Electrotherapy: TENS, EMS and muscle stimulation

Current through electrodes, with different goals

Electrotherapy is an umbrella term. A programme that makes a muscle contract has a different purpose from one aimed at pain perception. Ask which form is used and why it fits the treatment plan.

A visible contraction is not a complete strength-training programme. Discuss how the application relates to your own activities and the function you want to regain.

TENS, EMS and NMES explained

TENS means transcutaneous electrical nerve stimulation. EMS means electrical muscle stimulation. NMES means neuromuscular electrical stimulation and is used for a defined muscle-activation goal.

These terms describe functions, not automatic doses. Current waveform, electrodes and settings determine the application. The number of programmes does not prove added value for every complaint.

Stimsix 2 and Combisix UE

Sixtus Italia describes Stimsix 2 as a two-channel stimulator with manual, preset and customisable programmes. Combisix UE combines two-channel electrotherapy and ultrasound at 1, 2 and 3 MHz.

A combined system may affect practice setup. Check the accessories and documentation for each intended function. See the Sixtus equipment overview and request the offered set’s specification.

Pain modulation is not a general recovery promise

A change in pain perception does not necessarily resolve the underlying problem. NICE does not recommend TENS or NMES for osteoarthritis because evidence of benefit is insufficient. This recommendation concerns osteoarthritis; assess other applications separately.

Agree whether the intended outcome concerns pain, targeted contraction or function, and when the application’s added value will be reviewed.

Electrodes, skin and implants

Electrode placement and skin checks are part of safe use. Report electronic implants, altered sensation and skin problems. Instructions differ by device and application; a generic placement diagram is not personal guidance.

If home use is proposed, obtain specific instructions. Demonstrate that you understand the prescribed components and settings and when to contact the clinician. The safe-use guide helps organise these arrangements.

Making a clear choice

Patients should first establish the purpose. A practice must also decide who manages the equipment, how electrodes and cables are checked, and how training is recorded.

Compare required waveforms and accessories with the actual patient population. An extensive menu matters only when relevant functions are used competently and their effect is reviewed.