Electrotherapy

Electrotherapy is a technique that has been successfully used in physiotherapy for several decades. There are 2 main types of electrotherapy treatment:

  • Analgesic electrotherapy to reduce joint and muscle pain (TENS)
  • Muscle electrostimulation for muscle building and toning (EMS)

Your physiotherapist will use electrotherapy with you, depending on your pathology, your stage of development and the indications of the technique.

History of Electrotherapy

Contrary to what you might think, an electric current can help manage pain and promote tissue healing. Electrical stimulation for pain management was used in ancient Rome. It was reported by Scribonius Largus that pain was relieved using electric eels. From the 16th to the 18th century, various electrostatic devices were used to treat headaches and other pains. Benjamin Franklin was a proponent of this method for relieving his own pain.

Definition and operating principles

Electrotherapy is the contraction of “electro” for electricity, and “therapy”, so it’s a therapy using electricity. Electrotherapy is a medical treatment based on the use of electrical energy. Electrotherapy also refers to therecording of a muscle’s electrical activity.

For its proper functioning, the body naturally produces electricity which is transmitted via the nerves to the muscles. In this closed circuit, the generator is the brain, the wires are the nerves and the motor is the muscle. In this way, everyone has a role to play: the generator provides the information, the wires or cables transmit it, and the motor reacts to this information. Electrotherapy works in the same way. The only difference is that an external generator bypasses the brain’s voluntary control. For example, in the event of pain, the nerves are responsible for sending an alarm signal to the brain. Thanks to electrotherapy, this alarm signal does not reach the brain, as the external generator short-circuits the transmission of painful information. The patient will then feel less pain.

Electrotherapy uses electrical currents of different frequencies. For example, low-frequency processing takes place between 0 and 1,000 Hz, medium-frequency processing between 1,000 and 100,000 Hz, and high-frequency processing uses a current greater than 100,000 Hz. This current, applied to the body via electrodes, has the effect of relieving pain and promoting blood circulation. Depending on the electrotherapy method used, electricity can either relax or, on the contrary, contract the muscle(s) targeted by the treatment.

TENS or transcutaneous electrical neurostimulation for pain relief

Transcutaneous Electrical Nerve Stimulation (TENS) is a form of neurostimulation that is used to stimulate the nervous system.
Transcutaneous Electrical Nerve Stimulation
) involves electrically stimulating the nerves using electrodes placed on the surface of the skin. The main indication for TENS is pain management. Its analgesic action is thought to be due to the fact that transcutaneous currents interfere with nerve conduction. The currents used are generally low (60 – 200 Hz) or very low frequency (<10 Hz).

So-called “conventional” stimulation (or Gate Control) can be used for a short period, but the pain relief also lasts less time. Very low-frequency stimulation, sometimes similar to electropuncture, is more uncomfortable and tolerable for only 20-30 minutes, but the relief lasts longer. TENS users can experiment with different electrode placements. Electrodes can be placed on the pain territory, around the pain territory or on the nerve pathway afferent to the pain territory. Several trials are sometimes necessary to find the right combination of electrode positioning and program type for maximum effectiveness, and to determine whether or not the TENS device has a beneficial effect on pain.

EMS or excito-motor stimulation

Electrical muscle stimulation (EMS), or electro-myostimulation, is the triggering of muscle contraction using electrical impulses. Impulses are generated by a device and delivered via electrodes on the skin in the immediate vicinity of the muscles to be stimulated. Impulses mimic nerve impulses from the central nervous system, causing muscles to contract. Electrodes are usually plates that adhere to the skin. EMS is both a form of electrotherapy and muscle training.

This technique is mainly used by physiotherapists for muscle re-education, as a complementary technique for sports training, and also by individuals for amateur sports or aesthetic bodybuilding. Electrostimulation for excito-motor purposes can have several objectives: modification of muscle volume, modification of functional activity or metabolic modification. The neuromuscular response will depend on the characteristics of the current used. The currents used can be low-frequency (currently the most common) or medium-frequency.

It is possible to excite an innervated (healthy) muscle, but also a denervated (totally or partially injured) muscle, to stimulate it and maintain it during the re-innervation phase (nerve regrowth).

Indications for electrotherapy

  • Muscle pain
  • Joint pain
  • Neck pain
  • Back pain
  • Sciatica
  • Lumbosciatica
  • Cruralgia
  • Cervicobrachial neuralgia
  • Muscle damage
  • Shingles pain
  • Strengthening muscles