Electrical Stimulation

Electrical muscle stimulation, rebahilitation. Policlinica Gipuzkoa, San Sebastian, Donostia, Euskadi, Spain
Javier Larrea/Age Fotostock/Getty Images

So your doctor has ordered physical therapy for your injury, and he or she is recommending electrical stimulation. What is electrical stimulation, or e-stim, and how is it used in physical therapy?

Electrical stimulation is a type of physical therapy modality used to accomplish various tasks in physical therapy. If you have an injury or illness that causes pain or limited functional mobility, your PT may use electrical stimulation, or E-stim, as one part of your rehabilitation program.

Your physical therapist will use different types of electrical stimulation to accomplish different tasks. These may include:

  • TENS: Transcutaneous electrical neuromuscular stimulation (TENS) is a physical therapy modality used to manage acute and chronic pain in physical therapy. Your PT will use TENS to decrease your pain by applying electrodes to your body over painful areas. The intensity of the electricity will be adjusted to block the pain signals traveling from your body to your brain.
  • Iontophoresis: Iontophoresis is a type of electrical stimulation that is used to help administer medication to you in physical therapy. The electrical current pushes various medication in through your skin and into your body. Your PT will likely use medicine to decrease inflammation or muscle spasm, or iontophoresis drugs can be used to break up calcium deposits that may occur in conditions like shoulder calcific tendonitis. Different medicines are used to accomplish different goals using iontophoresis.
  • Neuromuscular electrical stimulation (NMES): NMES uses an electrical current to cause a single muscle or a group of muscles to contract. By placing electrodes on the skin in various locations the physical therapist can recruit the appropriate muscle fibersContracting the muscle via electrical stimulation helps improve the way your affected muscle contracts. The physical therapist can change the current setting to allow for a forceful or gentle muscle contraction. Along with increasing muscle function, the contraction of the muscle also promotes blood flow to the area that assists in healing. NMES can also be used to help decrease muscular spasm by artificially tiring your muscle in spasm, allowing it to relax.
  • Russian stimulation: Russian stimulation is a form of electrical stimulation that can accomplish a similar task as NMES: to improve the way your muscles contract. Russian stim simply uses a different waveform that may be a little more comfortable for you to tolerate.
  • Interferential current: Interferential current (IFC) is often used by physical therapists to decrease pain, decrease muscular spasm, or improve localized blood flow to various muscles or tissues. It is often used to decrease low back pain and muscular spasm. Interferential current typically uses 4 electrodes in a crisscross pattern. This causes the currents running between the electrodes to "interfere" with one another, and allows your PT to use a higher intensity current while still maintaining maximum comfort for you.
  • High voltage galvanic current (HVGC): High volt galvanic stimulation uses high voltage and low-frequency electricity to penetrate deep into tissues. It is used to relieve pain, improve blood flow, relieve muscle spasm, and improve joint mobility.

    Keep in mind that many forms of electrical stimulation are a passive treatment; you are doing nothing while receiving the stimulation. Some forms of estim, like NMES and Russian stim, require that you are active while the E-stim is in use.

    Electrical stimulation should never be the only treatment you receive during physical therapy. Research indicates that active engagement in your physical therapy program - with or without electrical stimulation - yields the best results. E-stim should only be used to augment your active physical therapy program that includes specific motions and exercises to treat your condition.

    Risks of Using Electrical Stimulation

    If your PT wants to use electrical stimulation during your rehab treatments, he or she should explain to you the various benefits and risks associated with the treatment. Risks to using estim include:

    • Muscle tearing
    • Skin irritation
    • Tissue burns

    Your PT can ensure that the electrical stimulation is used properly to minimize the risks associated with estim use. Understanding these risks can help you decide if you want to include it in your rehab.

    Contraindications to Estim Use

    There are some conditions where you should never use electrical stimulation. These contraindications to estim use should be heeded by your physical therapist. Contraindications to electrical stimulation include:

    • Altered tissue sensation
    • Impaired mental status
    • Presence of an implanted electrical device (The estim could interfere with pacemakers or implanted pain stimulators .)
    • Over malignant tissue
    • Over wounds that are overly moist
    • Near the eyes, carotid sinus, anterior neck, or over reproductive organs

    Your physical therapist should have identified these contraindications during your initial evaluation, but it is important to remind him of any condition that you may have that may have a negative interaction with estim.

    If you have pain or limited mobility, check in with your physical therapist and see if using electrical stimulation is the right treatment for you and your specific condition.

    A Word from Verywell

    If you have a condition that results in pain or limited functional mobility, you should check in with your doctor and see your physical therapist. He or she may use e-stim to help augment your rehab program. If so, knowing what electrical stim is and how it is used can help you fully understand your entire rehab program.

    View Article Sources
    • Carlo Ammendolia, D. C., Pierre Côté, D. C., Brian Budgell, D. C., Bombardier, C., & Hawker, G. (2016). Effect of TENS Versus Placebo on Walking Capacity in Patients With Lumbar Spinal Stenosis: A Protocol for a Randomized Controlled Trial.
    • Ward, Alex R. "E lectrical stimulation using kilohertz-frequency alternating current." Physical therapy 89.2 (2016): 181-190.