Electrical Stimulation for Back Pain

Electrical stimulation (electrotherapy) has been used to treat back pain for nearly 100 years now, either by preventing the atrophy of injured tissues or by stimulating the release of chemicals such as opioids and endorphins to prevent our experience of pain. Though years of medical science and practice, we have discovered that certain frequencies of energy may have the effect of building muscle, calming muscle spasms, and inhibiting the inhibiting the transmission of pain signals to the brain. Electrical stimulation is transmitted through electric generators, to the injured areas of the body or the nerves near the spinal cord. These electric generators may deliver energy at periodic intervals or through a continuous flow of electricity. These electric generators may be portable devices, or in some cases, permanently implanted inside the body. From these portable or implanted electric generators, wires are drawn and connect to the skin, into the muscle, or near the nerves near the spinal cord. These devices often are used in conjunction with other therapies, such as massage therapy, physical therapy, and acupuncture. Though electrical stimulation for back pain is a well established and practiced therapy, many in the medical community doubt its clinical benefits. Those among the healing professions that often use electrotherapy treatments include physical therapists and chiropractors. Physical therapists often use a system known as the TENS system to loosen up the muscles prior to physical therapy sessions, or to provide pain relief so that the physical therapy sessions may be tolerated. Let's take a look at the different types of electrotherapy treatments.

At the heart of these types of treatments is the electric generator. These generators are as large as the size of a small table to as small enough to be able to be safely inserted in the body. Through these electric generators, one to several leads may be drawn, to be applied to the patient, to stimulate multiple areas of the body at once. Each electrode run off the generator may be programmed to a deliver a specific type of energy, and may vary by frequency, waveform, and effects. There is no concrete right or wrong type of setting to apply to the body in terms of frequency, waveform, and effect, and doctors will continue to experiment with the electrical stimulation settings until the patient experiences the clinical benefits.

Electrical modalities include:
  • Galvanic Stimulation (GS)
  • Interferential Stimulation (IFC)
  • Percutaneous electrical Nerve Stimulation (PENS)
  • Transcutaneous Electrical Nerve Stimulation (TENS). The tens system is the most commonly used system. Several different companies make this type of system, and many units are designed for home use.
These electrical modalities work by delivering certain types of electrical stimulation from a generator, and to the patient's body via an insulated wire. At the end of the wire is an electrode that attaches onto a patient's skin via an adhesive pad. Complications related to this of therapy are rare and related to allergic reactions to the adhesive material on the adhesive pad. These pads should not be placed over a pacemaker or pacemaker leads as this could cause cardiac arrhythmia or the pacemaker to malfunction. These leads should also not be placed over a female uterus or ovaries, especially in a pregnant female, or over infected areas.

Galvanic Stimulation (GS): Galvanic Stimulation is most commonly used to treat acute injuries involving tissue trauma with swelling or bleeding. While TENS and IFC units involve the use of alternating (AC) current, GS devices use direct (DC) current. Direct current involves the flow of energy that travels in only one direction, while alternating current involves the cycling of energy in both the positive and negative directions that you would see in a wave. The theory about how galvanic stimulation works is that the direct current draws the flow of blood away from injured areas of the body. This technology, if it works successful as a treatment, will have the same effect of icing and anti-inflammatories in reducing inflammation in the injured areas. An alternating current would have the opposite effect on the injured tissues, increasing the flow of blood to the affected areas.

Interferential Current (IFC): Interferential Current works similar to the TENS technology, except that it delivers a much higher frequency of energy to the injured tissues. TENS stimulators delivers low frequency stimulation at frequencies of <10 Hz and high frequency stimulation at frequencies of 60-200 Hz. GS stimulation modulates at high frequencies of around 4000Hz. TENS and IFC treatments are designed to provide pain relief in the form of back pain relief and muscle pain relief.