Shocking Therapy? The Truth About E-Stim

A common line of questions we hear in our profession centers around E-stim, short for Electrical Stimulation. E-stim can be an effective treatment tool to reduce pain, improve strength, and even speed up wound healing. Let’s take a closer look at E-stim by explaining how it works, the various types, and some safety precautions to keep in mind when practicing E-stim.

E-stim involves placing adhesive electrodes on the skin, and hooking them up to a machine, usually called a TENS unit, or EMS unit. The electrodes deliver mild electrical impulses through the skin to target either muscles or nerves. When the muscle is stimulated, it causes a contraction. With repeated contractions, blood flow increases and the muscle can repair itself. The primary goal is to decrease pain, but improving strength, and healing wounds are also secondary effects of E-stim. The specific type of E-stim being used will determine what the overall goal of treatment will be. The different types are discussed below.

IFC: interferential current

IFC is the most common E-stim method. It involves placing the electrodes on the skin, “bracketing” the area of pain. Typically, 2 channels (4 total electrodes) are used in this method. The reason for using multiple channels is to create less skin resistance, allowing for the E-stim to reach deeper muscles, and to create the current necessary to stimulate the nerves. IFC is used primarily to treat pain and swelling in an affected area. Some different problems IFC is used to treat are arthritis, low back pain, fibromyalgia, and post-surgical pain.

NMES: Neuromuscular Electrical Stimulation

In NMES, stronger impulses are sent into the muscles, causing them to contract. In this way, the muscles are reeducated to facilitate muscle activation, and reduce atrophy. The electrical impulses can last for several seconds, and can be tailored to create a more forceful contraction. The goal with NMES is to improve strength. It is typically used in the post-surgical population, and with individuals who have suffered strokes.

High-Volt: High Voltage Pulsed Galvanic Current

High volt uses a high voltage applied with low frequency and low pulse duration. It is commonly used to speed up wound healing, such as dermal ulcers, though has application in treating multiple sclerosis, Myofascial pain syndrome, and patellofemoral syndrome.

Why Use E-Stim?

E-stim can be used to treat a variety of ailments. However, it is important to minimize risk by avoiding certain practices with E-stim. E-stim should not be used for the following conditions:

Malignant areas or where cell proliferation is contraindicated
Areas where the current might affect a reflex center such as carotid sinus, heart, or parasympathetic nerves, or might affect function of implanted device like a pacemaker

Untreated osteomyelitis or immature bone
Over an active DVT site
Heat-sensitive people
Over a pregnant uterus

Fun Fact!

E-stim can actually be traced back to ancient Egypt, when electric fish were used for electrotherapy.

Thanks for reading!

This article was written by Colin Fulton, PT, DPT. If you’re interested in learning more about E-stim or exploring personalized physical therapy options, the team at Rehab Solutions in Gillette, Wyoming is here to help.