Physiotherapy Modalities that treat Back Pain(1)


What is Electrotherapy?

Electrotherapy is the use of electricity to treat medical conditions. However, because some physiotherapy machines don't actually use electric current for their treatment process, a wider term "electro physical agents" is also used to describe these modalities of treatment.
It's not a new discovery that electricity can be used to reduce both acute and chronic pain, it has actually been a practice for over 100years!

How does electrotherapy relieve pain?

When electric signals are introduced into the body the result is a release of the body's natural pain killers called endorphins. The electrical current also interferes with the transmission of pain signals trying to notify the brain and accelerates healing of the body tissues.

TENS for back pain

Trans cutaneous Electrical nerve stimulation (TENS) stimulates the sensory nerves and in the process activates the body's natural pain relief mechanisms.
TENS is a commonly used home-based treatment, as most patients are advised by their therapists to buy or rent one. The effectiveness of using TENS is dependent on the type of pain being treated, placement of the electrodes and frequency of the electrical stimulation
.
Hi TENS (Traditional/normal TENS)
Hi TENS or what is also known the traditional TENS involves the use of high frequency electrical stimulation, usually between 80-130Hz. This high frequency electric current stimulates "non-pain" nerve fibres (ABeta sensory fibres) and in the process block the painful stimuli from reaching the brain. This form of pain relief is commonly referred to as stimulation of the pain gate mechanism.The minimum treatment time for this form of pain relief is 30 minutes and it is well tolerated; however the greater period of the pain relief is experienced during the treatment with a brief lasting effect after the machine has been turned off.

Lo TENS (Acupuncture TENS)
Lo TENS uses low frequency  electrical stimulation  usually between 2-5Hz, with a higher intensity than traditional TENS. Lo TENS stimulates the Adelta sensory fibres to cause the production of the body's natural pain relievers called endorphins.
Though the Lo TENS stimulation may be less comfortable and the pain relief process slower than  than the normal TENS,  the resulting relief of pain lasts longer after the machine has been stopped. The minimum treatment time for the Lo TENS is also 30 minutes.

How to Place TENS Electrodes

Placement of TENS electrodes is key in achieving pain relief. These placement styles work differently for different people so you may need to try out various electrode positions to get what works for you.
You can place the TENS electrodes directly on the spot you feel pain, around the area you feel pain or on the nerve that supplies the muscle where you feel the pain.

Contraindications

If you are using a pacemaker its not advisable to use TENS as there is likely to be interference in the functionality of both the pacemaker and the TENS machine. TENS is also not  usually recommended for pregnant women or people with skin conditions.
Always consult with your physiotherapist for an accurate assessment of your back pain before getting a TENS machine as not all causes of back pain are indications for Trans Cutaneous Electrical Nerve Stimulation.

Interferential Current (IFC)

Interferential current is a deeper form of TENS as it penetrates more than skin deep into the tissues.
Interferential currents may be recommended to pain sufferers who haven't had any relief from TENS. IFC is usually administered by a physiotherapist, unlike TENS that can be used by the patient at home.

Effects of IFC

  • Interferential current relieves pain
  • Stimulates the muscles and helps maintain their function.
  • Improves blood circulation
  • Helps reduce swelling.


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