Over the past 20 years, many healthcare professionals have used electrotherapy to help patients relieve acute and chronic sports, arthritic, and post-surgical pain and inflammation.
Electrotherapeutic devices come mainly in four different forms: transcutaneous electrical nerve stimulation (TENS), interferential (IF) therapy, microcurrent (Micro) therapy, and electrical muscle stimulation (EMS).
While each different type of stimulation offers distinct benefits, choosing the most appropriate one for your patient’s clinical goals don’t need to be overwhelming or complicated.
How it works
Before exploring the differences in electrotherapeutic devices, you need to have a fundamental understanding of how electrotherapy works. This is a frequently prescribed treatment modality with the ability to target a multitude of acute and chronic musculoskeletal ailments.
Electrotherapy, in basic terms, transfers a measured, safe electrical current from a power source to the soft tissues of the body through the use of electrodes placed over the desired treatment area.
The applied electrical current not only induces the body’s inherent ability to release endorphins, but, most importantly, it creates a pulse stimulus across the skin surface and underlying nerve structures. This measured electrical stimulus serves to partially disrupt pain signals, preventing them from reaching the brain.
Electrotherapy devices range from large, powerful clinical units, which are intended for use in the clinician’s office, to more compact portable units that are handheld and typically intended for personal use at home. One of the many benefits of a home unit is that it serves to encourage the patient’s active participation in his or her own care along with the clinician’s supervision and guidance.
The therapeutic effects on the neuromuscular tissues of the body may vary depending on the wave- length and frequency of the electrical current applied to the desired area of treatment.
Types of modalities
Each type of electrotherapy serves a different purpose. It is imperative to use the proper type of electrical impulse to optimally address the symptoms associated with your patient’s diagnosis and maximize the incidence of favorable treatment outcomes.
To review, the following are the four main types of therapeutic electrical current modalities:
- Transcutaneous electrical nerve stimulation (TENS)
- Interferential therapy (IF)
- Microcurrent therapy (Micro)
- Electrical muscle stimulation (EMS)
The first (and most popular) of the electrotherapy modalities is TENS. This type of therapy transfers current through the skin to interact with the nervous system by interrupting peripheral pain pathway receptors leading to the brain, resulting in a decrease of the pain sensation a patient is experiencing.
While TENS should not be considered a cure for the cause of the pain, it oftentimes serves to ease discomfort for the duration of treatment.
When applied optimally, the TENS current should feel robust but not painful. TENS therapy offers the advantage of relieving pain without the need for exposure to the potentially harmful side effects inherent in the use of other approaches to pain management, such as narcotics.
IF is another popular type of electrotherapy. It is similar to TENS in that it passes current through the skin to relieve pain. IF travels at a much higher frequency, however, allowing it to penetrate deeper into body tissues. It has the ability to target pain that may reside in parts of the body that cannot be reached by the frequency produced by a TENS unit.
The third type of electrotherapy under discussion is Micro. The current produced by Micro mimics the current that is naturally produced by the body. This promotes the production of adenosine triphosphate (ATP) in cells in and around the treatment area. It also increases blood flow, causing treated cells to become more energetic and may as a result induce healing.
The last of the four main types of electrotherapy is EMS. Unlike the above types of electrotherapy, EMS sends pulsing current specifically to the muscle, causing it to periodically contract and relax. EMS can be used to deter muscle atrophy and improve overall muscle tone or treat conditions such as chronic or recurrent muscle spasms.
These Class II medical devices should not be confused with the recent proliferation of less effective, over-the-counter devices that cannot, by law, produce effective power.
Accordingly, they cannot provide the therapeutic advantages and benefits imparted by a clinician-prescribed electrotherapy device.
Electrotherapy devices worth having
When applied appropriately as indicated, TENS, IF, Micro, and EMS can address and favorably affect a wide variety of neuromuscular conditions and symptoms. Due to the
ever-changing state laws and confusing insurance reimbursement regulations, some clinicians have unfortunately become reluctant to offer electrotherapy as a viable treatment option for their patients.
However, many clinicians have found that partnering with a reputable DME provider is an efficient and hassle-free way of offering the many benefits of electrotherapy to their deserving patients.
Nicholas Exarhos, DC, is a 1990 graduate from Life University. He practiced for several years in Northern Virginia, where he incorporated technology into chiropractic. He was responsible for promoting spinal decompression therapy, which changed the way chiropractors treat herniated discs. He is president and CEO of TENSSource, a durable medical equipment (DME) company. He can be contacted through tenssource.com.