By Mandi Blackwelder, DVM CCRP
What is electrostimulation?
Electrostimulation is using an electrical impulse to a nerve within a muscle to help decrease pain, increase muscle strength, or both.
Hang on a minute…..I’m picturing Frankenstein stuff…..
When delivered appropriately and with proper training, electrostimulation should be ONLY a positive experience, particularly in our pets who can’t understand why we would do something painful even if it was helpful. Stimulation devices all have multiple properties which can be adjusted to get the desired effect without discomfort.
Types of electrostimulation:
- Neuromuscular Electrostimulation (NMES)
- Transcutaneous Electrical Nerve Stimulation (TENS)
Neuromuscular Electrostimulation (NMES):
Who? Patients needing help with muscle contractions, usually with nerve damage. Examples are dogs with back fractures, slipped discs or nerve damage in a forelimb
What happens? Electrodes (which are the little gel stick pads that you think of for a heart monitor) are attached to the skin. The hair must be shaved or the contact is incomplete and then it hurts. The pads are applied over motor points. A motor point is the area inside the muscle where the nerve triggers the muscles to contract. The machine is set and turned on. It is then adjusted to assure there is no discomfort and so that the muscles contracts (the leg moves) for a short period of time and then releases for rest. As the patient improves, longer periods can be used so the muscle gets stronger.
Why? Since the patients cannot use the muscle by themselves due to paralysis or nerve damage, we are creating muscle contractions for them. It is not the exactly same muscle use as weight bearing, but when the dog or cat is able to get back on their paws, they have some muscles to use and are not standing on jello. Ultimately, progress to function is much faster.
Transcutaneous Electrical Nerve Stimulation (TENS)
Who? Patients with painful muscle spasms or tightly contracted muscles from compensating for another injury.
Here the hair is shaved and electrodes attached as in NMES. In TENS however, the electrode is placed over a trigger point. A trigger point is a point in a muscle that hurts when it is touched. These are the points we instinctively rub on ourselves when we have an ache. The machine is set and turned on, then adjusted for comfort. Generally a gentle pulsing is most comfortable for the pet.
Trigger points are tight balls of muscle fibers that due to pain, cannot let the contraction go completely. We usually say “I have a ‘knot’ in my neck.” The pulsing confuses the pain nerves which allows the muscle point to release, creating pain relief. This modality is not commonly used in pets, as trigger points can be painful until they release. These patients must be chosen carefully and their discomfort respected.
Who? Patients with musculoskeletal disease, neurological damage or pain.
What happens? Acupuncture needles are placed at appropriate points (learn more). Then electrode clips are attached to the needles. My clients often call these “jumper cables” as that is what they look like. The machine is turned on and slowly increased in intensity until the pet licks his lips or turns his head. This means he feels it. Then they are watched closely for comfort and turned down if they are panting or otherwise uncomfortable.
Why? The needles are a copper conductor that allows the electrical signal to penetrate better into the acupuncture point. Paralyzed patients and dogs with neuromuscular disorders seem to respond nicely to this technique. Electroacupuncture leaves a longer lasting or more complete effect than acupuncture alone for most patients. However, it should be used with caution. Some animals are sensitive to acupuncture in general, can appear quite relaxed at the treatment, but then are “wiped out” then next day or two.
Overall, electrical modalities are used to help the “boost” the nervous system’s conduction of signals for the betterment pain management or muscle strengthening.