Electrotherapy in Physiotherapy Treatments : TENS & Interferential Therapy
You might have heard of Electrotherapy before but perhaps you were not aware that it is one of the many methods by which we treat patients within our clinics. Veronica McCormack of our Clondalkin clinic has written this very informative and interesting post which tells us how Electrotherapy works and how we can use it to help in your treatment. Don’t be scared of this treatment, keep reading to find out more!!
Background to Electrotherapy
Ever get caught out by the electric fence as a child? You may recall the sensation of that sudden shock or maybe the feeling after of pins and needles?….well scale it down somewhat and it’s not completely dissimilar to a type of treatment available at The Physio Company in managing pain and promoting tissue healing, and believe it or not, it has been around quite some time…
Electrical stimulation for pain control was used in ancient Rome, 63 A.D. It was reported by Scribonius Largus that pain was relieved by standing on an electrical fish at the seashore. From the 16th to 18th centuries various electrostatic devices were used for headaches and other pains, even Benjamin Franklin was a supporter of this method for pain relief.
Electrotherapy uses electrical signals to interfere with the transmission of neural pain signals into the brain. It effectively slows down or distracts the message from the nerve to the brain. From a physiotherapy point of view, affecting one’s ‘Pain Gate’, whether in an acute or chronic pain episode, is crucial area of treatment and electrotherapy is a very useful resource where conventional medicines are not as affective. Electrotherapy can also involve the use of this electric current to speed tissue healing where tissue damage has also occurred. I’m going to discuss two different forms of it today, TENS (transcutaneous electrical nerve stimulation) and Interferential therapy.
Transcutaneous Electrical Nerve Stimulation (TENS)
TENS is widely used around the world for a variety of painful conditions such as;
-Low back pain
-Nerve related pain such as phantom pain.
How does it work?
A small electrical device (think back to the days of the Walkman!) delivers electrical impulses across the skin. Lightweight versions not much bigger than a credit card are available these days. This can be clipped to your jeans or placed in your pocket.
The device is connected by wires to sticky pad electrodes, which are placed on the skin in the area of the pain. This allows a small, low-intensity electric charge to be passed across the area.
TENS can work in two ways:
1/ On a high frequency, by selectively stimulating certain ‘non-pain’ nerve fibres to send signals to the brain that block other nerve signals carrying pain messages. High frequency stimulation, sometimes called “conventional”, is tolerable for hours, but the resultant pain relief lasts for a shorter period of time.
2/ Lower frequencies stimulate the production of endorphins, natural pain-relieving hormones – your own built-in pain management system. Low-frequency stimulation, sometimes called “acupuncture-like”, is more uncomfortable and tolerable for around 20-30 minutes, but the resultant pain relief lasts longer.
Unlike many pain-relieving drugs, TENS isn’t addictive and has few side-effects. Most people can use a TENS machine but it is unsuitable for:
-Patients with pacemakers and certain other types of heart disease.
-Unknown causes of pain.
-Certain body sites in pregnancy (other than in labour)
-Certain skin conditions
TENS users should experiment with various electrode placements. Electrodes can be placed over the painful area, surrounding the painful area, over the nerve supplying the painful area, or even on the opposite side of the body. TENS users need to try the unit for several days with several electrode placements prior to deciding if it will be useful. A home trial for several days to weeks is preferable.
Here at The Physio Company we also use an electrotherapy modality called interferential therapy (IFT). It is essentially a deeper form of TENS. It utilises two high frequency currents which are slightly out of phase, and are passed through the skin at the same time where they are set up so that their paths cross and simply interfere with each other. This interference gives way to a beat frequency which has the characteristics of low frequency stimulation deep under the skin.
It is administered by a physiotherapist and involves the placement of damp sponges on the body which deliver a mild current similar to the sensation of pins and needles. Manipulation of the current allows the physiotherapist to target the correct structure and to treat.
There are 4 main clinical applications for which IFT has been found to be effective:
-Pain relief (in a similar fashion to TENS)
-Muscle stimulation – prevent muscle wastage, re-education, maintain range of motion
-Increased local blood flow
-Reduction of oedema
Stimulating Soft Tissue Healing & Repair
In acute conditions, shorter treatment times of 5-10 minutes may be sufficient to achieve the effect. In other circumstances, it may be necessary to stimulate the tissues for 20-30 minutes. It is suggested that short treatment times are initially adopted especially with the acute case.
Electrotherapy is used as an adjunct to traditional physiotherapy treatments. TENS units are available for sale or hire from The Physio Company and our physiotherapists can give guidance on the correct programmes for use dependent on your condition. Many of our physiotherapists will recommend the use of Electrotherapy in the provision of their treatments.
If you would like to book an appointment with today’s author, Veronica (of our Clondalkin clinic) or indeed any of our other physiotherapist please contact us today! Not all patients will need to get Electrotherapy and this will be advised by the physiotherapist during the initial consultation.