The 4 most common electro stimulation modalities used by physical therapists that afford maximum pain relief and healing are:
TENS:
TENS stands for Transcutaneous Electrical Nerve Stimulation.
It uses low-voltage electric current produced by the device to stimulate the nerves
for therapeutic purposes. It is a noninvasive therapeutic pain management modality.
TENS is used to treat both chronic and acute pain associated with lower and upper back pain and
sciatica. Many medical practitioners and physio therapists prescribe the use of Tens machines as a means of controlling back pain either without the use of drugs or by limiting their use.
A TENS machine works by transmitting electrical impulses via special electrode pads
through the skin to the underlying nerves at the area where pain occurs. The impulses work by modifying the pain signals transmitted to the brain via the nerves thus obtaining pain relief.
Today many people confuse TENS with Electro Muscle Stimulation (EMS). EMS and TENS devices look similar, with both using long electric lead wires and electrodes. TENS is for blocking pain, where EMS is for stimulating muscles.
EMS:
EMS stands for Electro Muscle Stimulation.
The American Physical Therapy Association acknowledges the use of EMS for the treatment of neuromuscular dysfunction as a means to improve strength and motor control, blood flow to aid
muscle repair and to retard muscle atrophy.
The EMS modality is also useful in helping to manage back pain. Very often people who suffer from chronic low back pain and sciatica experience lower back pain due to the muscles being in spasm. While the TENs modality helps block nerve pain and certain forms of muscular pain the EMS modality is particularly useful in relaxing the muscles. EMS modes such as warm up, active recovery mode, and muscle calming very often will help decrease the recovery time for back pain sufferers.
EMS improves range of joint mobility by inducing the frequent stretching of contracted,
shortened soft tissue and enhances microcirculation as well as protein synthesis helping to
heal wounds and repair tissue.
EMS works by transmitting unique electrical wavelengths (different than TENS)
via the same special electrode pads though the skin.
IFT:
IFT is Interferential Therapy.
It uses a mid-frequency electrical signal to treat muscular spasms and strains.
The current produces a massaging effect over the affected area at periodic intervals, and this stimulates the secretion of endorphins, the body’s natural pain relievers, thus relaxing strained muscles and promoting soft-tissue healing.
IFT is used for helping promote healing and for pain relief as follows:
Stimulate muscles
Increases local blood flow
Reduces edema
Relieves pain
This Interferential therapy modality is set up so that stimulation basically involves putting 4 electrodes on the outer edges of where pain is felt. The interferential current therapy consists of one “channel -2 electrodes” going off and on 4,000 times per second. The other channel goes off and on 4,001 to 4,150 PPS. The interferential therapy treatment stops pain, also providing carryover pain relief that can last varying periods.
Microcurrent Stimulation:
Microcurrent stimulation is an advanced modality used in the treatment of problems with muscles, joints, tendons, and bones.
Acute and chronic injuries of the joints, tendons or muscles bring about significant inflammation.
Pain is frequently a considerable problem.
Microcurrent stimulation treats these injuries by having an effect on damaged tissue on a cellular level. There is an impressive reduction in the amount of inflammation and pain following treatments, thus promoting healing.
The use of anti-inflammatory drugs and ice are often used with microcurrent stimulation to bring the greatest relief. Some practitioners do not recommend anti-inflammatory drugs in order to avoid some of the negative side effects these drugs can bring thus actually hindering the healing process.
Microcurrent Stimulation is used extensively by professional sports teams and Olympic athletes to treat acute sport injuries. It is also successful in the treatment of plantar fasciitis when used in conjunction with acupuncture.
HISTORY AND SCIENCE
Electrical stimulation for pain control was used in ancient Rome, 63 A.D. It was reported that pain was relieved by standing on an electrical fish at the seashore. In the 16th through the 18th century various electrostatic devices were used for headache and other pain relief. Benjamin Franklin was a proponent of this method for pain relief. Throughout the nineteenth century numerous devices were used for pain control and cancer cures.
In 1830, the Italian researcher, Carlo Matteucci was one of the first to measure electrical current in injured tissue. After a lull in research, a study published in 1969, led by L.E. Wolcott applied micro-current to a wide variety of wounds. The treated test group showed 200%-350% faster healing rates, with stronger tensile strength of scar tissue and antibacterial effects.[2] In 1991, 2 scientists, Dr. Erwin Neher and Dr. Bert Sakmann shared the Nobel Prize in Physiology and Medicine for their development of a technique that allows the detection of minute electrical currents in cell membranes. This method confirmed that electrical activity is not limited to nerve and muscle tissue, further enhancing the knowledge base for electro stimulation healing.
Scientific studies show that high and low frequency TENS produce their effects by activation of opioid receptors in the central nervous system. Specifically, high frequency TENS activates delta-opioid receptors both in the spinal cord and supraspinally (in the medulla) while low frequency TENS activates beta-opioid receptors both in the spinal cord and supraspinally. Further high frequency TENS reduces excitation of central neurons that transmit nociceptive information, reduces release of excitatory neurotransmitters (glutamate) and increases the release of inhibitory neurotransmitters (GABA) in the spinal cord, and activates muscarinic receptors centrally to produce analgesia (in effect, temporarily blocking the pain gate). Low frequency TENS also releases serotonin and activates serotonin receptors in the spinal cord, releases GABA, and activates muscarinic receptors to reduce excitability of nociceptive neurons in the spinal cord.