Electrotherapy: Types, Safety, and Uses

• Electrotherapy uses electrical stimulation to treat various conditions
• It can reduce pain, improve muscle strength, and facilitate tissue healing

Types of Electrotherapy

• Transcutaneous Electrical Nerve Stimulation (TENS) is used for pain relief by stimulating sensory nerves
• Neuromuscular Electrical Stimulation (NMES) strengthens muscles by causing them to contract
• Interferential Current Therapy (IFC) penetrates deeper tissues for pain relief and reducing inflammation
• Microcurrent Electrical Therapy (MET) uses very low-intensity currents to promote tissue healing
• High Voltage Pulsed Current (HVPC) is used for wound healing and edema reduction

Safety Considerations

• Regularly inspect devices for damage
• Place electrodes on clean, intact skin, avoiding bony prominences
• Adjust intensity and duration based on patient tolerance
• Continuously monitor patient response during treatment
• Maintain open communication with the patient

General Contraindications

• Avoid electrotherapy during pregnancy, especially over the abdomen or lower back
• Electrical currents can interfere with device function in patients with pacemakers or implanted defibrillators
• Increased risk of dislodging a blood clot in patients with thrombophlebitis or Deep Vein Thrombosis (DVT)
• Avoid applying over or near cancerous tissue without oncologist approval
• Avoid application over infected areas with active tuberculosis
• Use caution due to risk of burns if the patient cannot feel the stimulation properly because of impaired sensation
• Patient must be able to understand instructions, otherwise it is contraindicated
• Electrical stimulation may trigger seizures in patients with uncontrolled epilepsy

Specific Contraindications

• Do not use on patients with undiagnosed pain, as it may mask the underlying condition when using TENS
• Avoid in patients with muscle tears or acute fractures where muscle contraction is contraindicated with NMES
• Exercise caution in patients with cardiac arrhythmias when using IFC
• Not recommended for patients with metal implants in the treatment area due to potential corrosion with MET
• Avoid in patients with severe edema due to the risk of fluid overload with HVPC

Precautions

• Monitor for redness, rash, or burns and adjust electrode type or intensity if skin irritation arises
• Monitor for increased swelling, especially with HVPC and adjust parameters accordingly for edema
• Advise patients that mild soreness is normal after NMES and reduce intensity if excessive for muscle soreness

Adverse Effects

• Usually caused by improper electrode placement or excessive intensity which results in skin burns
• Allergic reaction to electrode gel or adhesive resulting in skin irritation
• Overstimulation of muscles, particularly with NMES can cause muscle soreness
• Increase in pain due to incorrect parameter selection or application
• Fainting can occur due to sudden drops in blood pressure, especially with high-intensity currents

Documentation

• Record patient's condition before, during, and after treatment
• Document parameters used (frequency, intensity, duration)
• Note electrode placement
• Document patient's response to treatment
• Record any adverse reactions and actions taken

Legal and Ethical Considerations

• Obtain informed consent before starting treatment, explaining risks and benefits
• Ensure electrotherapy is within your professional scope of practice
• Adhere to state and federal regulations regarding electrotherapy
• Maintain competence through continuing education and training
• Prioritize the patient's safety and well-being at all times