Product Support	F.A.Q.	Ordering Info	About Us

Frequently Used Modalities

The following contains brief, easy-to-understand descriptions of TENS and other types of stimulation noted by their commonly referred acronyms. Not all electrotherapy devices function in the same way, nor do they produce the same results. Additionally, some individuals may not respond to a particular modality as well as expected. However, understanding the differences among the various modalities and what they each accomplish can help you be aware of the many options available to provide to your patient, and allow you to offer other alternatives if one modality seems to be ineffective. If you need any assistance or would like more information regarding any of these modalities, call us at 1-800-DME-STIM.

TENS - Transcutaneous Electrical Nerve Stimulation

A Transcutaneous Electrical Nerve Stimulator is primarily used for managing chronic pain. It utilizes biphasic electrical current delivered through electrodes placed on the surface of the skin to stimulate the sensory nerves to block pain signals and help the body's endorphin production (its natural analgesic). TENS can be worn all day or on an as needed basis.

Common device features include adjustable pulse rate, pulse width, and amplitude (intensity). Higher priced units offer modulation (variations) of pulse rate, width, and/or amplitude settings, and other user friendly features.

Most TENS units will utilize an asymmetric waveform which is more comfortable than other waveforms such as symmetric or monophasic. TENS units offering "Strength Duration" modes help normalize sympathetic function distal to the electrodes. Placement of electrodes are usually at pain site or along the nerve channels, called dermatomes.

TENS devices are the most often prescribed modality in electrotherapy. These devices are easier to use than other modalities. A TENS unit is not the same as other electrical stimulators (e.g., neuromuscular stimulators) which are used to directly stimulate muscles and/or motor nerves.

Indications

• Symptomatic relief and management of chronic (long-term) intractable pain
• Adjunctive treatment for post-surgical and post-traumatic acute pain

Common Uses

• Chronic & acute pains
• Back & cervical muscular and disc syndromes
• RSD
• Arthritis
• Shoulder syndromes
• Neuropathies

Learn more about how TENS works.
Browse our selection of TENS units.
Download our "Introduction to TENS".

NMES - Neuromuscular Electrical Nerve Stimulation

Primarily used for preventing disuse atrophy (muscle wasting), NMES is stronger than a TENS unit with a wider pulse width to elicit muscle contraction for a period of time. More than just nerve stimulation, muscles are contracted and relaxed on and off to strengthen muscles, increase blood circulation to the area, and/or to reduce edema. Device features include adjustable pulse rate, width, amplitude, ramp, alternating or synchronous stimulation. Higher priced devices offer accessory jacks for remote switches, AC adapters, and other user friendly features. Electrode placement is very important, mostly over motor points or on the belly of muscles.

Indications

• Relaxation of muscle spasms
• Prevention or retardation of disuse atrophy (wasting of muscle due to lack of use)
• Increasing local blood circulation
• Muscle re-education, such as after surgery or trauma
• Maintaining or increasing range of motion or joint mobility
• Preventing venous thrombosis (blood clots due to inactivity) immediately following surgery

Common Uses

• Post-orthopedic surgery
• Joint replacement (i.e. hip, knee, shoulder)
• Muscle strengthening programs
• Shoulder subluxation
• Reduction of muscle spasms

Learn more about how NMES works.
Browse our selection of NMES units.

HVPG - High Volt Pulsed Galvanic Stimulation

Primarily used for quickly increasing circulation or reducing edema in a specified area, HVPG is also used widely by physical therapists for wound healing. This modality uses high voltage and direct current (DC) as opposed to low voltage and alternating current (AC) common in TENS or NMES. Device features include adjustable pulse rate, positive or negative polarity switch, alternating or synchronous stimulation. Large "dispersive" pad is needed to ground the current. Smaller "active" pads are placed over treatment site.

Indications (same as NMES)

• Relaxation of muscle spasms
• Prevention or retardation of disuse atrophy (wasting of muscle due to lack of use)
• Increasing local blood circulation
• Muscle re-education, such as after surgery or trauma
• Maintaining or increasing range of motion or joint mobility
• Preventing venous thrombosis (blood clots due to inactivity) immediately following surgery

Common Uses

• Post-orthopedic surgery
• Pain control
• Sprains and strains
• Degenerative point disease
• Edema reduction
• Wound healing
• Diabetic neuropathy

Browse our selection of HVPG units.

 

INF - Interferential Stimulation

Primarily used to manage deep chronic pain, Interferential current uses very high pulse rate, usually 4001 - 4150 pulses per second. This higher frequency goes through the skin and muscle better than TENS or other modalities, thus can be more effective in pain control. Provides more analgesic, or nerve blocking effect. Device features include adjustable pulse rate, two or four electrode treatment selection, and modulation of pulse rate. Because of such frequency, these devices will require a lot of power, and thus, batteries will not last long. AC Adapters are usually provided with device. Electrode placement should be in an "X" pattern, as the point of intersection provides a third stronger frequency.

Indications

• Symptomatic relief and management of chronic and post-traumatic acute pain
• Management of post-surgical pain

Common Uses

• Pre- and post-orthopedic surgery
• Joint injury syndrome
• Cumulative trauma disorders
• Inflammatory conditions
• Pain control of various origins

Learn more about how Interferential stimulation works.
Browse our selection of Interferential units.
 

MENS - Microcurrent Electrical Nerve Stimulation

Microcurrent electrical nerve stimulation (MENS) uses micro-amperage current as opposed to millamperage current which is found primarily in TENS devices. Microamp current is 1/1000 of a milliamp current and is closer to our own body's natural healing current.

Whereas TENS is generally used for pain relief, MENS works more on a cellular level and aids in the healing process while relieving pain. It has been found that MENS can help increase levels of a chemical called ATP (adenosine triphosphate) which promotes protein synthesis and healing in tissue cells. MENS is a very subtle, yet powerful current, and treatment levels are usually sub-sensory-- the patient barely feels the stimulation. In many cases where TENS or other electrotherapy modalities have been unsuccessful, MENS has been proven to be an effective alternative.

Indications

• Symptomatic relief and management of chronic (long-term) intractable pain
• Adjunctive treatment for post-surgical and post-traumatic acute pain

Common Uses

• Chronic & acute pains
• Swelling
• TMJ dysfunction
• Post-op care
• Sports injury
• Wound healing
• Arthritis

Browse our selection of Microcurrent units.

EMG - Electromyography

Sometimes referred to as biofeedback, this procedure is very similar to routine electro-cardiography (ECG). While ECG measures the activity of the cardiac muscle, EMG measures the electrical activity of contracting skeletal muscles. Muscle activity produces electrical signals that can be detected through the skin with surface electrodes. The magnitude of electrical activity is proportional to the strength of the contraction. Thus, surface EMG can quantify muscle activity non-invasively. Common uses include muscle re-education, post-op knee rehabilitation, hand rehabilitation, work hardening, posture training, relaxation, stress management training, and incontinence.

Common Uses

• Muscle re-education
• Post-op knee rehabilitation
• Hand rehabilitation
• Work hardening
• Posture training
• Relaxation
• Stress management training
• Incontinence

Learn more about how EMG works.
Browse our selection of EMG units and accessories.