Electrical stimulation is administered via a machine that sends electrical impulses through the skin on the back to the sensory and motor nerves in the skin, fascia and muscles. Electrical stimulation devices range from small hand-held devices for a single person to larger devices that can supply electrical stimulation to more than one person. Stimulation is delivered through electrodes placed on the skin over the area to be treated or sometimes through needles inserted through the skin into the fascia or muscles below as part of a technique called dry needling.

There are several types of electrical stimulation. Each is defined by the quality of the stimulation and how the device is used. Variations in waveform, amplitude and intensity lead to different effects from the electrical stimulation. Your therapist will decide which type of electrical stimulation to use based on what they have available in the clinic and also on the goal of the treatment. Often electrical stimulation is used in the acute phase of healing though sometimes it may be used to manage chronic and ongoing conditions.

ELECTRICAL STIMULATION FOR BACK PAIN

As mentioned above, electrical stimulation is usually prescribed early in your treatment and tapered off later in favor of other techniques and exercises that you can utilize on your own after discharge from therapy. Sometimes in the case of chronic back pain, patients will purchase an electrical stimulation unit for home use and use it as part of an ongoing pain-management strategy.

Electrical stimulation is contraindicated in the presence of certain medical conditions like infection or tumor or the presence of certain medical devices like a pacemaker or deep brain stimulator. Be sure to tell your physical therapist your entire medical history so that they can decide if electrical stimulation is a safe option for you.

Here are some of the proposed benefits of electrical stimulation for back pain:

• Decrease pain
• Promote healing
• Re-educate and strengthen muscles
• Increase range of motion and reduce stiffness in the spine
• Increase circulation to promote healing
• Reduce edema
• Decrease inflammation
• Decrease spasticity
• Improve overall function

If you decide to work with a physical therapist to help correct your lower back issues, your entire treatment plan could consist of around 8-20+ different physical therapy sessions that will each last 60-90 minutes. Once you complete your customized physical therapy treatment plan, you will be able to continue to do the prescribed stretches and exercises utilized during your PT sessions yet in the comfort of your own home.

WHAT ARE THE DIFFERENT TYPES OF ELECTRICAL STIMULATION USED BY PHYSICAL THERAPISTS?

There are several different types of electrical stimulation. Each one is designed for a specific purpose. If your PT decides electrical stimulation is indicated in your care, they will select the type of stimulation based on their goals. Here is a list of some of the most common types of electrical stimulation used to manage back pain:

TENS (Transcutaneous Electrical Nerve Stimulation): Stimulates sensory nerves to decrease pain. It may be used to manage soreness or aching muscles and is commonly used in the management of chronic pain.

IFC (Interferential current): This type of electrical stimulation is also indicated for the management of acute, chronic, post-surgical or post-traumatic back pain.

NMES (Neuromuscular Electrical Stimulation) and FES (functional electrical stimulation): Primarily used for muscle re-education, NMES/FES is typically used to stimulate a muscle to contract–though sometimes just targets the sensory nerves in the area–to help re-educate a weakened muscle. These types of electrical stimulation are not used to treat pain.

Iontophoresis: This is a more specialized type of electrical current that helps transport medications through the skin. These medications are prescribed by your doctor and applied to specialized electrodes and placed over the affected area. The type of drug utilized will determine the effect of the treatment but iontophoresis may be used to decrease inflammation, decrease pain, manage scar tissue or reduce calcium deposits.

Electrical Stimulation + Dry Needling: Dry needling involves the insertion of thin, solid needles into the skin, fascia, muscles and periosteum of bone. Dry needling is used to address trigger points in a muscle, modulate fascial tension and increase blood flow. The addition of electrical stimulation to dry needling is thought to help with pain reduction and enhance the effects of dry needling.

SHARE YOUR INTEREST IN ELECTRICAL STIMULATION WITH YOUR PT

If you are experiencing back pain and are curious if electrical stimulation can help, discuss it with your physical therapist. Whether your therapist elects to use electrical stimulation or not, my team of therapists and I have a large toolbox of interventions ready to address your back pain. Modalities like electrical stimulation may be beneficial in some cases but you can expect we will work to address the root of the problem. In this way, we hope to improve your symptoms through our care and empower you to manage them long-term on your own. Schedule your initial evaluation with Evolve Physical Therapy today.