July 10 2018
Joints can crack naturally or from manipulation—but is this cracking doing more harm than good?
If you’ve ever been hooked up with electrodes that make your muscles twitch, chances are the treatment occurred in a physical therapist’s office. But recently, small stimulation machines that deliver an electrical current, often called e-stim for short, are becoming commonplace at event expos, health fairs and sporting goods retailers—with home use as the goal.
We’ve seen a proliferation of these devices, but we were curious…do they really work? If so, how does a runner know if she needs one? We turned to a couple of experts: NYC-based pain specialist Dr. Febin Melepura and San Diego physical therapist Chelsea Best to get some answers.
They deliver electrical stimulation, which can reduce pain and increase blood flow, but how much of a difference they make varies based on the situation. There are two ways they tend to work: You may see NMES (neuromuscular electrical stimulation) or EMS (electrical muscle stimulation), which means the therapy is designed to stimulate motor neurons—“the nerves that control the muscle,” Dr. Melepura explains. Whereas TENS (transcutaneous electrical nerve stimulation) units are designed to stimulate sensory neurons, aka “the nerves that transmit the pain.” Physical therapist Best explains the former (NMES/EMS) is intended for “someone having trouble contracting the muscle itself.” For example, after a knee injury, it could help prevent atrophy in your quad muscle. TENS, on the other hand, is used only to reduce pain.
“While there are many electrotherapy devices available, their basic function is the same,” Dr. Melepura says, as is their efficacy. “Some stimulators are simplified and have preset stimulation settings (frequency, amplitude and duration) for different body parts. The user just pushes a button that corresponds to the part of the body that they want treatment for.” Best says the in-office machines may have more potential settings—but a simple device, even one that only offers TENS, is suitable for most people for home use.
“People do tend to self-medicate,” Best says. “If you read the directions and you understand what’s going on, they can definitely be very beneficial. In our practice, it’s commonly used as a modality at the end of [one day’s] treatment, because a lot of times people have increased pain, and it calms everything down so that they feel better.” For in-office patients who say e-stim is particularly beneficial, she has recommended a home unit.
It’s up to the individual, but Dr. Melepura says, “The best initial treatment is rest, applying ice or cold compresses and elevating the injured body part. Some injuries will need additional treatment, so if the pain persists for a week to 10 days, individuals should seek the care of a physician who will be able to recommend if electrotherapy is appropriate.”
Yes. Since you can crank up the electrical stimulation on your own, Best says, “You want it to be a moderate feeling but not painful or uncomfortable.” She also suggests treatment for 15 to 20 minutes at a time, and you can use ice with it to help reduce inflammation.
We found a lot of different machines, so here are three questions to ponder:
Dr. Melepura offers these tips.