Electrotherapy

TENS is a non-invasive method of electrical stimulation designed to provide pain relief by stimulating sensory nerves and modulating pain signals. It serves as an alternative to drug treatments and has few side effects. A TENS machine consists of a handheld, battery-operated unit that generates electrical stimulation. Pre-gelled electrodes are placed on the skin to convey it. High frequency stimulates 'non-pain' nerve fibres, which send signals to the brain that block pain messages; low frequency promotes the production of endorphins. TENS is used for acute pain such as sports injuries, acute torticollis, low back pain and joint pain, and for chronic pain including low back pain, rheumatoid arthritis, peripheral nerve injuries and phantom limb pain, as well as postoperative pain, pain associated with Raynaud's disease, diabetic neuropathy pain, and pain during labour and delivery.

Ultrasound is an electrotherapy technique that promotes healing and reduces inflammation at the cellular level. An ultrasound machine generates mechanical sound waves that create energy, causing micro-vibrations in the cells when they penetrate the skin. During treatment, an ultrasound head is placed on the affected area using specialised gel to ensure optimal contact, then slowly moved across the skin. It is a painless procedure commonly used to treat soft tissue injuries such as ligament sprains and muscle tears. For acute injuries a pulsed, low-intensity mode is often used; in chronic conditions ultrasound increases blood flow to the affected area, and continuous mode may be used. Ligaments, tendons, fascia, joint capsules and scar tissue, which contain high amounts of collagen, absorb ultrasound waves effectively.

Interferential therapy employs electrical currents to reduce swelling, relieve pain and stimulate muscles, using two different frequencies that interfere with one another to create a medium frequency current within the tissues. It is applied for pain relief in acute and chronic pain such as lower back pain and sciatica, muscle spasm relief, tissue healing promotion, and deep muscle stimulation including the pelvic floor muscles. Conditions treated include lateral epicondylitis (tennis elbow), frozen shoulder, osteoarthritis, bursitis, tendinitis, fractures, incontinence and muscle weakness. For stress incontinence, electrodes are placed over the lower abdomen and inner thigh to facilitate pelvic floor muscle contractions.

FES, also known as neuromuscular stimulation, uses electrical currents to activate nerves that control muscles affected by paralysis due to neurological conditions such as multiple sclerosis, stroke, head injury and spinal cord injury. The stimulation is delivered through surface electrodes to facilitate functional movements, such as lifting the foot during walking. Currents can be controlled by the physiotherapist using switches or dials; for home use FES can be operated via buttons, switches, joint position sensors and heel switches. It is commonly used for foot drop, and is also used to assist upper limb movements such as grasping, to encourage hip flexion during standing and walking, and to support bladder and bowel control in individuals with spinal cord injuries.

L.A.S.E.R stands for Light Amplification by Stimulated Emission of Radiation. Laser therapy involves applying low-intensity laser light to relieve pain and promote healing in damaged soft tissue. Low-level laser therapy uses the infrared spectrum, which penetrates the skin to stimulate cells within muscles, tendons and ligaments. The method of application varies with the condition, typically involving a treatment head or probe applied directly to the affected tissue, with the energy delivered carefully controlled by the physiotherapist. It is used for soft tissue and sports injuries such as muscle strains and ligament injuries, repetitive stress injuries including tendinitis, bursitis and carpal tunnel syndrome, arthritic conditions such as osteoarthritis and rheumatoid arthritis, tissue repair and wound healing including burns and ulcers, nerve regeneration such as Bell's palsy, and temporomandibular disorder.

PSWD uses high-frequency electromagnetic currents to promote tissue healing and alleviate pain. It has both thermal (mild heating) and non-thermal effects, making it effective for treating muscles, nerves and areas of swelling. It can assist with wound healing, haematomas, oedema, and soft tissue injuries and wounds. Its benefits relate primarily to the inflammatory and repair phases in soft tissue injuries and are similar to those of ultrasound and laser therapy: increased blood flow, decreased inflammation, improved quality of repair, pain control, and facilitation of tissue repair.