General Electrotherapy Information.doc 1

General Electrotherapy Information

This information is not to be taken as medical advice in any manner. It is presented as general information. We make no claims to the accuracy. All information is on a best efforts basis for accuracy. Consult your health care professional regarding any contraindications associated with electrical stimulation or any medical equipment before use.

General Pain Information:Pain is the body’s warning system used to prevent additional injury. It is important because without pain vital parts of our bodies might be permanently damaged or injured without our knowledge. However, long lasting persistent pain, often called chronic pain, once diagnosed, serves no apparent purpose. TENS and other electrical stimulation programs areused to stop some types of chronic and acute pain. TENS is developed to relieve some types of chronic and acute pain.

Electrotherapy (TENS) Theories:The Gate Control Theory (Localized Effect-High Frequency):The Gate Control Theory is the most commonly advanced explanation, suggesting that by electrically stimulating sensory nerve receptors (nerves that convey impulses to the brain and spinal cord), a gate mechanism is closed in a segment of the spinal cord, preventing pain carrying messages from reaching the brain and thus blocking the perception of pain. High frequency (pulses per second), continuous, mild, electrical activity is what is believed to block the pain signal traveling to the brain. Brain cells perceive pain. If the pain signal does not get through to the brain, the pain is not “felt”.

The Endorphin Release Theory (Low Frequency Endorphin Release Localized Effect):The Endorphin Release Theory suggests that electrical impulses stimulate the production of endorphins (neurotransmitters thatare released as a pain response or natural pain killers by the body) in the body. These natural, morphine like substances block pain messages from reaching the brain in a similar fashion to conventional drug therapy, but without the danger of dependence or other side effects. Low frequency or short bursts (Burst Mode) of mild electrical activity is believed to cause the body to release its own pain erasers called beta endorphins. It has been explained that this effect continues after treatment.

Neuromuscular Electrical Stimulation: Also known as NMES, NMS, EMS or Muscle StimulationMuscle stimulation is for the purpose of relieving muscle spasms, countering the effects of disuse atrophy, increasing range of motion, muscle re-education due to illness or injury, and treatment of scoliosis. The contraction of muscle fibers, as is known, is connected with the introduction of electrical nerve impulses, which in turn leads to the generation of another electrical signal, or potential of action of the muscle fibers, which allows the contracting process to take place. In sports medicine, neuromuscular electrical stimulation (NMES) has been used for muscle strengthening, maintenance of muscle mass and strength during prolonged periods of immobilization, selective muscle retraining, and the control of edema. A wide variety of stimulators, including the burst-modulated alternating current (‘Russian stimulator’), twin-spiked monophasic pulsed current and biphasic pulsed current stimulators, have been used to produce these effects.

Interferential Stimulation:The interferential stimulator minimizes impedance (skin, fat and bone that are poor conductors of current flow) levels of the body by delivering medium frequency current of 4000Hz - 4150Hz. This current has the force to pass through the peripheral (outer parts) layer with very little stimulation of the sensory or motor (initiates muscle contraction) nerves. This current can penetrate deep within the tissue creating physiological effects at the cellular level. The interferential unit operates on an ionization theory based on its capable of changing the permeability (permits passage of a substance) of the plasma (fluid fraction of blood) membrane (thin lining or covering substance) through graded potential/graded response (a response which varies in magnitude with the stimulus strength, at least over some ranges of stimulus strengths). These graded potentials change the electric potential difference of the intracellular (inside cells) fluid enough to allow sodium ions (Na+) to cross the plasma membrane and be actively transported by activating the Na/K+ pump. The pump will begin to control the concentration gradients of Sodium (Na+) and Potassium (K+) ions within the interstitial (fluid that surrounds cells) fluid. This activity will directly affect the cell content and force the displaced fluid to exit the swollen cell that will eliminate edema. Inflammation is also reduced as the Sodium ion activity increases. The blood proteins that were trapped in the extra-cellular fluid will be removed by eliminating the Sodium ion imbalance and increasing the oxygen to the area. The oxygen will remove bradykin (a substance that restricts blood flow) and histamines (a chemical substance involved in edema and inflammation) that cause instant inflammation. The oxygen also removes prostaglandin (a natural pain substance of the body). Many people are also amazed at it’s pain relieving effects.

General Electrotherapy Information.doc 2

What is TENS?TENS is an acronym for Transcutaneous (through the skin) Electrical (battery operated) Nerve (conveys impulse to the brain through the spinal cord) Stimulation. Developed in the late 1960’s, the TENS stimulator is a battery powered device which transmits an electrical impulse (a conducted wave of excitation moving over nerves or muscles) through lead wires and surface electrodes to underlying nerves. The stimulator converts the direct current (the flow of charged particles (electrons or ions) moving past a specific point in a specific direction. Current is produced by a difference in potential (V). In the therapeutic use of electricity, current flow in tissue is discussed as ion flow. Current is measured in amperes (A): 1A = 1 C/sec. ) of the battery into pulses (with reference to electric current, a signal of short duration describable in terms of rise time, decay, duration and amplitude) of stimulation. Most stimulators feature adjustable settings to control amplitude (intensity) of stimulation by controlling voltage, current, and pulse width (duration) of each pulse. Electrodes are placed at specific sites on the body for treatment of pain. The current travels through electrodes and into the skin stimulating specific nerve pathways to produce a tingling or massaging sensation that reduces the perception of pain. TENS is a safe, non-invasive (any procedure that does not penetrate the skin or body cavity), drug free method of pain management. It is used to offer a better quality of life for people with pain.

How Does A TENS Unit Work?TENS or Transcutaneous Electrical Nerve Stimulation, means the transmission of small electrical pulses through the skin to the underlying peripheral (the nerves which supply the musculoskeletal system and surrounding tissues) nerves. The neurophysiological (normal process of the body related to the nervous system) basis of the analgesic (pain reducing) action of TENS remains under investigation, yet there are two popular theories to explain how TENS successfully decreases or eliminates pain.See ‘Gate Control Theory’ and ‘Endorphin Release Theory’ above.

How does a TENS unit compare to other electrical stimulators in relation to pain reduction?TENS (Transcutaneous Electrical Nerve Stimulation) is strictly a non-invasive pain management tool. TENS stimulates peripheral nerves producing a tingling sensation that interferes with pain. TENS masks pain by blocking nerve impulses on the sensory nerve (Gate Control Theory). TENS, has no other physiological effect except to possibly stimulate blood flow in an area if the pulse rate creates a massaging action on the body part. The increased sensory activity activates cells in the dorsal horn (pertaining to the lower part of the spine) of the spinal cord, closing the gate to pain transmission along the nerve & muscle fibers that send pain response’s to the brain. Accommodation (dependency on a device) and habituation (becoming used to something) are concerns when TENS is used for an extended period of time. If the stimulation parameters are kept constant, the patient will adapt to unchanging stimulus. When this happens the TENS will no longer be as effective on the patient, and TENS has no curative value. A TENS unit should not be plugged into the wall per FDA/FDC regulations. If a TENS unit fails to help with pain, other electrical stimulation devices to consider are high volt pulsed galvanic stimulation, interferential current stimulation, micro-current stimulation or neuromuscular stimulation. TENS devices can be used for the management of chronic, acute, post surgical pain or almost all types of pain. TENS is a symptomatic treatment of pain and may suppress the sensation of pain that would otherwise serve as a protective mechanism. TENS devices have no curative value.

High Volt Pulsed Galvanic Current (HVPGC)High voltage galvanic stimulation (HVG) is recognized by many different names, including high volt pulsed galvanic (HVPG), high voltage stimulation (HVS) and direct current stimulation (DC). While used clinically over the last 45 years, this type of stimulation and its applications have received much more attention recently. Typical indications for use include a wide range of clinical problems where high voltage may be applied alone or in combination with other modalities. HVPGS is the use of a high driving voltage (up to 500V) to produce analgesia, muscle contractions, and to facilitate wound and soft tissue healing. Galvanic current can best be described as a direct, constant, bipolar, unidirectional current of high voltage and low amperage. It is the basic, and also the first known form of electric current flow. HVPGC is low (Micro) amperage. It allows for deeper penetration. It does not burn (low amps). It flows between each treatment electrode and dispersive electrode (usually placed on large muscle group). It can be used in water. It has the ability to move fluids. Is used for open wounds, burns and over scar tissue.

The human body may be considered, from the viewpoint of electrotherapy, as a bag of skin holding a solution of common salt (NaCl). When the molecules of NaCl dissolve in water, they dissociate into sodium ions bearing a positive charge and chlorine ions bearing a negative charge. The flow of direct current through the salt solution causes these ions to move in a definite direction with the sodium (Na+) ions migrating toward the negative pole (cathode) and the chlorine (Cl-) ions moving toward the positive pole (Anode).

This information is presented for informational purposes only. It is not meant to be taken in any way by anyone as medical advice, medical consultation or as a recommendation for treatment for any purposes. It is not to be taken as electrical advice. Please consult your physician for any and all medical treatment advice. Please review all warnings, contraindications and precautions listed in device manual before use.