Electrophysical means in physical therapy: Electrotherapy, Shock Wave, TECAR etc.

What are the electrophysical means?

Electrophysical means are quite widespread in the field of physical therapy and are part of the treatment of patients. What they do is introduce some form of energy into the human body which causes normal tissue changes. This energy of electrophysical means is mainly used for symptom relief and analgesia.

Important: Electrophysical means should prevail during a rehabilitation program, but are -usually- used in the initial stages to reduce pain, except in cases of muscle weakness or atrophy where the use of electrotherapy can be prolonged and combined with exercise.

Which are the electrophysical means?

The group of these means includes Electrotherapy, Percussive Ultrasound, TECAR κ.α.

What is electrotherapy?

Electrotherapy is the use of electricity for therapeutic purposes. It is applied through electrodes that are placed on the body at the point we want to treat. It always starts at a low volume and gradually increases.

What are the types of electrical stimulation?

There are many types of electrical stimulation. The most commonly used ones are Transcutaneous Electrical Neuromuscular Stimulation (TENS), Interferential Current (IFC), High-Voltage Galvanic Current (HVGC), Neuromuscular Electrical Stimulation (NMES) and Iontophoresis.

Electrotherapy: TENS (Transcutaneous Electrical Nerve Stimulation)

TENS currents are a method of electrical stimulation that aims to reduce pain. The way it works to reduce pain is by modifying the painful stimulus someone receives in the spinal cord. It is based on the well-known theory of “pain gate” control, according to which an unpleasant or painful stimulus can be modified when it reaches the spinal cord from one point of the body through the various nerves scattered throughout our body, thus reducing the intensity of pain. The electrodes are placed in the area of ​​the spine which is neurally connected to the area where the patient is in pain.

Electrotherapy: High-Voltage Galvanic Current

There are several main areas of use of these currents. The two main ones are for wound healing and pain management. In addition, there are applications that have been advocated (and researched to a limited extent) for edema management and muscle strengthening. Each is briefly summarized below with links to key research and references.

Wound healing

This topic has been explored quite well (along with many other electrical stimulation options) and has been reviewed in Watson (2008) and Kloth (2005).

A test on the effects of high frequency currents was reported by Kloth and Feedar (1988). A group of 16 patients with stage IV decubitus ulcers were recruited for the trial and all had lesions unresponsive to previous treatment. Patients were randomly assigned to a treatment group (n=59) or sham treatment (n=57). Protocols were given for one 45-minute session per day for 5 days per week.

All patients in the treatment group achieved complete healing of their ulcers (on average for 7.3 weeks with a mean healing rate of 44.8% per week). Patients in the control group fared less well, with an increase in average wound size of nearly 29% between the first and last treatment. A subgroup of patients who were in the control group went on to complete a course of current therapy after the main trial. The three patients achieved complete healing of their ulcers in 8.3 weeks with an average healing rate of 38% per week.

Goldman et al (2002) aimed to evaluate the ability of high-voltage pulsed current (HVPC) to increase microcirculation in critical ischemic wounds and, as a result, improve wound healing. Diabetic patients presented with ischemic lesions of the arsenic oil and serial measurements were made of wound parameters, including oxygen tension. The results showed that the use of electrical stimulation with these patients objectively improved tissue oxygenation and improved the expected wound healing profile.

Electrotherapy: Interferential Current

It is a type of electrotherapy that delivers low-frequency electrical pulses through the skin to nerves located on the surface of the body. These pulses “block” the transmission of harmful signals to the brain. Interfering current stimulation also enhances cellular repair to promote the body’s natural healing process.

What are the benefits of electrical stimulation?

Intermittent current stimulation relieves pain and increases local circulation while reducing inflammation and swelling. It can also contract small groups of muscle fibers to improve the health of muscle tissue.

Cross-current stimulation offers pain relief for a variety of conditions, including some arthritis, back pain, sciatica, back or neck pain.

Is interferon electrical stimulation safe?

Interfering current stimulation has been used safely to treat pain for many years. It is suitable for most patients, but if you are pregnant or have a pacemaker, you may not be allowed to use them.

Electrotherapy: Neuromuscular Electrical Stimulation

Neuromuscular Electrical Stimulation using electrical impulses causes the muscle to contract. These impulses mimic the action potential originating from the central nervous system and thus cause contraction. Electrodes are placed on the skin near the muscles we want and cause rhythmic contractions.
They replace and strengthen the way muscles contract and are used in cases where there is muscle weakness due to surgery, paralysis of the muscle due to damage to a nerve, or any other form of weakness.

Electrotherapy: Iontophoresis

Iontophoresis is a method where medicinal substances are placed on electrodes and by applying a constant direct electric current they are introduced into the tissues located deeper through the skin.

• Neck pain
• Back pain/Sciatica
• Muscle Sprains
• Osteoarthritis

• Nervous muscle
• Muscle weakness
• Fractures
• Nerve paresis
• Bursitis/ Frozen shoulder

What is TECAR?

The TECAR method represents a pioneering technology in the way of transferring energy to the affected areas of the body. Electrodes are used where high frequency radio frequencies are emitted through them which stimulate the ions found in our cells thus accelerating the normal recovery processes in our body tissues. It causes an endogenous increase in tissue temperature which increases blood flow and helps reduce pain, inflammation and swelling.

How does TECAR work?

The TECAR method has two ways of application. The first is capacitive where it is done through a capacitive electrode and targets more superficial structures such as muscles and the second is antistatic where it is achieved through an antistatic electrode and targets deeper structures such as joints, tendons and ligaments. The application of this method is completely painless and very pleasant for the patient.

What is achieved by using the TECAR method?

Through the application of TECAR the following is achieved

– immediate pain reduction

– increase in blood flow

– acceleration of recovery

– faster healing and tissue regeneration

– deep action and endogenous temperature increase

– better tissue oxygenation

• Muscle pains
• Back pain
• Neck pain
• Sprains

• Muscle Sprains
• Inflammation, swelling
• Tendonitis
• Arthritis

What is Shock Wave?

Shock Wave therapy is a modern and innovative non-surgical/invasive treatment applied outside the body to the affected areas based on the principles of the extracorporeal lithotripsy method. Because it is an invasive method it needs special care and should not be abused with many and frequent treatments.

How is it applied?

It is applied through a device where it is placed on the surface of the affected area and produces shock waves with adjusted intensity and frequency which enter deep into the tissues. Its application and its settings must be done by specialized and trained personnel. It is a non-invasive method that does not require the use of any drugs and is immediate, tolerable and effective.

What is achieved with Shock Wave treatment?

What is achieved with Shock Wave treatment?

This treatment achieves:

• Analgesia, pain reduction
• Tissue reconstruction and healing
• Restoration of mobility of the affected area.
• Increased blood flow
• Faster tissue collagen synthesis

• Calcific tendinitis/shoulder tendinopathy
• Acantha heel
• Plantar fasciitis
• Epicondylitis (tennis elbow)

• Achilles tendonitis
• Hip trochanteritis
• Patella tendonitis

Manual Physiotherapy is a Physiotherapy Clinic founded in 1999 by Physiotherapist Konstantinos Sakellariou. A space staffed by a team of scientists of various specialties and equipped with modern physical therapy and therapeutic exercise infrastructures, so that it can effectively cover the entire spectrum of rehabilitation services for musculoskeletal diseases.

Kostas Sakellariou has 31 years of experience in physical therapy and 19 consecutive years of teaching in internationally recognized postgraduate specialization programs in Manual Therapy.

At the Manual Physiotherapy Center we can help substantially – either preventively or therapeutically. We all share the same vision of fully recovering our patients and returning them quickly and safely to the activities they used to do before the onset of their problem.