TECAR Therapy
Original Editor - Malisha van der Berg
Top Contributors - Malisha van der Berg, Vidya Acharya and Alexandra Stead
Page Summary
- Transfer of Energy Capacitive and Resistive (TECAR) therapy is a form of diathermy using 400 to 500 kHz radiofrequency to heat tissue internally for musculoskeletal disorders.
- Capacitive mode heats superficial water-rich tissue (muscle, blood, fat), while resistive mode heats deeper dense connective tissue such as tendons, ligaments and fascia.
- Evidence supports TECAR for short-term pain relief, including delayed onset muscle soreness and low back pain, though meta-analysis rates overall certainty of evidence as low.
- Clinicians apply TECAR as an adjunct before exercise or manual therapy; contraindications include pacemakers, local malignancy, deep vein thrombosis and abdominal or pelvic treatment in pregnancy.
Introduction
Transfer of Energy Capacitive and Resistive (TECAR) Therapy is a form of diathermy used by clinicians treating musculoskeletal disorders.[1] It is a physical treatment modality that uses longwave radio frequency in the region of 400 to 500 kHz, though some devices operate up to 1.2 MHz.[2] It is also known as: Capacitive-Resistive Electric Transfer (CRET) Therapy, Targeted Radiofrequency (TR) Therapy, non-invasive radiofrequency therapy (NIRF).
Diathermy uses electromagnetic waves to generate heat within tissue, and TECAR sits within this category as an endogenous heating technique.[3] This means that heat is generated inside the tissue by the body's own resistance to electromagnetic current flow rather than applied from the external source. It is a safe form of diathermy with a low risk of skin burns.[1]
The strength of evidence for TECAR varies considerably by condition.[4] Indications, such as delayed onset muscle soreness (DOMS) and short-term low back pain relief,[1] are reasonably well supported. Others, including knee osteoarthritis,[5] myofascial pain and lateral elbow tendinopathy,[6] have mixed evidence, and the largest and most rigorous meta-analysis of diathermy to date rates the overall certainty of evidence for the use of TECAR as low.[7]
Biophysics of TECAR Therapy
TECAR delivers energy in two distinct operating modes, capacitive and resistive, which differ in how the electrical field distributes through tissue.[2]
Capacitive Electrode Transfer (CAP/CET)
The capacitive electrode is insulated by a dielectric layer. This increases impedance at the electrode and directs electrical current into tissues with lower resistance and higher water content, producing a more superficial heating effect.[2][3] Tissues targeted includes:
- muscles
- blood
- fat
Resistive Electrode Transfer (RET/RES)
The resistive electrode has no insulating layer and makes direct contact with tissue. Current flows through tissues of higher electrical resistance, producing a deeper heating effect in dense connective tissue. Tissues including;[2][3]
- tendons
- ligaments
- joint capsules
- fascia
A neutral or ground electrode, usually a plate, completes the circuit. Some systems allow bipolar use, permitting two handheld applicators to be used together.[3]
The following video shows the effect of RES and CAP application via infrared camera;
Physiological Effects of TECAR Therapy
Vasodilation and local blood flow
Capacitive and resistive modes significantly affect skin microcirculation perfusion, with resistive mode producing a significant increase in skin temperature and intramuscular blood flow.[3] TECAR's capacity to affect blood flow is the primary mechanism supporting tissue healing.[3]
Increased cellular metabolism and proliferation
Radio frequency stimulation at 448 kHz promotes proliferation of human mesenchymal stem cells (MSC) and supports their differentiation towards chondrocytes, osteoblasts and adipocytes without compromising their multipotency[9]. This suggests a possible role in supporting regeneration of cartilage, bone and adipose tissue beyond simple heating.[9]
Mechanism
Electrical stimulation at 448 kHz promotes cellular proliferation via stimulation of the Epidermal Growth Factor Receptor (EGFR), up-regulating the Extracellular Signal Regulated Kinase (ERK 1/2) signalling pathway, also known as Mitogen Activated Protein Kinase (MAPK) signalling pathway.[10]
This signalling pathway activates the DNA within the nucleus and in doing so increases the proportion of cells in S (copying DNA), G2 (preparing to divide) and mitosis (splitting into new cells) phases.[9] “Tricking” cells into accelerating its natural growth and healing cycles.
The following video explains in detail what the ERK/MAPK signalling pathway activates and its influx into the nucleus that drives cellular growth:
Stimulation at 448kHz appears biologically significant:[9][10]
- Below 448 kHz, the cell membrane behaves as an insulator and only a vibration-like ion movement is produced
- 448 kHz initiates a linear ion flow that enables intercellular exchange (explained above)
- Frequencies above 448kHz cause ion rotation and thermal effects without intracellular exchange
Thus, depending on the intensity used, TECAR can produce either non-thermal cellular stimulation or strong hyperthermic (heating) effects.[2]
Evidence suggests low-intensity, low-thermal applications drives interstitial fluid drainage and cell proliferation without raising tissue temperature that may suit inflammatory or acute presentations. Chronic conditions requiring deep tissue heating and viscoelastic change, are better suited to higher intensities.[2][12]
TECAR Components and Use
A standard TECAR unit consists of a capacitive (CAP) applicator, a resistive (RES) applicator and a neutral or ground plate, with conductive coupling cream or gel.[2] Many systems allow additional fascia attachments, and clinicians can incorporate manual myofascial techniques into treatment.[6][13]

Typical Dosing Patterns
Timing
Research using different devices (Indiba Active Pro, Physio Radio Stim Pro) has used 5 minutes of CAP mode followed by 10 minutes of RES mode for lumbar applications and 10min CAP followed by 20min RES for quadriceps.[14][15] A 1:2 CAP:RES ratio.
Commercial rehabilitation protocols also exist that vary intensity and duration by anatomical region within a single session. One such 60-minute whole-body recovery protocol specified:[16]
- Quadriceps for 3 minutes per leg in RES mode followed by 3 minutes per leg in CAP mode
- Hamstrings for 3 minutes per leg RES followed by 2 minutes per leg CAP
- Triceps surae for 3 minutes per leg in CAP mode
Duty cycle
Where duty cycle was reported in literature, CAP mode has been delivered at 50% duty and RES mode at 100% duty.[14][15]
A pilot study on healthy forearms used RES mode at 70% intensity and CAP mode at 40% intensity, reduced to 35% and 20% respectively if not tolerated.[3]
Indications for TECAR Therapy and Evidence
The table below summarises the current evidence for TECAR therapy across musculoskeletal and related conditions.
| Condition | Key study | Evidence summary |
|---|---|---|
| Chronic non-specific low back pain | [1][7][15][17][18] |
|
| Knee osteoarthritis | [7][5] |
|
| Lateral elbow tendinopathy | [19] | |
| Delayed onset muscle soreness (DOMS) | [20] |
|
| Warm-up / pre-activity preparation | [14] |
|
| Post-exercise recovery in athletes | [16] |
|
| Myofascial pain syndrome (general) | [6] |
|
| Cervical myofascial pain | [13] |
|
| Acute hamstring strain | [21][22] | |
| Chronic stroke spasticity (lower limb) | [23][24][25] |
|
| Diabetic peripheral neuropathy | [25][26] | |
| Lymphoedema / lipoedema (lower limb) | [25][27][28] | |
| Paediatric faecal incontinence (adjunct) | [29] |
|
| Postpartum perineal pain | [30] |
|
| Chronic pelvic pain (women, general) | [31] |
|
| Sports-related musculoskeletal pain (general) | [32] [33] | |
| Musculoskeletal disorders (diathermy, general) | [7] |
|
Current evidence supports TECAR use as a short-term pain relief and mobility adjunct rather than a primary treatment.
Machine Settings
Settings vary significantly between manufacturers. Figures below are drawn directly from the studies cited and should be treated as illustrative reference points rather than universal protocols; always refer to the specific device manual and titrate to patient response.Example videos of how to apply TECAR to these regions are added where available.
| Condition | Mode sequence | Reported settings |
|---|---|---|
| Chronic low back pain
|
CAP then RES |
|
| Knee osteoarthritis
|
CAP and/or RES |
|
| DOMS
|
CAP then RES |
|
| Warm-up / pre-activity | CAP then RES |
|
| Post-exercise recovery (multi-region) | RES then CAP per region |
|
| Lateral elbow tendinopathy
|
RES + CAP combined |
|
| Acute hamstring strain
|
CAP only | |
| Diabetic peripheral neuropathy | CAP, low intensity | |
| Chronic stroke spasticity | CAP; CAP+RES |
Regional Protocol:[24]
|
| Lipoedema | CAP + RES |
|
| Lymphoedema | Capacitive |
|
| Healthy tissue microcirculation (mechanistic reference) | RES vs CAP compared |
|
Precautions and Contraindications
As with other forms of diathermy, standard contraindications and precautions apply. Reported contraindications and precautions in the literature are presented in the table below.[12][4]
| Contraindications | Precautions |
|---|---|
|
|
In paediatric populations specifically, interference with cardiac implantable electronic devices has been reported, and thermal effects require careful dose monitoring given children's differing tolerance and communication of discomfort.[29]
Summary
TECAR therapy is a form of endogenous diathermy delivering radiofrequency energy through CAP and RES applicators to generate heat within tissue.[2] The CAP mode directs energy into superficial, water-rich soft tissue, while the RES mode reaches deeper, denser structures.[2] Proposed mechanisms include local vasodilation and increased blood flow,[3] and cellular proliferation effects that have both thermal and non-thermal components.[9]
Current evidence supports TECAR for short-term pain reduction and ROM improvement.[1][20][25]
TECAR should be used as an adjunct rather than a primary intervention. Therapists can apply it ahead of exercise, manual therapy or myofascial work to reduce guarding and stiffness and allow fuller, more comfortable engagement with active rehabilitation that follows.[4]
References
- ↑ 1.0 1.1 1.2 1.3 1.4 1.5 Ismail S, Usa H, Nidhya K. The effectiveness of capacitive and resistive electric transfer therapy for nonspecific chronic low back pain: a systematic review. Published online 2025. Accessed September 20, 2026.
- ↑ 2.0 2.1 2.2 2.3 2.4 2.5 2.6 2.7 2.8 Ida AM, Neves EB, Stadnik AMW. Effects of Tecartherapy on Body Tissue: A Systematic Review. Journal of Biomedical Science and Engineering. 2023;16(10):133-148.
- ↑ 3.0 3.1 3.2 3.3 3.4 3.5 3.6 3.7 3.8 Clijsen R, Leoni D, Schneebeli A, et al. Does the Application of Tecar Therapy Affect Temperature and Perfusion of Skin and Muscle Microcirculation? A Pilot Feasibility Study on Healthy Subjects. The Journal of Alternative and Complementary Medicine. 2020;26(2):147-153.
- ↑ 4.0 4.1 4.2 Lupowitz LG, Ramus L, Delacour F, Johnson K. TECAR Therapy: A Clinical Commentary on its Evolution, Application, and Future in Rehabilitation. IJSPT. 2025;20(4).
- ↑ 5.0 5.1 5.2 5.3 5.4 Musorrofiti MG, Bonifacio M, Cipolloni V, Mattia E, Bellomo R, Saggini R. The Use of Physical Energy-Based Therapies in the Management of Osteoarthritis. Medicina. 2026;62(6):1119.
- ↑ 6.0 6.1 6.2 6.3 He P, Fu W, Shao H, et al. The effect of therapeutic physical modalities on pain, function, and quality of life in patients with myofascial pain syndrome: a systematic review. BMC Musculoskelet Disord. 2023;24(1):376.
- ↑ 7.0 7.1 7.2 7.3 7.4 7.5 7.6 Pollet J, Ranica G, Pedersini P, Lazzarini SG, Pancera S, Buraschi R. The Efficacy of Electromagnetic Diathermy for the Treatment of Musculoskeletal Disorders: A Systematic Review with Meta-Analysis. Journal of Clinical Medicine. 2023;12(12):3956.
- ↑ Human Tecar USA. How Human Tecar Therapy Works | Human Tecar USA. Available from: https://www.youtube.com/watch?v=UDrfCtr9DvM [last accessed 02/10/2026]
- ↑ 9.0 9.1 9.2 9.3 9.4 Mazurek B, Ali QM, Mashkoor NH. THE USE OF ELECTRIC TRANSFER 448 kHz THERAPY IN SPORTAND IMPACT OF HUMAN MESENCHYMAL STEM CELLS. مجلة دراسات وبحوث التربية الرياضية. Published online November 15, 2024:540-548.
- ↑ 10.0 10.1 Hernández-Bule ML, Paíno CL, Trillo MÁ, Úbeda A. Electric stimulation at 448 kHz promotes proliferation of human mesenchymal stem cells. Cell Physiol Biochem. 2014;34(5):1741-1755.
- ↑ Hussain Biology. MAPK/ERK Signaling Pathway. Available from: https://www.youtube.com/watch?v=thLsxvqDZ04 [Last accessed 24/09/2026]
- ↑ 12.0 12.1 Lytras D, Iakovidis P, Kasimis K. Movement within a therapeutic field as a framework for multimodal neuromodulation in musculoskeletal pain rehabilitation. Discov Neurosci. 2026;21(1):54.
- ↑ 13.0 13.1 13.2 Simati K, Paraskeva A, Tzigkounakis G. Multimodal Physiotherapy Interventions for Cervical Myofascial Pain (2019-2025): A Structured Narrative Literature Review of Randomized Trials. Cureus. Published online November 13, 2025.
- ↑ 14.0 14.1 14.2 14.3 14.4 Wachi M, Jiroumaru T, Satonaka A, et al. Possibility of a Novel Warm-Up Strategy Using Capacitive and Resistive Electric Transfer: A Pilot Study. OJTR. 2022;10(03):89-100.
- ↑ 15.0 15.1 15.2 15.3 15.4 Wachi M, Jiroumaru T, Satonaka A, et al. Effects of capacitive and resistive electric transfer therapy on pain and lumbar muscle stiffness and activity in patients with chronic low back pain. Journal of Physical Therapy Science. 2022;34(5):400-403.
- ↑ 16.0 16.1 16.2 16.3 Canet-Vintró M, Oviedo GR, López-de-Celis C, et al. Muscle Massage Adding Capacitive Resistive Electric Transfer Therapy in Active or Sham Condition for Post-Exercise Recovery in Athletes: A Crossover Clinical Trial. European Journal of Sport Science. 2026;26(10):e70246.
- ↑ 17.0 17.1 Avramova, M., Mitova, S., Karashtranova, E. Capacitive and resistive electrical transfer method for athletes with non-specific low back pain. JPES. 2024;24(11).
- ↑ 18.0 18.1 Ortiz HA de la B. Comments on ‘The effectiveness of capacitive and resistive electric transfer therapy for nonspecific chronic low back pain: a systematic review.’
- ↑ 19.0 19.1 19.2 Dimitrios S, Efstratia G, Aikaterini S. Diathermy and TECAR Therapy for Lateral Elbow Tendinopathy: A Systematic Review of Randomized Controlled Trials. SN Compr Clin Med. 2026;8(1):206.
- ↑ 20.0 20.1 20.2 20.3 Nakamura M, Sato S, Kiyono R, et al. The Effect of Capacitive and Resistive Electric Transfer Intervention on Delayed-Onset Muscle Soreness Induced by Eccentric Exercise. International Journal of Environmental Research and Public Health. 2022;19(9):5723.
- ↑ 21.0 21.1 21.2 Kelli A, Apostolou T, Iakovidis P, Koutras G, Kellis E. Acute effects of medium-frequency electrical energy transfer (TECAR) and transcutaneous electrical nerve stimulation (TENS) on pain and flexibility in athletes with an acute hamstring injury: A randomized controlled trial. Sports Medicine and Health Science. 2026;8(2):210-218.
- ↑ 22.0 22.1 22.2 Olaniszyn G, Kużdzał A, Bas O, Tyravska O, Kawczyński A, Trybulski R. Transcutaneous Electrical Nerve Stimulation (TENS), Interferential Current (IFC) and Percutaneous Needle Electrolysis (PNE) in the treatment of sports-related pain: a scoping review with an evidence gap map. BMC Sports Sci Med Rehabil. 2026;18(1):149.
- ↑ 23.0 23.1 23.2 García-Rueda L, Cabanas-Valdés R, Salgueiro C, Pérez-Bellmunt A, Rodríguez-Sanz J, López-de-Celis C. Immediate effects of TECAR therapy on lower limb to decrease hypertonia in chronic stroke survivors: a randomized controlled trial. Disability and Rehabilitation. 2025;47(5):1214-1223.
- ↑ 24.0 24.1 24.2 García-Rueda L, Cabanas-Valdés R, Salgueiro C, Rodríguez-Sanz J, Pérez-Bellmunt A, López-de-Celis C. Immediate Effects of TECAR Therapy on Gastrocnemius and Quadriceps Muscles with Spastic Hypertonia in Chronic Stroke Survivors: A Randomized Controlled Trial. Biomedicines. 2023;11(11):2973.
- ↑ 25.00 25.01 25.02 25.03 25.04 25.05 25.06 25.07 25.08 25.09 25.10 25.11 Vinolo-Gil MJ, Estebanez-Pérez MJ, Vera-Serrano FJ, et al. Non-Invasive Radiofrequency Therapy for Musculoskeletal, Neurological, and Vascular Conditions of the Lower Limb: A Systematic Review and Meta-Analysis. Journal of Clinical Medicine. 2026;15(6):2428.
- ↑ 26.0 26.1 26.2 Javan Amoli M, Khademi-Kalantari K, Niajalili M, Daryabor A, Sadat Naimi S. Comparison of the effect of separate and simultaneous application of Tecar therapy and low-level laser therapy on the neurological symptoms of type 2 diabetic patients with peripheral neuropathy of lower limbs. Turk J Phys Med Rehabil. 2024;70(3):344-357.
- ↑ 27.0 27.1 27.2 Uzun Ö, Sezgin Özcan D, Bölük Şenlikçi H, Atalay Z, Ünal R, Dalyan M. Clinical effects of TECAR therapy in the conservative management of Stage 2 lipedema in females: A randomized controlled trial. Turk J Phys Med Rehabil. 2025;71(4):560-573.
- ↑ 28.0 28.1 Cau N, Cimolin V, Aspesi V, et al. PRELIMINARY EVIDENCE OF EFFECTIVENESS OF TECAR IN LYMPHEDEMA. Lymphology. 2019;52(1).
- ↑ 29.0 29.1 29.2 Stavăr AV, Daia CO, Mitoiu BI, Verenca MC. Electrotherapy in Pediatric Rehabilitation: A Structured Narrative Review of Clinical Applications, Treatment Parameters, Safety, and Evidence Gaps. Journal of Clinical Medicine. 2026;15(18):7012.
- ↑ 30.0 30.1 Wagih R, Fawzy MA, Osama Y, Kora AN. Effect of TECAR Therapy on Musculoskeletal Pain: A Narrative Review. Egyptian Journal of Physical Therapy and Rehabilitation. 2025;0(0):0-0.
- ↑ 31.0 31.1 Pinto L, Soutinho M, Coutinho Fernandes M, et al. Chronic Primary Pelvic Pain Syndromes in Women: A Comprehensive Review. Cureus. Published online December 1, 2024.
- ↑ 32.0 32.1 Kudich E, Miha V, Kozinc Ž. Effectiveness of TECAR Therapy for Managing Pain in Sports-Related Musculoskeletal Pathologies: A Systematic Review with Meta-analysis. SN Compr Clin Med. 2025;7(1):28.
- ↑ 33.0 33.1 Mitrić Ž, Vučković M, Hadžiomerović AM, Lalović M. Comparison between capacitive and resistive electronic transfer therapy and high-intensity laser therapy in pain conditions related to musculoskeletal disorders. Journal of Health Sciences. 2022;12(2):98-109.
- ↑ EME Italy. Low back pain treatment with tecar HR TEK. Available from: https://www.youtube.com/watch?v=NBnYUroEpi8 [last accessed 02/10/2026]
- ↑ Electrotherapy Explained. Tecarpuls for knee arthritis. Available from: https://www.youtube.com/watch?v=sKZcHaNdw1Q [last accessed 02/10/2026]
- ↑ @jheminitv5380. Tecar Therapy #winback #muscles. Available from: https://www.youtube.com/shorts/Rl5PcNycWoA [last accessed 02/10/2026]
- ↑ @Dr.AmanPriyadarshi. TECAR Therapy for Lateral Epicondylitis (Tennis Elbow). Available from: https://www.youtube.com/shorts/hVx4Ju8-jEU [last accessed 02/10/2026]
- ↑ Progetto FisioLab - Centro Fisioterapico. TECAR Terapia Civitanova Marche - Lesione Hamstring in fase post acuta #1. Available from: https://www.youtube.com/watch?v=lJrA8Xe9lqU [last accessed 02/10/2026]