TENS, EMS, IF, HVPC! Oh My! The DME Providers' Ultimate Guide

As a durable medical equipment (DME) provideror increasing range of motion or joint mobility,
you no doubt already know about the therapeuticprevention of venous thrombosis (blood clots due
benefits and the market demands for electricalto inactivity) immediately following surgery and for
therapy devices. You may even be aware of thegeneral muscle strengthening and toning.
various devices on the market and what purposeIF
each serves. But do you know how each deviceI.F. stands for Interferential. It crosses two slightly
works and why?different, medium-frequency alternating currents
Understanding the science behind the specificto create a third, much stronger and deeper sub
functions of each type of electro therapy devicefrequency current ideal for deep tissue stimulation.
will help you to choose the best solution for yourIt has both healing and pain relief benefits. Its
patients, which will improve the end user'sunique current is able to pass through skin, fat
experience, which will in turn lead to customerand bone-which are poor conductors of current
satisfaction, referrals and more sales.flow-to target the fluid inside the cells of the
So here we go, one by one:damaged area. It changes the fluid in such a way
TENSthat excess sodium ions are able to cross the
T.E.N.S. is an abbreviation for Transcutaneouscell's plasma membrane and be actively
Electrical Nerve Stimulation. Transcutaneoustransported out of the cell by activating the Na
(trans-kyoo-tey-nee-uh s) means "through, or byK+ pump which then controls the concentration
way of the skin." TENS sends electrical impulsesof sodium and potassium ion within the fluid that
via electrodes or conductive garments to occupysurrounds the cells. This occurrence forces
the nerve pathways with a more comfortabledisplaced fluid to exit the swollen cell which
sensation which overrides the pain. Moreeliminates edema. Inflammation is also reduced as
specifically, according to Wikipedia, the high andthe blood proteins that were trapped in the
low frequencies of TENS activate receptors in theextra-cellular fluid are removed when the sodium
spinal cord and the medulla. Further, highimbalance is corrected and oxygen flow increases
frequency TENS reduces excitation of centralto the cell. Oxygen removes bradykin (a blood
neurons that transmit nociceptive (pain)flow restrictor) and histamines (a chemical
information, reduces the release of excitatorysubstance involved in edema and inflammation)
neurotransmitters and increases the release ofthus speeding the cell's recovery. Oxygen also
inhibitory neurotransmitters (GABA) in the spinalremoves prostaglandin-a natural pain substance of
cord, and activates the main "end" receptorsthe body. To obtain IF frequency, electrode
centrally resulting in the blockage of pain. Lowplacement should be in an "X" pattern, with the
frequency TENS also releases serotonin andpoint of intersection located directly over the
activates serotonin receptors in the spinal cord,affected tissue area.
releases GABA, and activates the main endHVPG
receptors to reduce excitability of nociceptiveH.V.P.G. is an abbreviation for High-Voltage Pulsed
neurons in the spinal cord.Galvanic Current. Galvanic is another word for
EMSdirect current (DC). Unlike low-voltage, alternating
E.M.S. is an abbreviation for Electrical Musclecurrent (AC) that is found in TENS, EMS and IF,
Stimulation. Whereas TENS targets the nervesgalvanic is best suited for major tissue trauma
and is primarily for pain relief, EMS is more for aidincluding bleeding and swelling. It quickly increases
in healing via direct muscle stimulation. It sendsblood circulation while reducing edema. Like TENS,
electric impulses to elicit muscle contraction andit stimulates the nerves, which aids pain relief. It
relaxation by mimicking signals normally comingalso helps relax muscle spasms and is ideal for
from the central nervous system. Studies havediabetic-induced neuropathy. It is unique in its
shown EMS to be beneficial for the prevention ofapplication using a large dispersive pad which is
muscle edema and atrophy by increasing bloodplaced in a neutral area on the body to ground
circulation. Positive results have also been shownthe current while smaller "active" pads are placed
for the adaptation (training) of skeletal muscleover treatment area.
fibers, help in relaxing muscle spasms, maintaining