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A Shock to the System: How Electrotherapy Helps Manage Back Pain

Published November 13, 2018   | Written By Raphael Salazar II, MHS, OTR/L   | Reviewed By Jerry Nichols, MD

Though it's been around for more than half a century, many people still wonder how does electrotherapy work for back pain relief. Approved by the Federal Drug Administration (FDA), the treatment involves using electricity as a therapeutic tool to heal your body. Electrical current is sent into the body through the skin to stimulate nerves and muscles.


What is Electrotherapy Used For?

Doctors use electrotherapy to manage pain stemming from nerve pain or muscular or neurological conditions. Pain varies from person to person and may include sharp pain, shocking pain, and pain with movement. If you suffer from back muscle weakness, numbness, tingling and extreme sensitivity, electrotherapy can help. People without good range of motion caused by muscle spasms can also benefit.

Electrotherapy reduces swelling by stimulating infrequently used muscles to improve range of motion. This also helps with muscle maintenance, strength, and prevents muscle atrophy, which affects victims of strokes or accidents.

One of the more common electrotherapy treatments is with a Transcutaneous Electrical Nerve Stimulation (TENS) unit.

“Some patients experiencing back pain may be prescribed a TENS unit that can be worn throughout the day for certain periods of time (normally 45-90 minutes at a time) to decrease pain during functional tasks and activities. Though some studies suggest that daily use may lead to some tolerance and reduced effectiveness,” said Rafael E. Salazar II, MHS, OTR/L, President & CEO of Rehab U Practice Solutions.

Electrotherapy for Back Pain

People suffering from nerve pain in their lower or upper back or both might find relief from electrotherapy. If you have sprained or strained your muscles in your back, electrotherapy penetrates your injured tissue without invasion. In addition, electrotherapy releases tight muscles and reduces muscle spasms.


What are Electrotherapy’s Benefits?

Doctors prescribing electrotherapy believe that certain forms, like TENS, help to "gate" pain. This form helps block pain signals from getting to the brain by disrupting information or providing competing information from nerves in painful areas, and the electrical shocks themselves may stimulate release of the body's own endorphins locally in the painful areas.

“The main benefits of using TENS to manage pain is that the patient is able to manage pain in a way that does not involve narcotic medication,” said Salazar.

“By applying TENS and then completing a task, the patient is able to complete what was once an unbearably painful task with little or no pain. Combined with appropriate physiotherapy guidance, this can be used to get the patient to a point where there is no pain with that certain activity.”


What Are the Types of Electrotherapy?

There are several types of electrotherapy: Transcutaneous Electrical Nerve Stimulation (TENS), Electrical Muscle Myostimulation, Microcurrent and Interferential Current (IFC). The treatments differ in the way wave forms are used to administer the treatment. Some patients receive more than one type of electrotherapy treatment.

  • TENS is the most common form of electrotherapy. It uses low voltage electrical currents to ease pain. Patients often say their pain is gone after they administer treatment. It can release the body’s natural pain reliever, called endorphins.
  • Microcurrent is similar to TENS in that it is a nerve stimulator but with a smaller current. It sends a more discrete current than TENS does. Microcurrent is most often used for pain management. Other uses are delayed wound healing, non-union fractures and other disorders.
  • Interferential Current is a very high pulse rate current. The high frequency uses electrodes to penetrate the skin and muscles better than TENS or other electrotherapy forms. It gives pain relief and a nerve blocking effect making it more effective with pain control.
  • EMS is an electrotherapy that stimulates muscles. There is more focus on the muscles than Microcurrent, TENS and Interferential. The muscle receives the EMS signal through the electrode and that causes the muscle to contract just as if the brain sent the signal. Those electrotherapy treatments focus more on the nerve endings. EMS can increase circulation and help with muscle relaxation.


Pregnant women, people who experience seizures or have a pacemaker should avoid TENS, EMS, Microcurrent and Interferential Current unless their physician says otherwise. It is important to read the warnings carefully.


Is There a Preferred Therapy for Back Pain Patients?

According to Salazar, “for patients experiencing back pain, TENS would likely be the ideal form of electrotherapy. For therapy treatment in general, then TENS would be an adjunct to treatment provided by a competent physiotherapist.”



Electrotherapy Side Effects

There are precautions and considerations to be aware of when using electrotherapy, both involving overuse.

“As far as side effects go, if applied for extended durations, the skin may burn (this is typically from using the wrong electrode pads or wearing the unit for several hours in a row with no break time),” Salazar said.

“There is also some research showing that there is an adaptive response of the nervous system to TENS. This is known as accommodation, but it basically means this: if you use it several times a day, every day, then your body will build a “'tolerance' for it and the effect will be diminished.”


Conclusion

Electrotherapy treatment may be beneficial for people with back pain by helping with nerve and muscle stimulation. Studies have been inconclusive as to whether it's completely effective or not. If you're interested in trying TENS for back pain, or other methods of electrotherapy treatment, talk to your doctor to see if this could be an effective therapy for you. Lastly, be sure to educate yourself on the correct use and best practices of whichever form of therapy recommended to you.

Added Salazar, “As with any pain treatment, it’s not something you want to just go to the Walmart and slap on your back. You need to make sure you are applying it correctly and using it appropriately — not only to prevent any injury, but to ensure that you are going to get the best possible result from treatment.”

Last change: November 13, 2018

Contributors and Experts

Rafael E. Salazar II, MHS, OTR/L is a licensed occupational therapist and President & CEO of Rehab U Practice Solutions.