INDICATIONS FOR ELECTROTHERAPY CURRENT
APPLICATION
1. Pain Relief (Analgesia)
Mechanisms:
Gate Control Theory:
Electrical stimulation activates large-diameter A-beta sensory fibers,
which inhibit the transmission of pain signals carried by smaller A-
delta and C fibers at the spinal cord level (dorsal horn), effectively
"closing the gate" to pain perception.
Endogenous Opiate Release:
Some currents stimulate the release of endorphins and enkephalins,
which are natural pain-relieving chemicals in the body, providing
Common Currents Used:
Transcutaneous Electrical Nerve Stimulation (TENS)
Interferential Current (IFC)
High-Voltage Pulsed Current (HVPC)
Examples of Conditions:
Chronic musculoskeletal pain (e.g., arthritis, back pain)
Postoperative pain
Neuropathic pain (e.g., diabetic neuropathy)
Sports injuries
2. Muscle Stimulation (NMES - Neuromuscular
Electrical Stimulation)
Mechanisms:
Electrical impulses depolarize motor nerves, causing
muscle fibers to contract similarly to voluntary
contraction.
Enhances recruitment of muscle fibers, especially in weak
or inactive muscles.
Improves muscle strength, endurance, and coordination.
Prevents muscle atrophy during immobilization
Common Currents Used:
Russian Current (Medium frequency, bursts)
Faradic Current (Short pulse, asymmetric biphasic)
Symmetrical or Asymmetrical Biphasic Pulsed Current
Examples of Conditions:
Post-fracture or post-surgical muscle weakness
Muscle re-education after stroke or spinal cord injury
Prevention of muscle atrophy in immobilized patients
Enhancing voluntary motor control in neurological patients
3. Promotion of Tissue Healing (Wound Healing)
Mechanisms:
Electrical currents promote increased cellular activity
(fibroblasts, keratinocytes) for tissue repair.
Enhances protein synthesis and collagen production,
improving wound healing rates.
Creates an electrical field that attracts cells (galvanotaxis)
necessary for tissue repair to the injury site.
Increases local blood flow, delivering nutrients and oxygen.
Common Currents Used:
Microcurrent Electrical Neuromuscular Stimulation
(MENS)
High-Voltage Pulsed Current (HVPC)
Examples of Conditions:
Pressure ulcers (bed sores)
Diabetic foot ulcers
Venous ulcers
Post-surgical wound healing
Soft tissue injuries (e.g., ligament sprains, tendon injuries )
4. Edema Reduction
Mechanisms:
Muscle Pump Effect: Rhythmic muscle contractions
promote venous and lymphatic return, reducing fluid
accumulation.
Polarity Effect: Certain currents (e.g., HVPC with
negative polarity) repel negatively charged proteins,
reducing capillary permeability and fluid leakage.
Enhances absorption of accumulated interstitial fluid.
Common Currents Used:
NMES for muscle pumping
HVPC for acute edema
Examples of Conditions:
Acute or chronic limb swelling
Post-traumatic or post-operative edema
Lymphedema management (with caution)
5. Improvement of Local Blood Circulation
Mechanisms:
Muscle contractions increase metabolic demand, causing
vasodilation and improved blood flow.
Enhanced circulation delivers oxygen and nutrients,
promoting tissue repair and removing waste products.
Reduces ischemic pain and muscle fatigue
Common Currents Used:
NMES
Interferential Current (IFC)
Microcurrent therapy
Examples of Conditions:
Peripheral arterial disease (with caution)
Muscle spasm relief
Chronic ischemic conditions
6. Functional Electrical Stimulation (FES)
Mechanisms:
Stimulates motor nerves to assist functional, purposeful
movements (e.g., walking, grasping).
Encourages neuroplasticity by pairing electrical
stimulation with voluntary movement attempts.
Assists weakened muscles during specific activities,
reducing disability.
Common Currents Used:
Modified NMES protocols
Examples of Conditions:
Foot drop correction post-stroke or nerve injury
Shoulder subluxation management in hemiplegia
Improving gait patterns in neurological disorders
Assisting hand function in spinal cord injury
7. Denervated Muscle Stimulation
Mechanisms:
Uses long-duration pulses or interrupted direct current (IDC) to
directly depolarize muscle fibers in absence of intact motor nerve
supply.
Prevents or delays fibrosis and atrophy of denervated muscles.
Maintains muscle mass until nerve regeneration occurs.
Common Currents Used:
Interrupted Direct Current (IDC)
Examples of Conditions:
Peripheral nerve injuries with muscle denervation
Facial nerve palsy (e.g., Bell’s palsy)
Post-surgical nerve repair rehabilitation
CONTRAINDICATIONS OF ELECTROTHERAPY
• It should not be used to treat symptomatic
local pain unless the cause of the pain has
been clearly diagnosed.
• Electrotherapy should not be used in areas
of the body where cancerous lesions exist.
• The treatment should not be applied in areas
of the skin that are swollen, infected, or
inflamed (e.g. varicose veins)
• Patients suspected of having serious
infectious diseases or diseases that require
heat or fevers to be suppressed should not
• Electrotherapy current should not be applied to the
anterior neck (carotid sinus) or through the head.
• Women who are pregnant should avoid
electrotherapy treatment, as safe use has not been
established for pregnancy.
• Patients with cardiac demand pacemakers should not
be treated using powered muscle stimulators.
• TENS waveforms should not be used on patients who
have cardiac demand pacemakers.
