Electrotherapy

Iontophoresis

Iontophoresis is the introduction of charged ions across the skin using low-voltage direct current. The active electrode is placed over the area to be treated, and a second dispersive electrode, which completes the electrical circuit, is placed on the body away from the first electrode. The active electrode is the one with the same polarity as the drug ions, which causes the drug to be driven across the skin. The drug used most often is dexamethasone sodium phosphate, which can help decrease inflammation often caused by tendinitis or bursitis. Acetic acid can also be used to eliminate calcium deposits from a joint.

Transcutaneous Electrical Nerve Stimulation

Transcutaneous electrical nerve stimulation (TENS) is a form of electrical stimulation that can help with pain control. Pain relief can be achieved through two mechanisms. The first is the gate control theory. This proposes that electrical stimulation inhibits transmission of painful stimuli from the spinal cord to the brain. This is called high-rate or conventional TENS, and it uses high-frequency, low-intensity pulses. No muscle contraction occurs. The second theory is that electrical stimulation can stimulate the release of the body's own natural endorphins and enkephalins. This is often called low-rate or acupuncture-type TENS, and it uses low-frequency, high-intensity pulses. Mild muscle contraction occurs. Currents are superficial with TENS due to high skin resistance to the pulse frequencies. TENS may be used to help control acute pain (postoperative) or pain in more chronic conditions, such as low back pain and complex region pain syndrome (CRPS).

Interferential Current

Interferential current (IFC) is similar to TENS, but it uses two different channels with medium frequencies. The currents intersect and interfere with each other, producing a current that is said to penetrate the skin more deeply and more comfortably, thus providing pain relief to deeper tissues. It is claimed that IFC may be effective for pain control in acute, subacute, and chronic pain conditions, but TENS is often as effective.

Electrical Stimulation with Direct Current

Electrical stimulation with direct current is used when the nerve has been affected by injury and the patient is no longer able to produce a voluntary muscle contraction (denervated muscle). The type of pulse it generates produces a twitch response in the muscle. Traditionally, direct current was used to produce muscle activity with the intention that it would prevent muscle atrophy. Recent studies have not supported this outcome, except in some cases of chronic facial nerve palsy (Bell palsy).

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