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

Dr. Zatrok's blog

Electrotherapy and implants

by Dr. Zsolt Zatrok

Electrotherapy treatments (e.g. TENS, EMS, FES, MENS) can now be performed at home without risk. However, many people are afraid of these treatments. They do not know whether they should be performed near or directly above implants or metallic fixtures. How scared should they be? What is the truth?

There are two types of implants

  • ACTIVE implants. These include pacemakers, defibrillators, insulin pumps and others. These are battery-powered devices that are “implanted” under the skin.
  • PASSIVE implants. Most commonly used to fix bones, such as a marrow pin, screw, plate. But they can also replace a complete joint (e.g. knee, hip)

Active implants

Active implants are electrically powered. Pacemakers and defibrillators, for example, monitor the electrical activity of the heart and intervene if they detect abnormal heart activity that could be life-threatening.

Any external electrical impulse can interfere with these devices!

So the pacemaker may not detect the slowed heartbeat and “let the patient die”. Or the defibrillator may detect the high-frequency TENS pulses as arrhythmia and deliver an electric shock when it should not.

In the case of active implants, the use of any electrotherapy treatment is always PROHIBITED. This is an absolute contraindication, no exceptions!

Passive implants

There is a long-standing prohibition on passive implants. It is based on the assumption that a metal implant can be “significantly” heated by an electric current. This could have a detrimental effect on the tissue surrounding the implant. In particular, it could damage bone marrow and periosteum.

At the time when this opinion was formed, iron and steel alloys were still mostly used and electrotherapy devices were imperfect.

In the meantime, the materials used for implants have changed completely and electrotherapy devices are much more precise.

Today, titanium and other light metal alloys react differently to electricity and magnetism. Despite this, you’ll find a prohibition in the description of every electrotherapy device in the home: don’t use over implants.

Some electrotherapy methods should not be used at home!

There are a number of treatment methods whose main effect is heating and the changes this creates that produce the healing effect.

Examples of such treatments are shortwave, microwave, TECAR, diathermy, continuous ultrasound, medical laser. Their inappropriate use could even cause harm.

These treatments, however, cannot be done at home, but only in an institute by a professional! Draper and colleagues have shown that relatively high-power, pulsed, short-wave treatment had no harmful effects on metal implants in the treated area (Draper et al., 2004). In other words, in the right hands, even otherwise harmful things can be “tamed”


Laws do not allow you to buy medical therapy equipment for your home that could be used to do harm.

Electrotherapy, ultrasound, soft laser, etc. devices that you can buy for personal use are safe to use. Of course, if you use them with the express intent to harm, disregard the instructions for use, and for a medical condition for which they are not intended, then it is a different story. But if used as intended, you can do no harm!

Follow these instructions:

If you have an active implant, the use of any electrical treatment is prohibited. Even if you really need it.

In the case of passive implants, the effects of electrical treatments (TENS, EMS, MENS, FES), even after prolonged use, will not have any harmful effects on the implant or its environment. Home electrotherapy devices can be used with or over any passive implant.

If you are still unsure about treatment, you should seek advice from a physiotherapist experienced in electrotherapy treatments.

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