an ultra-thin device that's about the same thickness as a stack of coins, and it didn't disappoint. 

Auskang 5,000mAh power bank tech specs

• Capacity : 5,000mAh
• Outputs:  Built-in USB-C cable : 5V⎓2.1A max USB-C port : 5V⎓2.1A max
• Input:  USB-C port : 5V⎓1.5A max
• Recharge time : 3.5 hours at 5V⎓1.5A
• Protections : Overcharge, overdischarge, overvoltage, overcurrent, and short circuits
• Battery type : Li-polymer
• Shell : 304 stainless steel
• Size : 124 x 66 x 6.8 mm
• Weight : 130g
• Finishes : Beige, Black, Blue, Pink 

The first thing that's utterly striking about this power bank is how thin it is. It's really thin, much thinner than my iPhone, and about the thickness of a few credit cards or a few coins.

When I first saw it, I thought it might be plastic and worried that the battery could bend and catch fire in my pocket. Fortunately, everything is encased in a stainless steel shell that has so far resisted everything I've thrown at it.

It's thin!

Sure, I'm certain I could bend it in half if I tried, but the same goes for my phone or tablet. What matters is that it's strong enough to handle day-to-day life.

Also:  This powerful power bank is perfect if you charge a lot of devices

The power bank has all the basics you'd expect -- there's a power button, four LEDs showing current charge levels, and a USB-C port that can both charge devices and recharge the power bank itself.

Charge indicator lights

It also features a built-in USB-C connector on a short pigtail cable for charging any device with a USB-C port. This brilliant twist adds versatility, meaning you don't need to carry an extra cable or rely on wireless charging. Prefer a Lightning connector instead of USB-C? No problem! There's a version available with just that . 

The two outputs allow the power bank to either charge two devices simultaneously or be charged while it's charging another device. This makes it incredibly handy for those on-the-go moments when you need reliable power without the bulk.

Testing power input and output of the Auskang 5,000 mAh power bank.

I put this power bank through the wringer, and it passed all my tests with flying colors. The power outputs and input match up to the spec sheet, and the power bank can operate at full capacity for extended periods without overheating.

Also: How we test portable power stations at ZDNET in 2024

Perhaps most importantly, the success of this power bank has cured me of the need to always carry the biggest one I can find. It offers 5,000mAh of capacity, which isn't a huge amount, but it's enough to charge a modern smartphone about once over. If you need more than that, you'll need bigger pockets for a bigger power bank or access to AC power. 

ZDNET's buying advice

The Auskang 5,000mAh power bank is perfect for on-the-go use with your smartphone. It's small, light, and packs a punch. The only criticism I have is that it can't be charged using the built-in USB-C cable; you'll need a separate cable for that. Yet another item to carry makes it harder to travel light. Think of this power bank as more of a one-and-done use case.

Overall, for around $20, the Auskang offers a lot of bang for your buck. If you're looking for something small, thin, and robust enough to survive in a pocket or bag, it's a great buy.

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