Yes, there is a new medical phenomenon called iPad elbow. At first I thought I hurt my arms lifting some bedroom furniture, but that was months ago. The arm braces helped a little, but did not cure anything. I saw this set and purcahsed because of the good reviews. Everyone was right. Take the time to read the manual so that you understand the difference between TENS and EMS. Whatever mode you are in, once all your settings are up, you push the up arrow to increase the intensity to a point that is comfortabnle to you. That is how you "START" the device. For the life of me I was wondering why it was all programmed but wouldn't start pulsating. This device pays for itself after missing 3 PT deductables. If you plan on using this a lot, you may end up needing to buy some extra sensor pads.