Types of Electrical Stimulation Used in Physical Therapy

Different types of electrical stimulation (e-stim) can be used in physical therapy. These therapeutic treatments can decrease pain and inflammation, improve circulation, and help your muscles contract properly.

The various types include:

  • Transcutaneous electrical nerve stimulation (TENS)
  • Russian stimulation
  • Neuromuscular electrical stimulation (NMES)
  • Inferential current (IFC) electrical stimulation
  • High voltage electrical stimulation
  • Iontophoresis

Electrical stimulation often is used to augment your physical therapy program after an injury or illness. It should not be the only treatment you receive when attending physical therapy.

This article lists the types of electrical stimulation to help you understand how it's commonly used in physical therapy. Be sure to ask your physical therapist about your specific needs and gains that are expected when you use electrical stimulation in the physical therapy clinic.

1

TENS

Pain therapy with TENS
Stefan Rupp / Getty Images

Transcutaneous electrical nerve stimulation (TENS) is a type of electrical stimulation used to help decrease acute and chronic pain. TENS works by altering or interrupting the painful signals that travel from injured tissues to your brain. It is performed by placing electrodes over the painful part of your body and using electricity to alter pain signals to your brain.

2

Russian Stimulation

Russian stimulation is a form of high-frequency electrical wave stimulation that uses electricity to contract muscle tissue. After injury or surgery, you may be experiencing muscle weakness. Often, muscles are inhibited after an injury and are unable to generate a forceful contraction. Russian stimulation is used to help improve the contraction of your muscles.

3

Neuromuscular Electrical Stimulation

Neuromuscular electrical stimulation (NMES) is used much like Russian stimulation. Your physical therapist may use NMES to help your muscles contract properly after injury or surgery. This form of muscular re-education can be useful in helping you return to normal function quickly after an injury or surgery.

NMES can also be used to help you perform functional tasks. Small switches in the unit can be applied to your body that control when the stimulation is on or off. When performing a task, like walking, the switch may turn the stimulation on when your leg muscles are supposed to contract, and then turn it off when they are meant to rest.

4

Interferential Current (IFC)

Inferential current (IFC) electrical stimulation is a type of electrical stimulation that your physical therapist may use to help decrease your pain and improve circulation to injured tissues. The IFC works much like TENS, but the current can be easily moved and varied to target your most painful area of injury.

5

High Voltage Stimulation

High voltage electrical stimulation is a type of electrical stimulation that your physical therapist may use to help decrease your pain or improve circulation. It is also occasionally used to help with wound healing. It is thought that the high voltage stimulation helps to change the type of cells near your wound, and this can speed healing.

6

Iontophoresis

Iontophoresis is a type of electrical stimulation used to administer medication into your body through your skin. The medication, such as dexamethasone, can be used to help decrease inflammation, decrease localized swelling, or decrease muscle spasm. Some medication used in iontophoresis can also help to decrease calcium deposits and can be used to help manage scar tissue.

Summary

Electrical stimulation therapy can be a useful tool to augment your rehab program. Different types of e-stim can be used to help your muscles contract properly after injury or surgery, reduce pain, improve circulation, or administer certain medications through the skin.

If your PT recommends you use electrical stimulation in your therapy program, be sure to ask questions and understand what the goal of the stim use is. And always make sure you have an active, self-care exercise program in place to take control of your rehab program.

6 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Jin HK, Hwang TY, Cho SH. Effect of electrical stimulation on blood flow velocity and vessel size. Open Med (Wars). 2017;12:5-11. doi:10.1515/med-2017-0002

  2. Vance CG, Dailey DL, Rakel BA, Sluka KA. Using TENS for pain control: the state of the evidence. Pain Manag. 2014;4(3):197-209. doi:10.2217/pmt.14.13

  3. Wang TJ, Sung K, Wilburn M, Allbright J. Russian stimulation/functional electrical stimulation in the treatment of foot drop resulting from lumbar radiculopathy: a case seriesInnov Clin Neurosci. 2019;16(5-6):46-49.

  4. Hauger AV, Reiman MP, Bjordal JM, Sheets C, Ledbetter L, Goode AP. Neuromuscular electrical stimulation is effective in strengthening the quadriceps muscle after anterior cruciate ligament surgery. Knee Surg Sports Traumatol Arthrosc. 2018;26(2):399-410. doi:10.1007/s00167-017-4669-5

  5. Rampazo ÉP, Liebano RE. Analgesic effects of interferential current therapy: a narrative reviewMedicina. 2022;58(1):141. doi:10.3390/medicina58010141

  6. Brown CD, Lauber CA, Cappaert T. The effect of dexamethasone iontophoresis on decreasing pain and improving function in patients with musculoskeletal conditions. J Sport Rehabil. 2015;24(3):327-31. doi:10.1123/jsr.2014-0172

Additional Reading
  • Prentice, W. (1998). Therapeutic modalities for allied health professionals. New York: McGraw-Hill.

By Brett Sears, PT
Brett Sears, PT, MDT, is a physical therapist with over 20 years of experience in orthopedic and hospital-based therapy.