How Physical Therapists Use Electrical Stimulation

Control Chronic and Acute Pain

Transcutaneous electrical neuromuscular stimulation (TENS) is a form of 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.

Improve Muscular Function

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.

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 may 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.

Control Incontinence

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 by touch because of the location of muscles that control urination and bowel movements.)

Reduce Trigger Point Symptoms

If you are feeling muscle spasms and have trigger points, your PT may use electrical stimulation such as interferential current to help reduce 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 calm. Most research indicates that the electricity may reduce your symptoms, although the trigger point in your muscle may still remain.

Administer Medication

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 such as dexamethasone. It may also be used to help reduce muscle spasm or break up calcific deposits that may form in muscle tissue or tendons.

Heal Wounds

Some physical therapists are wound care specialists, and they may use electrical stimulation to accelerate wound healing. High voltage electrical stimulation has been shown to be of some use with wounds that are difficult to manage and to heal properly. The electricity improves 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. Once you're aware of the options for using electrical stimulation, you'll have no surprises when your therapist introduces electricity into your rehab program.