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9 percutaneous electrical nerve stimulation

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9 pens

  1. 1. DR. SUBHANJAN DAS, PT Subhanjan_82@yahoo.com +91 8967549104 Dry Needling Instructor MPT (Musculoskeletal & Sports) Assoc. Prof., BIMLS, Burdwan
  2. 2. Also in the series  http://www.slideshare.net/SubhanjanDas/introduction-to-dry-needling  http://www.slideshare.net/SubhanjanDas/2-brief-hisory-of-needling  http://www.slideshare.net/SubhanjanDas/3-superficial-dry-needling  http://www.slideshare.net/SubhanjanDas/4-indications-of-dry-needling  http://www.slideshare.net/SubhanjanDas/6-dangers-of-dry-needling  http://www.slideshare.net/SubhanjanDas/7-physiologic-background-of-dry- needling  http://www.slideshare.net/SubhanjanDas/8-dn-vs-acupuncture  http://www.slideshare.net/SubhanjanDas/9-electroacupuncture  http://www.slideshare.net/SubhanjanDas/10-legalities-involved-in-dry-needling
  3. 3.  One of the advantages of DN is that physical therapists can easily combine the needling procedures with electrical stimulation.  Several terms have been used to describe electrical stimulation through dry needling, including percutaneous electrical nerve stimulation (PENS), percutaneous electrical muscle stimulation, percutaneous neuromodulation therapy, and electroacupuncture (EA)
  4. 4.  Electrical stimulation via needle is almost exclusively given for pain relief.  Using the needles as electrodes offers many advantages over more traditional transcutaneous nerve stimulation (TENS)
  5. 5. Advantage skin impedence is bypassed Current is directly delivered to exact location of pain Both A delta and A beta system is engaged,giving better analgesia several studies have also demonstrated that PENS provided more pain relief and improved functionality than TENS.
  6. 6. parameters Frequencies between 2 and 4 Hz with high intensity are commonly used in nociceptive pain conditions and may result in the release of endorphins and enkephalins. For neuropathic pain, it is recommended to use currents with a frequency between 80 and 100 Hz, which are thought to affect release of dynorphin, GABA, and galanin
  7. 7. Electrode placement Many conventions exist.  the negative electrode is usually placed in the MTrP and the positive in the taut band but outside the MTrP  Elorriaga recommended inserting two converging electrodes in the MTrP, while Mayoral del Moral et al suggested inserting the electrodes at both sides of an MTrP inside the taut band
  8. 8. Equipment  Specific electroacupuncture machines are available.  A standard battery operated machine can be used with add on crocodile electrode  Chu developed an electrical stimulation modality that automatically elicits LTRs, which she referred to as “electrical twitch-obtaining intramuscular stimulation” or ETOIMS
  9. 9. Precaution  Strong responder  Voltage fluctuation

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