While it may sound a bit intimidating, electrical stimulation really isn’t at all! When used correctly and provided under the guidance of a licensed and skilled physical therapists, electrical stimulation is a safe and effective modality that can be used to treat a variety of conditions.

While individual units and modes of delivery can vary, the standard electrical stimulation device utilizes self-adhesive electrodes placed around the target treatment area on the body. These electrodes are connected via wire leads to the unit, through which electricity can pass and ultimately interact with sensory and/or motor nerves (depending on the type of current utilized).

Knee Physical Therapy with TENS Electrode Pads, Transcutaneous Electrical Nerve Stimulation

What is electrical stimulation used for in physical therapy?

There are several electrical stimulation modes that use different types of currents intended to stimulate different nerves in a variety of specific ways. These include modes such as transcutaneous electrical nerve stimulation (TENS), interferential, pre-modulated, Russian, and symmetrical or asymmetrical bi-phasic. Don’t let the words confuse you, though. Your physical therapist will decide the right one to meet your unique needs.

Our clinic frequently utilizes electrical stimulation in order to provide a variety of beneficial healing effects, including:

  • Reduce, eliminate, and/or control pain (both acute and chronic)
  • Increase local circulation
  • Decrease swelling
  • Improve range of motion
  • Reduce muscle spasm
  • Provide biofeedback (aka improve body awareness)
  • Improve motor coordination
  • Provide neuromuscular re-education
  • Prevent or reverse muscle atrophy (especially after prolonged immobilization, such as a limb being casted as a fracture heals)

The intensity of the electrical muscle stimulation, or sensory nerve stimulation, is easily modifiable and ultimately will only be as much as you, the patient, can tolerate.

Typically, electrical stimulation will feel tingly or prickly (some patients describe it as a comforting “pins and needles” sensation).

Sometimes, as in the case when used for muscle strengthening, the intensity level can be high and somewhat uncomfortable, but it should never cause pain.

Pain control and reduction is probably the most frequent indication of electrical stimulation usage. Specifically, this modality can trigger an innate and completely natural analgesic effect by stimulating specific sensory nerve fibers (including A-beta, A-delta, and C fibers) which both disrupt or decrease the sensation of pain and elicit the release of certain neurotransmitters which can prolong the pain-relieving effects.

Electrical stimulation can be used for a wide variety of conditions as indicated, including acute sports-related or auto accident-related injuries, repetitive stress injuries, muscle strains, ligament sprains, and even neurological conditions including stroke.  

Electrical stimulation should not be performed on people with: deep vein thrombosis, pacemakers, impaired cognition, or who are pregnant. E-Stim is not safe to use on every region of the body including, the front of the neck, eyes, or areas with damaged skin or decreased sensation.   

What should I expect during an electrical stimulation session?

Our patients’ comfort and safety, and dignity are the number one priority. For this reason, we will ask you to come in comfortable loose-fitting clothes and sturdy shoes when you come to see us for an appointment.

At your initial evaluation, expect to be taken through a thorough patient history and physical examination. Your physical therapist will be able to diagnose your condition and then devise an appropriate treatment plan to meet your unique needs.

If your physical therapist decides that electrical stimulation is an appropriate part of your plan of care, he or she will first educate you about the specific modality. You will be asked to sit or lie in a comfortable position, your skin in the target treatment area will be cleaned and prepped, and your physical therapist will guide you step-by-step through the entire treatment.

Frequently Asked Questions About Electrical Stimulation

Physical therapists use electrical stimulation, or e-stim, for different reasons. Some forms may help manage pain. Others can help activate a muscle when an injury, surgery, or another condition makes normal muscle activation difficult.

Your expert physical therapist at MVPT will use electrical stimulation only when it serves a specific purpose within your individualized plan of care. For example, e-stim may help activate weakened thigh muscle during early knee rehabilitation. Your expert provider at MVPT Physical Therapy can pair stimulation with exercise and gradually increase active strengthening as your muscle control improves.

Electrical stimulation commonly feels like tingling, buzzing, or pulsing beneath the electrodes. If your MVPT physical therapist uses it for muscle activation, you may also feel and see the targeted muscle tighten and relax.

Your MVPT Physical Therapy provider controls the settings and can adjust the intensity according to your response and treatment goals. Electrical stimulation should not cause burning or unexpected discomfort. Tell your expert physical therapist at MVPT Physical Therapy what you feel so adjustments can be made when necessary. Your feedback helps keep your care collaborative and appropriate for your needs.

Certain forms of electrical stimulation can help activate muscles that are difficult to contract after an injury or surgery. Neuromuscular electrical stimulation, or NMES, sends electrical impulses that produce a muscle contraction and may be combined with active exercise.

Your physical therapist at MVPT Physical Therapy may use NMES as part of your care plan when muscle activation limits your progress. As you regain control, your MVPT Physical Therapy expert can advance your strengthening and functional exercises so your muscles increasingly perform the work independently. The goal is to build the strength you need for activities such as walking, climbing stairs, lifting, working, or returning to sports.

Some forms of electrical stimulation may provide temporary pain relief for certain patients. TENS, or transcutaneous electrical nerve stimulation, uses electrical impulses delivered through your skin to influence how your nervous system processes pain signals.

Symptom relief may make movement easier, but your MVPT physical therapy expert will also identify the strength, mobility, endurance, or movement limitations affecting what you want to do. Your individualized plan of care addresses those factors while symptom-management treatments provide support when appropriate. This keeps your care focused on meaningful functional progress.

Electrical stimulation is not appropriate for everyone. Implanted electrical devices, certain medical conditions, skin problems, pregnancy, and changes in sensation may affect whether or where the treatment can be used.

Tell your MVPT physical therapist about your medical history, implanted devices, pregnancy, changes in sensation, and other health concerns before treatment. Your provider at MVPT Physical Therapy can determine whether electrical stimulation belongs in your care plan. If it does not, your physical therapy partner at MVPT Physical Therapy can choose another treatment that supports the same functional goals.

No. Electrical stimulation may help muscle activation, but meaningful strength gains require muscles to progressively tolerate greater resistance and physical demands.

Your MVPT physical therapist may initially combine stimulation with exercise when muscle activation is limited. Your care plan can then progress toward increasingly challenging strengthening and functional tasks. If you want to return to stairs, lifting, running, or sports, later rehabilitation can prepare you for those specific demands as you work toward your potential.

Expect great results!

Are you interested in trying electrical stimulation? Wondering if it can help your pain or dysfunction? Our physical therapy services, including electrical stimulation and other modalities, are evidence-based, state-of-the-art, effective, and have minimal to no risk of side effects. Come experience the difference and call your closest MVPT location today at Bedford, Manchester, Londonderry, & Nashua, NH to schedule an initial appointment.