Electrical Stimulation Therapy

Electrical stimulation therapy is a standard treatment used in physical therapy to deliver electrical current into your body for therapeutic effects. Also known as e-stim therapy, it is often combined with therapeutic exercise or manual therapy to enhance your results.

During electrical stimulation therapy, electricity is directed to a specific body part by electrodes that are attached or adhered to your skin. The electrodes connect to an electrical stimulation device, where the settings can be controlled and modified for a specific purpose. 

Electrical stimulation has many uses, but is often used to aid in pain relief or to teach muscles how to move. Electrical stimulation therapy can:

• Build muscle strength
• Prevent muscle atrophy
• Muscle re-education
• Increase range of motion
• Improve muscle tone
• Pain control
• Wound healing
• Increase blood circulation
• Reduce edema
• Relieve muscle spasms
• Provide biofeedback
• Boost body awareness
• Administer medications

Our physical therapists use electrical stimulation for:

• Neck pain
• Shoulder pain
• Arm pain
• Hip pain
• Pelvic pain
• Low back pain
• Knee pain
• Ankle pain
• Tendonitis
• Bursitis
• Ligament sprains
• Muscle strains
• Muscle weakness
• Wound care
• Post-surgical pain 

There are several reasons you should not use electrical stimulation therapy. One of our physical therapists will review your medical history before starting any treatment to ensure it is appropriate for you. 

If you have the following conditions, you may not be a candidate for electrical stimulation therapy:

• Pacemakers
• Seizure disorders
• Thrombosis
• Thrombophlebitis
• Infection
• Neoplasms/cancer
• Over your carotid artery
• Pregnancy
• Impaired mental status

Electrodes will be placed on the area to be treated. If you need to treat an area underneath your clothing, you will be asked to expose your skin to allow for the placement of electrode pads. You will be in a private room and draped for modesty.

Electrode pads are placed over clean, dry skin and away from excessive hair. Hair may need to be removed or shaved to allow direct pad placement on the skin.

Electrodes are adhered to your skin using adhesive backing or electrode gel. Depending on the size of the treatment area, two or four pads are placed around or along the line of treatment.

Lead wires connect electrodes to an e-stim machine where one of our physical therapists will have control of the type and intensity of electrical current you will receive. As the device is turned on and the intensity turned up, you will feel a slight tingling sensation through the pads. Report how much intensity you can tolerate to your physical therapist.

It is best to stay relaxed throughout the whole treatment session. Sometimes, your PT will ask you to actively contract your muscles while the machine is on. If you feel uncomfortable during the session, immediately inform your therapist so the intensity can be adjusted or turned off.

Application of electrical stimulation to your pelvic floor muscles can improve your ability to control urinary incontinence, improve collagen production, reduce pelvic pain, and assist in muscle contraction to build pelvic floor muscle strength to improve conditions such as:

• Pelvic organ prolapse
• Perineal lesion
• Urinary incontinence
• Fecal incontinence
• Erectile dysfunction
• Chronic prostatitis
• Chronic pelvic pain syndrome
• Vulvodynia

External electrodes are placed along your perineum, abdomen, or your lower back and tailbone area. You can also use internal probes to be inserted into your vagina or rectum to directly reach your pelvic floor muscles.

Contracting pelvic floor muscles alone can be difficult if you cannot feel or see the muscle contractions. As many as 30% or more of women with pelvic floor dysfunctions cannot tell if they are contracting their pelvic floor apart from their abdominal, hips, or gluteal muscles. And if women could actively contract their pelvic floor muscles, many demonstrated very weak contractions. 

Transcutaneous Electrical Stimulation (TENS) is used to help reduce pain. Electrical currents modulate pain signals that travel to your brain. A therapeutic effect is achieved when pain signals are interrupted and never reach your brain. Researchers use the term Gate Theory of Pain to describe this phenomenon.

Electrical stimulation causes a tingling sensation that stimulates the nerves in your skin, reaching your brain before the pain signals do and blocking or shutting “the gate” to pain. Motor nerves, or those nerves responsible for moving your body, become stimulated. A chemical release of endogenous opioids is released into your body, creating an analgesic effect to reduce your pain.

Neuromuscular Electrical Stimulation (NMES) or Electrical Muscle Stimulation (EMS) uses electricity to contract your muscles. Depending on the placement of electrodes on your body, you can stimulate a single muscle or a group of muscles to contract. This is useful to help with muscle re-education, prevent atrophy, and help you identify and improve the control of your body by producing strong muscular contractions.