Electrotherapy Evaluation Checklist

Electrotherapy commonly refers to ultrasound, Interferential Current (IC), Functional Electrical Stimulation (FES), Transcutaneous Electrical Nerve Stimulation (TENS), Transcutaneous Spinal Electroanalgesia (TSE), Spinal Cord Stimulation (SCS), Electroacupuncture (EA), Percutaneous Electrical Nerve Stimulation (PENS) and Pulsed Shortwave Diathermy (PSWD). Before initiating electrotherapy treatment, there are several conditions that should be evaluated either because they are contraindicated or because treatment should be used with caution.

Pregnancy

• Pregnant women should avoid electrotherapy to the abdomen or pelvis.

  Use of electrotherapy during pregnancy is generally contraindicated. Some electrotherapists prefer not to use it at all, although TENS is sometimes used during labor, and some simply don't apply electrotherapy in the region of the fetus--around the lower back, abdomen and pelvis. Either way, it is important to ask the patient whether or not she is pregnant.

Implants

• Some people, especially the elderly, may have pacemakers.

  In the presence of certain metal implants, especially pacemakers, electrotherapy is contraindicated. Some therapists may still use electrotherapy when the patient has certain metal implants, but those with pacemakers should avoid all electrical stimulation and shortwave and microwave treatments, as these may interfere with the pacemaker.

Epilepsy

• Caution is needed when dealing with patients with epilepsy.

  Although some patients with epilepsy are fine when treated with electrotherapy, there are reports of people reacting badly to electrical stimulation if they do have some form of epilepsy. Caution is advised if the patient has ever had any form of epilepsy, even if it is now under control--but especially if the epilepsy is active.

Cancer

• Those with a history of malignancy should use electrotherapy with caution.

  There is controversy regarding the use of electrotherapy in the presence of cancer, even with patients who have a history of cancer. However, unless the cancer is active and current, it may be possible to use electrotherapy with the patient. Caution should be taken, however, not to stimulate malignant tumors or areas of possible malignancy.

Skin Injuries

• Electrotherapy should be avoided when bleeding is present.

  Electrotherapy should be avoided if the patient is currently bleeding, as it can increase blood flow; this is especially important if the patient is suffering from hemophilia. Also take note of skin conditions such as open sores that might be a contraindication.