Dr. Zatrok's blog
Dr. Zatrok's blog

Dr. Zatrok's blog

Electrotherapy – an overview of methods

by Dr. Zsolt Zatrok

It’s not easy to navigate the range of appliances that offer electric handling. Electrotherapy is not a single treatment, but different treatments. How can you decide what you need? This article will help you find out.

Electrotherapy is an umbrella term. It includes all treatments that use electric current. The best known are TENS, EMS, MENS or MCR, iontophoresis or interferential.

Most electrotherapy devices now provide not only one type of current but also multiple (i.e. multiple) functions. The more different treatments a device contains, the more expensive it is, but it also provides treatment for more different problems.

The more expensive device is not necessarily the better one for you, as they may have many treatments that you don’t need for your particular situation. There are treatment modalities in the expensive devices that a physical therapist treating multiple patients can take advantage of. If you just want to relieve pain or strengthen your muscles, it’s unnecessary to buy the best you can get, because that’s not what makes the difference!

Before you buy a device, check which types of treatments and functions you need and decide based on that!

In this article, I’ll take a look at what electrotherapy treatments you can have in a device and what you can use them for.

I will only mention the methods that are available in devices that you can buy for home use. In addition, there are electrotherapy methods, but they require a specialist and are therefore only available in machines designed for practice.

Types of electrotherapy

TENS (nerve stimulation)

A pain-relieving effect, the pulses of the treatment “suppress the pain stimulus”, thus eliminating the symptoms for a while. This type of treatment has no (or minimal) curative effect, it does not act on the muscles, it “only” reduces the pain for a while. The advantage over drugs is that you are not poisoned and there are no side effects.

The pain-relieving effect of TENS can be felt during the treatment and lasts for a few hours.

[message title=”Dolito – TENS” title_color=”#ffffff” title_bg=”#1e73be” title_icon=”” content_color=”#000000″ content_bg=”#ededed” id=””]

  • simple, dual-channel TENS unitDolito tens device
  • pain relief programmes, no other functions
  • modulated, conventional, endorphin and burst TENS programs
  • customized program enabled (requires expertise)
  • applicable to any area of the body (skull excluded)

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EMS (muscle stimulation)

A method of treating muscles (except for muscles affected by so-called peripheral paralysis, because it requires selective stimulation current treatment, see below).

EMS works depending on the settings of the treatment program. Other stimulation is needed to relax muscles, improve muscle strength, speed up post-operative recovery (muscle strength regain). It increases blood circulation by up to 300% by contracting muscles, so it improves circulation and also stimulates healing. Indirectly relieves musculoskeletal pain – even stronger than TENS for muscle pain.

It is excellent for all conditions where muscle strength, mass, support and function need to be restored. This includes but is not limited to, incontinence, muscular atrophy, spinal hernia, lumbago, sciatica, varicose veins, vascular stenosis, muscle pain, neck, back, waist, knee and other muscle pain. Helps relieve muscle stiffness in cases of central pain, Parkinson’s disease, ALS, multiple sclerosis, etc. It speeds up movement recovery after paralysis caused by a stroke.

Strengthening muscles takes time. If you could get stronger from a single stimulation, that’s all athletes would use: I’m stimulating one tonight because the Olympics are tomorrow…It’s not that simple. Muscles are strengthened by regular contractions. So muscle stimulation should be used 1x or 2x a day. Improvement is noticeable after 2-3 weeks and should be maintained for at least 2-3 months. There are conditions (paralysis) where you may need to use it for years.

Related Devices

[message title=”Rehalito – EMS” title_color=”#ffffff” title_bg=”#1e73be” title_icon=”” content_color=”#000000″ content_bg=”#ededed” id=””]

  • simple, dual-channel muscle stimulatorrehalito dual-channel muscle stimulator EMS device
  • muscle stimulation programmes only, no other functions
  • programs for muscle pain, muscle stiffness relief, prevention of muscle atrophy and muscle strength recovery
  • customized program enabled (requires expertise)
  • recommended for small area treatment such as unilateral shoulder, forearm, calf pain, neck, back and waist

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Lastly, there are devices that can deliver both TENS and EMS.

[message title=”Myolito – TENS & EMS in one ” title_color=”#ffffff” title_bg=”#1e73be” title_icon=”” content_color=”#000000″ content_bg=”#ededed” id=””]

  • simple, 2-channel electrotherapy devicemyolito multifunctional electrotherapy unit
  • multifunctional, i.e. provide TENS, EMS currents, versatile in use
  • modulated, conventional, endorphin and burst TENS programs for pain relief
  • muscle tension, stiffness release programme
  • muscle strengthening programmes
  • customized program allowed (expertise required)

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Denervated muscle therapy

A method of treating damaged motor nerve -called denervated, or nerve-losing, muscle. Such a condition is known as peripheral paralysis, which can result from accidental or surgical injury to the nerve fibre, but also from herniated discs, spinal fractures, spinal stenosis, etc. Facial nerve paralysis, although it usually occurs after a cold, can cause such a condition. The denervated muscle does not respond to normal EMS! Therefore, a specially adjusted pulse is needed. In addition, the recovery time for nerve injury is very slow, even in a lucky case it is definitely several months, but more likely several years! If the muscle is not treated with electrotherapy during this time, it will be destroyed. Even if the nerve regenerates, it will no longer find a functioning muscle. This is why you need to use the stimulator continuously (up to 2-3 times a day) in case of peripheral paralysis.

Strengthening denervated muscles takes a very long time. The first positive signs are usually only noticeable after a few months, and in most cases it may be necessary to use it for more than a year.

Related Devices

You only need a device which is able to treat denervated muscles, i.e. muscles that have lost their nerve and suffer from peripheral paralysis.

[message title=”PeroBravo peripheral paralysis therapy device” title_color=”#ffffff” title_bg=”#1e73be” title_icon=”” content_color=”#000000″ content_bg=”#ededed” id=””]

  • high-end electrotherapy devicePerobravo Electrotherapy Device for Peripheral Paralysis Treatment, Bell's palsy
  • specialised in the treatment of peripheral paralysis
  • triangle, trapezoidal, square wave in millisecond pulse length range
  • biphasic square wave for muscle with preserved innervation
  • ETS (EMG based) – biofeedback triggered stimulation
  • time/intensity (i/t) testing support
  • gait relearning function in peroneal palsy
  • own program creation capability (requires expertise)
  • also recommended for home use, physiotherapist, surgery

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[message title=”Genesy 600 Multifunctional Electrotherapy Device” title_color=”#ffffff” title_bg=”#1e73be” title_icon=”” content_color=”#000000″ content_bg=”#ededed” id=””]

  • Excellent level of knowledge, 4-channel electrotherapy deviceGenesy 600 electrotherapy device
  • multifunctional, i.e. in addition to muscle stimulation, it also provides other forms of current (TENS, MENS, FES, denervated), i.e. it is versatile
  • precise programs for muscle pain, muscle stiffness relief, prevention of muscle atrophy and muscle recovery
  • treatment of central (stoke) and peripheral (nerve injury) paralysis
  • treatment of arthritis and tendonitis
  • sports applications
  • possibility of creating your own program (expertise required)
  • can be used to treat 1 channel only (i.e. small muscles) or the largest muscles (thighs, back, abdomen) simultaneously
  • for home use, but also recommended for beginner physiotherapists, trainer

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Microcurrent (MENS or MCR)

Microcurrent has a more effective pain-relieving effect than TENS. On the other hand, it has healing and regeneration-stimulating effects. It can be used for all inflammations, and muscle and ligament injuries. Furthermore, it is excellent for arthritis, arthrosis, carpal tunnel syndrome, tennis elbow, golf elbow, frozen shoulder, rotator cuff inflammation, neck-back-waist pain, lumbago, sciatica, sciatica, sciatic nerve inflammation, piriformis syndrome, hip pain, knee pain, Achilles tendon and plantar fascia (fascia plantaris) inflammation, spur pain.

In addition, it stimulates the healing processes of inflammation, meaning that its effects develop slowly, over a period of weeks. However these conditions tend to cause complaints that last for years, so a few weeks of persistent microcurrent treatment is distinctly short-lived compared to the persistence of the disease.

Microcurrent stimulates the body’s self-healing processes, so minimal results can be expected from a single treatment. A minimum of 40-50 treatments is required. A minimum of 1 treatment per day is required, with the whole treatment having to be restarted if the treatment is missed for several days.

[message title=”Premium 400 Multifunction Electrotherapy Device” title_color=”#ffffff” title_bg=”#1e73be” title_icon=”” content_color=”#000000″ content_bg=”#ededed” id=””]

  • high-end 4-channel electrotherapy device
  • multifunctional, i.e. in addition to muscle stimulation, it also provides otherglobus premium 400 forms of current (TENS, MENS, FES), i.e. versatile
  • precise programs for muscle pain, muscle stiffness relief, prevention of muscle atrophy and muscle recovery
  • sport applications
  • joint and tendonitis treatment
  • possibility to create your own program (requires expertise)
  • can be used to treat 1 channel only (i.e. small muscles) or the largest muscles (thighs, back, abdomen) simultaneously
  • for home use, but also recommended for beginner physiotherapists, trainers

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Iontophoresis

In iontophoresis treatment, a direct current is used and a flow of charges delivers the drug to the site of treatment (avoiding the digestive tract). This gets the drug where it needs to be immediately and avoids the usual “wastage” of a pill (the oral drug is digested, absorbed in the intestines, enters the bloodstream and only a fraction of it reaches where it should, say your injured ankle).

Iontophoresis takes advantage of the fact that electrical charges shift between the positive and negative poles. During the treatment, a current will pass between electrodes placed on either side of your joint, passing through the joint and “carrying” the medication inside the joint.

The treatment is given as a course of treatment. A minimum of 10 treatments is needed before the effect is seen.

[message title=”IontoBravo iontophoresis device” title_color=”#ffffff” title_bg=”#1e73be” title_icon=”” content_color=”#000000″ content_bg=”#ededed” id=””]

  • iontophoresis in both continuous and pulsed modesiontobravo iontophoresis device
  • dual use
    • Iontophoresis: substances (electrolytes) with an electric charge can be delivered to a specific point in the body by means of an electric current, avoiding digestion. It is therefore excellent for conditions requiring local treatment such as arthritis, tendonitis, Peyronie’s disease, etc.
    • condensation iontophoresis, an effective treatment for abnormal sweating of the hands, feet or armpits
  • not providing other programs or forms of current
  • possibility to create your own program (requires expertise)
  • also recommended for home use, physiotherapists, surgeries

[/message]

Kotz (Russian) and Interferential

These are important forms of current not for the home user but for the physical therapist. For home use (in general) you don’t need a device that has them.

[message title=”Genesy 1500 Multifunction Electrotherapy Device” title_color=”#ffffff” title_bg=”#1e73be” title_icon=”” content_color=”#000000″ content_bg=”#ededed” id=””]

  • Excellent level of knowledge, 4-channel electrotherapy deviceGenesy 1500 electrotherapy device, Peripheral paralysis, facial nerve palsy, facial paralysis, bell's palsy
  • multifunctional, TENS, MENS, FES, iontophoresis, denervated, interferential, provides Kozt (Russian) currents), versatile
  • can be powered from both battery and mains power
  • Physical therapists, rheumatologists, and medical practitioners can take advantage of its capabilities
  • also suitable for home use
  • possibility to create your own program (requires expertise)
  • can be used to treat only 1 channel (i.e. small muscles) or the largest muscles (thighs, back, abdomen) simultaneously

[/message]

[message title=”Genesy 3000 Multifunction Electrotherapy Device” title_color=”#ffffff” title_bg=”#1e73be” title_icon=”” content_color=”#000000″ content_bg=”#ededed” id=””]

  • Counter-level, 4-channel electrotherapy machinePeripheral paralysis
  • multifunctional, TENS, MENS, FES, iontophoresis, denervated, interferential, provides Kozt (Russian) currents), versatile
  • can be operated not only from battery but also from mains power
  • Physical therapists, rheumatologists, medical practices can take advantage of its capabilities
  • also suitable for home use
  • possibility to create your own program (requires expertise)
  • can be used to treat only 1 channel (i.e. small muscles) or the largest muscles (thighs, back, abdomen) simultaneously

[/message]

Other applications of electrotherapy

So far I have listed the forms of current that provide the treatment, and now I will mention other forms of current that primarily help in the versatility of the device.

Multifunctional appliances provide a wide range of functions, but you may not need them all. Obviously, different aspects are important for the individual, the masseur or physiotherapist, or even the amateur or professional athlete. Remember that electrotherapy is also effective in beauty care!

A serious electrostimulator can be used for about 8-10 years. It’s worth considering what other features, in addition to the forms of current, you and your immediate family might want to consider. This may also be a consideration when making your choice.

Globus sports muscle stimulators are the best price/performance performers on the market.

Pictured are some of the Globus electro-stimulator devices

Muscle management (SPORT programs on Globus devices)

You can use the SPORT programs on the devices for injuries, diseases, muscle-related issues, strength loss, and muscle mass reduction, among other conditions. Not only for patients but also for athletes. The parameters of each muscle treatment program vary so that a different program will provide improved muscle blood circulation (capillarisation), relaxation of stiff muscle, increase of core strength or maximum strength or increase of muscle mass.

Why are they different? If you’ve played sports, you know that long-distance runners and bodybuilders prepare their muscles differently. A runner wants to build thin but enduring muscles, a bodybuilder wants to build huge muscles. The training is different – the results will be different!

The muscle conditioning programs are the same for all Globus 4-channel muscle stimulators!

Special muscle treatment (Special SPORT programs)

While “regular” sports programs are useful for patients and athletes alike, specific sport programs are more for the enthusiasts of the specific sport(s). The name of the device usually provides a clue to this. Runner Pro is for running, Cycling Pro is for cycling. The Champion can be used in more than 10 sports. You won’t find any specific sports programs in the Genesy devices, so the Genesy is mainly a good choice for people with medical conditions.

Fitness and shaping programs

These programs are designed to assist regular, non-competitive athletes in building muscle and improving their physique. They help to shape the abdominal muscles, buttocks, thighs, arms and eliminate small and hard to “move” fat pads.

These programs are available in all Globus devices.

Beauty programs

Muscle stimulation programs for the face, neck, décolletage, breast area are included here. For example, restoration of sagging skin after pregnancy, fading and elimination of stretch marks and facial capillaries. Stimulation of the facial muscles helps to eliminate incipient wrinkles. You won’t find any beauty programs in Genesy devices, so Genesy’s are mainly a good choice for people with medical conditions.

The electric pulses accelerate the skin’s collagen production processes, and regular repetition is needed to maintain this. Visible results can be expected after 40-50 treatments.

G-Pulse beauty programs

A group of specialised facial and cosmetic treatments developed by Globus. These programs can only be used with the G-Trode handpiece. G-Trode is included “as standard” in the price of the Activa 700 alone, the others must be purchased separately. The G-Pulse programs go far beyond the beauty treatments mentioned above. The electrical stimulation increases the production of collagen in the skin, so regular treatment improves skin elasticity, tone and smoothes wrinkles.
This includes muscle stimulation programmes for the face, neck, décolletage and breasts. For example, restoring sagging skin after pregnancy, fading and eliminating stretch marks and facial capillaries. Stimulation of the facial muscles helps to eliminate incipient wrinkles. You will not find G-Pulse programs in the Genesy, Premium 400 and The Champion!

The electric pulses accelerate the skin’s collagen production processes, and regular repetition is needed to maintain this. Visible results can be expected after 40-50 treatments.

[message title=”Activa 700 Multifunction Electrotherapy Device” title_color=”#ffffff” title_bg=”#1e73be” title_icon=”” content_color=”#000000″ content_bg=”#ededed” id=””]

  • High-end, 4-channel electrotherapy deviceActiva 700 multifunctional electrotherapy unit
  • Multifunctional, i.e. TENS, MENS, FES, incontinence treatment and beauty care programs
  • precise programs for muscle pain, muscle stiffness relief, muscle atrophy prevention and muscle strength recovery
  • sport applications
  • joint and tendonitis treatment
  • beauty care and G-Pulse programs (with accompanying handpiece)
  • possibility to create your own program (requires expertise)
  • for home use, but also recommended for physiotherapists, trainers and beauticians

[/message]

Incontinence treatment – aka functional stimulation

It can treat urine or feces incontinence. In fact, these are EMS, or muscle stimulation treatments. Because the muscles in the pelvic floor are tiny and located in a special way, we need specialized programs. You can’t treat a tiny rectus sphincter with the same program you use to treat a huge thigh muscle. If you (also) need such treatment, you need to know if you have stress, urge or mixed incontinence.

Functional stimulation causes the muscles of the pelvic floor to adapt, i.e. to strengthen or relax depending on the program. To develop the effect, one needs regular repetition. You can expect noticeable results after 40-50 sessions, which can be maintained with maintenance sessions.

[message title=”Biolito Incontinence Treatment Device” title_color=”#ffffff” title_bg=”#1e73be” title_icon=”” content_color=”#000000″ content_bg=”#ededed” id=””]

  • basic, dual-channel incontinence management deviceBiolito Incontinence Management Device
  • anal and vaginal probes available
  • abdominal and transdermal treatments
  • 1-1 program for stress, urge and mixed incontinence
  • possibility to create your own program (expertise required)
  • recommended for home use

[/message]

[message title=”evoStim UG Perineal Stimulator” title_color=”#ffffff” title_bg=”#1e73be” title_icon=”” content_color=”#000000″ content_bg=”#ededed” id=””]

  • professional dual-channel incontinence management deviceevoStim UG Perineal Stimulator
  • anal and vaginal probes available
  • Vaginal and transdermal treatments
  • 10-10 programs for stress, urge and mixed incontinence
  • comprehensive, professional customization (requires expertise)
  • recommended for incontinence clinics and home use

[/message]

2+2 mode

The device can run two programs at the same time, meaning you can use it on your right knee and left shoulder, but with different programs. You can also use the device “split”: on channels 1-2, you treat your knee pain while your partner next to you treats your shoulder pain. You can combine the TENS and EMS programs this way.

Furthermore, you can use this method on the thigh muscles, as well as the abdominal and core muscles. I recommend it mainly for post-operative recovery and regaining muscle strength, and for athletes to maximize muscle development. More effective than physiotherapy or “plain” exercise! You can combine voluntary gymnastics exercises with muscle stimulation.

For example, squats are best for developing the strength of your hamstrings. When you connect the electrodes of the device to your hamstring, it triggers a contraction of the hamstring at the touch of a button. Perform the squat movement at the same time.

You can set the length of the contraction and rest period (e.g. 2 sec contraction followed by 2 sec rest). You can adapt the timing to the exercise.

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