Different Ways Your Physical Therapist Uses Electrical Stimulation

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E-Stim Use in Physical Therapy

Electrical stimulation unit in PT.
An electrical stimulation and ultrasound unit in PT. Eliza Snow/Getty Images

Electrical stimulation is a therapeutic modality commonly used in physical therapy as part of a comprehensive physical therapy program. There are different types of electrical stimulation, or E-stim as it is commonly referred to as. These different types may be used to accomplish different goals during your rehab program.

If you are having difficulty moving around after injury or illness, you may benefit from physical therapy to help restore normal mobility. Your PT may choose to use e-stim to help you move better or feel better.

Here are some examples of how your physical therapist uses electrical stimulation during physical therapy. By having a basic understanding of what your PT is trying to accomplish while using e-stim, you can be sure to be fully invested in your rehab program.

First up: electrical stimulation for pain relief.

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TENS to Control Chronic and Acute Pain

Electrical stimulation applied to a woman's rotator cuff.
Your physical therapist may apply NMES to your muscles to help them function better. E+/Getty Images

Transcutaneous electrical neuromuscular stimulation, or TENS, is a form a electrical stimulation used by your physical therapist to help control pain. The electricity stimulates nerve endings in your skin that communicate pain signals to your brain. These signals can be interrupted to help you decrease the pain that you are feeling.

A word of caution: TENS is a passive treatment, and most successful rehab programs are ones that are built around active exercises. Be sure you are only using TENS to control your pain as part of an active rehab program.

Related: Does TENS Really Work?

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NMES to Improve Muscular Function

Photo of a man with drawn on muscles for arms.
Electrical stimulation can be used to improve muscle function. Jessica Peterson/Getty Images

Your physical therapist may use electrical stimulation to help improve the way your muscles contract. This may be especially important after surgery, injury, or a long-term period of immobilization.

Russian stimulation or neuromuscular electrical stimulation (NMES) is often used to help your muscles to relearn how to contract properly. To perform NMES, your PT will place electrodes on specific areas of a muscle that are not contracting properly. Electrical impulses will then be introduced, and these impulses will work to contract your muscle.  While the electricity is stimulating your muscle, you should be working with the stimulation to improve neuromuscular recruitment of the injured muscle. 

Some specialized stimulation units, like the Bioness, use functional NMES. A small switch is added to the unit that can rapidly turn it on or off during functional activities like walking and reaching. These units can help people regain functional independence after stroke or injury that causes paresis or muscle atrophy.

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E-Stim to Control Incontinence

Photo of a woman running to potty.
Your physical therapist can help if you have urinary incontinence. Peter Cade/Getty Images

If you are having difficulty with incontinence, your PT may use electrical stimulation to help you engage the proper muscles that help keep urine flow at bay. Your PT may also use a form of electrical stimulation as biofeedback--electrical impulses that monitor your muscle contractions to tell you if you are working the right muscles properly. (This can be difficult to monitor visually or with a finger due to the location of the muscles that control urination and bowel movements.)

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Electrical Stimulation to Decrease Trigger Points

Photo of a man holding his painful neck.
Trigger points may be attacked by your PT with electrical stimulation. Tetra Images/Getty Images

If you are feeling muscle spasm and trigger points, your PT may use electrical stimulation, like interferential current, to help decrease your symptoms. The electricity can be used to contract and relax the affected muscle, helping to decrease the tension in that muscle.

Remember, active stretching after the electrical stimulation is necessary to help keep the trigger points away, and most research indicates that the electricity may decrease your symptoms; the trigger point in your muscle may still remain.

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Administer Medication with Electrical Stimulation

Photo of injectable medicine.
Your PT may use e-stim called iontophoresis to administer medication. nano/Getty Images

Iontophoresis is a form of electrical stimulation that is used by your physical therapist to administer medication. The electricity pushes the medicine through your skin and into your injured tissues.

Iontophoresis is often used to administer anti inflammatory medicine, like dexamethasone. It may also be used to help decrease muscle spasm or break up calcific deposits that may form in muscle tissue or tendons.

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Electrical Stimulation to Heal Wounds

Photo of a man caring for a wound on a child's leg.
Your PT may use electrical stimulation to care for your wound. Andy Crawford + Steve Gorton/Getty Images

Some physical therapists are wound care specialists, and they may use electrical stimulation to help improve wound healing. High voltage electrical stimulation has been shown to be of some use with wounds that are difficult to manage and heal properly. The electricity helps to improve circulation around the edges of the wound to aid in healing.

Your physical therapist is a movement specialist who can prescribe exercises and home programs to help you move better and feel better. Sometimes, external supports and modalities, such as electrical stimulation, may be used to help augment your active rehab program. By learning about the different ways your PT uses electrical stimulation, there will be no surprises when your therapist introduces electricity into your rehab program.

Sources

Gemmel, H and HIlland, A. Immediate effect of electric point stimulation (TENS) in treating latent upper trapezius trigger points: A double blind randomised placebo-controlled trial. Journal of Bodywork and Movement Therapies, 15(3), July 2011. 348-54

Rhouabhia, M, etal. Electrical Stimulation Promotes Wound Healing by Enhancing Dermal Fibroblast Activity and Promoting Myofibroblast Transdifferentiation. PLOSone. August, 2013.

Thakral, G. Electrical stimulation to accelerate wound healing. Diabetic Foot Ankle. 4(10). 2013.

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