How to use a TENS units & EMS machines for sciatica & lumbago? Placement of electrode pads

Regardless of the type of activity you do, the back is a vitally important structure for the support and stability of the body's center of gravity, and for protecting the spinal cord through the vertebrae. However, a variety of factors such as lifestyle, poorly executed exercises or bad posture can alter its integrity.

For this reason, it is necessary to have available methods to treat the ailments caused by the various injuries that can be suffered in the back, especially in the lumbar region. This is where TENS and EMS electrotherapy units come in, which are very useful for treating the symptoms of lumbar injuries.

How to use TENS machines to relieve low back pain?

TENS units are relatively easy to use if you have the proper guidance. However, certain factors need to be taken into account in order to get the most out of each session. These are the location of the electrodes, and the current to be applied to the area.

Where to place the electrodes?

The location of the electrodes of the TENS machine will depend on the type of pain you are suffering from. In case of pain caused by overload of the lumbar muscles and nerves, the ideal position will be with the four electrodes on the lumbar frame, on each side of the spine, at the height of the L4 and L5 vertebrae, on the iliac crests.

Now, the positioning for pain caused by the sciatic nerve is more complex, since this can extend to the sole of the foot and generally only affects one side of the body, which is also a factor to consider for positioning.

The first two electrodes should be placed in the lumbar region at the level of the iliac crests, where the sciatic nerve branches into the legs, while the last two electrodes should be placed in a vertical orientation on the back of the affected leg, along the extension of the sciatic nerve, on the biceps femoris muscle, just below the buttock.

Which current to use?

The intensity to be applied for the treatment of low back sciatic pain will depend to a great extent on the time that has elapsed since the onset of the pain, since the optimum intensity is different for acute and chronic pain.

Acute pains are those with a lapse of less than three months, during which the optimal intensity to be applied may vary between 90 and 120 Hz, depending on the cause of the pain and the level of pain. Conditions such as herniated discs pressing on the sciatic nerve require an intensity of approximately 100 Hz, while nerve degeneration caused by other diseases may require a higher intensity in order to reduce the sensation of pain.

If the condition has lasted more than three months, it is considered chronic pain, which requires more frequent treatments at a much lower intensity, between 2 and 10 Hz, with this range varying if the patient has disabling pain. This frequency favors a slower but longer lasting release of endorphins that act as the body's natural painkillers, mitigating the sensation of pain for a longer period of time.

Best TENS units to treat low back pain

The use of TENS therapy for the treatment of low back pain and sciatica is well established due to its effectiveness in relieving the sensation of pain. This relief effect can be increased by using the right devices, which are listed below:

One of the best features of the Belifu electro stimulator is its 4 independent channels that allow you to individually treat different areas of the body with the different modes of use available. This electrotherapy machine has 24 programs and 30 intensity levels with different massage modes for pain relief and muscle stimulation.

The Belifu electric massager includes 10 reusable self-adhesive conductive pads and 5 sets of guide wires. The electrodes are coated with a layer of adhesive that gives them perfect adhesion to the skin, and with proper care, can withstand many uses before they need to be replaced.

The TENS 7000 has one of the most complete models of electrostimulator, which includes a wide variety of functions and accessories. It is a digital unit that combines TENS and EMS technologies together with an innovative dual channel function that allows you to apply these electrostimulation modalities on different parts of the body simultaneously.

The TENS 7000 muscle stimulator includes one of the most complete electrical stimulation therapy packages you will find. It includes 1 TENS 7000 unit, 2 guide cables, 4 packs of reusable pads, 1 9-volt battery, 1 instruction manual and a hard case to carry your electrostimulation equipment wherever you want.

The Etekcity massage unit offers one of the most comprehensive pain relief experiences you will find in a device of this type, with an innovative 4-channel function that allows you to apply different types of massage to individual areas of the body, increasing the effectiveness of electrostimulation therapy and delivering far superior results.

All its modes of use are FSA and HSA approved, making it completely safe for anyone to use. It can be operated and set up very easily. The package includes reusable electrodes coated with adhesive gel in 3 sizes: 2 units of 2x4 inches, 4 units of 2x2 inches and 2 units of 1.5x1.5 inches.

Spacerest offers its users its newest model of electro stimulator that combines TENS and EMS technologies in a dynamic and compact device that includes 24 reusable electrodes of excellent quality and an incredible 4-channel function that will allow you to apply different modes of use to 4 different areas of the body, or even to 4 different people.

It has an incredibly portable size that will allow you to take it anywhere, and a high-powered rechargeable battery that will give you up to 20 hours of continuous use. It can be connected to AC power through its AC adapter, or to an external battery or laptop through its USB charging port.

The Med-Fit model BAL-906ª is a very complete rechargeable electrostimulation device of premium quality that has an incredible function of 4 individual channels that will give you a great coverage and a perfect effectiveness when applying different electrical massages simultaneously. It also has a large LCD screen that makes it especially easy to operate, so you can program your sessions with great ease.

It has 24 clinically proven massage programs, which are divided into 12 TENS therapy programs and 12 muscle stimulation training modes. It has a long-life rechargeable lithium battery that will give you a great autonomy of several hours of continuous use, eliminating the extra cost of buying replacement cylindrical batteries.

How to use EMS to strengthen muscles and prevent low back damage?

Although EMS is not intended for the treatment of symptoms of sciatic nerve injuries, it is possible to take advantage of its use on the muscles of the lower back to improve back stability and prevent future injuries

Where to place the electrodes?

Unlike other areas of the body, the positioning of electrodes for lower back training is relatively simple, since the main location of the pads is the lumbar frame.

In this region, the electrodes should be positioned in pairs on each side of the spine, at the boundary between the thoracolumbar fascia and the erector spinae muscle, in order for the electrical impulses to cover both muscle groups.

What intensity to use?

The lower back muscles require a relatively low level of current compared to other muscles, since their strengthening does not require too intense a stimulus.

In the specific case of the erector spinae, oblique muscles and thoracolumbar fascia, the recommended intensity ranges from 60 to 85 Hz, depending on the individual's level of conditioning. Lower frequencies are usually applied in 60-second bursts to begin muscle adaptation to the contractions.

Subsequently, the intensity and frequency of the pulses can be increased as the user adapts.

Best EMS machines to prevent sciatica and low back pain

Conditioning the muscles of the lower back is especially important to protect the area from overuse injuries. To do this, it is necessary to make use of the appropriate machines. Among these we can highlight the following:

Compex presents the Muscle Massage Kit that includes the versatile Compex Edge 2.0 electrostimulator, which is presented as one of the most effective options to complement physical training, thanks to its 4 programs of use, 2 for strength training, 1 for recovery, and 1 TENS massage mode, which will allow you to increase the strength and endurance of your muscles, while reducing the ailments caused by fatigue.

The package includes 12 clip-type electrodes, 4 guide wires, built-in battery and a dust-proof bag so you can take your electrostimulation device with you wherever you go. Its training modes will allow you to increase your endurance and explosive strength, while the recovery modes will allow you to expel lactic acid and reduce aches and pains caused by post-workout exhaustion.

The Quad Stim portable electrostimulation unit is one of the most versatile devices you will find on the market. It seamlessly combines TENS and EMS electrostimulation technologies, as well as a 4-channel function that maximizes the results of your workouts and therapies by allowing you to apply different types of massage to various parts of the body at the same time.

It has 8 customizable massage modes, which are divided into 5 TENS therapy modes, and 3 EMS stimulation modes, which together with its pulse rate adjustment function, make it one of the most versatile electrostimulation machines you can find. It works with 4 cylindrical AA batteries that give the device great portability and allow you to take it wherever you want.

The Belice brand has one of the most powerful and versatile electrostimulation units available on the market, which comes in a package with everything you may need to apply a successful electro massage therapy, from the reusable pads to a travel bag to take your device with you wherever you go.

It has 24 modes of use and 30 intensity levels that you can program individually on each of its 4 channels, so you can apply them to different parts of the body, or even different people, simultaneously. Its high-powered battery will allow you to apply electrostimulation for 20 continuous hours, and is fully rechargeable through the current or from a USB charger.

From the FEIHAI brand, you have at your disposal one of the most complete electric massage machines on the market, thanks to its large number of functions. Among these are its 20 predefined massage modes that will allow you to relieve any type of muscle ailment, and its 4-channel function through which you can apply different massages on various parts of the body at the same time.

It has 20 modes of use and 40 adjustable intensity levels, as well as a time controller that allows you to adjust the therapy sessions according to your needs. Its compact size makes it incredibly discreet, so you can take it to the office, on a trip, on the street or wherever you like.

The Laspi brand of products has an electrostimulation machine designed to maximize the results of your workouts through a complete massage therapy provided by TENS and EMS technologies, which will allow you to combat acute and chronic ailments, as well as increase the results of your exercises by stimulating muscle growth.

It has a function of 4 individual channels that will allow you to apply different massage programs in various areas of the body, in addition to 3 programs that together give you more than 20 options between TENS, EMS and recovery massages, 40 levels of intensity and time control function that will allow you to define the duration of each session.

Video: How to place electrodes pads on the back?

Electrodes for back

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What is sciatica or lumbago and what are the causes?

Sciatica is a term that refers to a pain that covers the area that runs along the sciatic nerve, from the lower back, through the buttocks and ending in the legs. Usually, it is an ailment that affects only one side of the body.

The main cause of sciatica occurs due to the pinching of the sciatic nerve, which can be caused by factors such as those described below:

• Herniated disc: a herniated disc in the lower back can put pressure on the sciatic nerve, causing pain and numbness.
• Bone overgrowth: Bone spurs are very common in the spine, and can cause low back pain when they come in contact with the sciatic nerve.
• Tumors: on rare occasions, a tumor may appear in the lumbar area and produce a pinching of the sciatic nerve, causing pain.
• Nerve damage: certain diseases such as diabetes can cause damage to the sciatic nerve and generate a sensation of pain that can last for a long time.

What are the most common types of back injuries?

Throughout our lives, there are an enormous number of factors that can alter the condition of the back in its entirety. However, one of the most vulnerable areas is the lumbar area, which can be affected in the long term by poor standing position or heavy lifting, among many other factors.

These situations can cause a wide variety of diseases and ailments, among which the following stand out:

• Low back pain: is a pain located in the lower back that is highly related to the muscle and bone structure of the spine, can cause stiffness, difficulty of movement and pain of varying intensity. Its main causes are muscular overload, degeneration of the intervertebral disc and alterations of the vertebral structure, among others.
• Scoliosis: consists of a lateral deviation of the spine that can cause disparity of the hip, scapula or shoulders, muscle contractures and generalized pain in the back. It may present as a congenital condition or as a neuromuscular disorder.
• Herniated lumbar disc: A herniated disc is caused by wear and tear of the intervertebral discs that cushion the collision of the vertebrae during movement causing symptoms such as pain, numbness, tingling and weakness. Factors such as age, weight and genetics can increase the possibility of suffering from herniated discs.
• Impingement: Impingement low back pain occurs when there is acute compression of the sciatic nerve by adjacent tissue. It can produce numbness, weakness, stiffness and severe pain. This condition is caused by overuse, accidents, sedentary lifestyle or osteoarthritis, among other causes.
• Arthrosis: it is produced by the degeneration of the cartilaginous tissue of the lumbar area of the spine. This degeneration produces limited mobility, stiffness and acute pain. It may be caused by a combination of environmental and genetic factors, or by trauma, infection or congenital malformation.
• Sciatica: it is a generally unilateral pain that is produced by pressure, pinching or degeneration of the sciatic nerve, it can cause variable pain and extend from the lumbar area to the leg.

Differences between TENS and EMS: Which is better for treating sciatica and low back pain?

TENS and EMS electrostimulation therapies are widely used in the field of physiotherapy due to their effectiveness in their respective areas. Although both work with electrical impulses, these are programmed with different intensities and frequencies, giving both therapies unique characteristics and functions.

To begin with, transcutaneous electrical nerve stimulation (TENS) is a therapy oriented to the treatment of pain that is defined by the following characteristics:

• It uses low intensity electrical impulses, between 1 and 250 Hz.
• It numbs the nerve endings of the sciatic nerve and the terminal branches of the lumbar nerves, thus attenuating the sensation of pain and generating relief in the patient.
• It is used only for the treatment of symptoms of injuries and diseases. It is not a method to cure injuries.

EMS or Electro Muscular Stimulation, on the other hand, is a physical conditioning and rehabilitation method used in physiotherapy and high competition sports, which has the following characteristics:

• The intensity of its discharges varies between 70 and 150 Hz.
• It is used in muscle training and conditioning.
• It increases the strength, resistance and elasticity of the muscles by means of contractions caused by electrical impulses.
• It is not recommended for the treatment of painful injuries.

The best therapy to treat pain caused by alterations in the sciatic nerve is TENS stimulation therapy, since its frequency exerts an effect on the sciatic nerve endings and the ramifications of the lumbar spinal nerve that innervates part of the quadratus lumborum muscle, the iliopsoas muscle and the obturator externus. This effect is the release of endorphins and the suppression of the cells that produce pain, causing a feeling of relief in the patient.

On the other hand, EMS therapy is contraindicated for the treatment of sciatic nerve pain, since the muscle contractions caused by its electrical discharges can increase pain in the affected area and produce other adverse results.

Contraindications in the use of electrodes and electrotherapy