People who experience mobility issues, muscle pain or spasms and related conditions may benefit from a variety of physical therapy treatments, including electrical stimulation, also known as e-stim.

Understanding How E-Stim Works

Generally , e-stim treatments mimic the way the brain sends signals through the body to stimulate muscles and nerves in order to improve their function, reduce pain or both. Electrical stimulation can be administered through a variety of techniques.

The most common types of e-stim therapy include:

  • Transcutaenous electrical nerve stimulation (TENS). One of the most common forms of e-stim, a TENS unit uses strategically placed electrodes to send signals that disrupt the brain’s response to pain.
  • Electrical muscle stimulation (EMS). While similar to a TENS unit, this device uses a stronger current to help improve muscle strength and function.
  • Interferential current (IFC). The goal of using this device is to reduce pain by stimulating nerve response.
  • Neuromuscular electrical stimulation (NMES). This aim of this device is to lessen the occurrence of muscle spasms and atrophy in addition to improving function and strength.
  • Electrical stimulation for tissue repair (ESTR). This device improves circulation and reduces swelling, which can help wounds heal faster.
  • Spinal cord stimulation (SCS). This e-stim device works as an implant that helps relieve neuropathic pain.
  • Functional electrical stimulation (FES). This device targets certain types of paralyzed muscles to help regain limited use of those muscles in patients who have suffered a back injury, stroke or other neurological injuries.

Certain types of e-stim devices are better for some conditions than others. Your doctor or physical therapist can help you determine which e-stim device will be effective for your needs.

Conditions Commonly Treated with E-Stim

E-stim treatments are used to treat many different conditions that arise from injury, illness or hereditary causes. Some types of e-stim units treat muscles or nerves through centralized placement or they may be used on more targeted areas depending on the type of unit and the type of condition being treated.

The following conditions may benefit from e-stim therapy:

  • Difficulty swallowing, other muscle weaknesses
  • Improving bladder control related to urinary incontinence
  • Recovery from surgery, stroke, cancer or tissue trauma and injury
  • Joint, muscle or nerve pain caused by inflammation, arthritis or fibromyalgia
  • Back pain, including spinal cord injuries

Medicare Coverage for E-Stim

Medicare benefits for services that fall under Part A or Part B services do not typically provide coverage for e-stim therapy as a stand-alone procedure. If a specialist uses e-stim therapy during the course of other approved services and does not bill Medicare for the e-stim therapy alone, recipients may not face additional out-of-pocket expenses beyond their normal cost-sharing obligations.

Medicare Advantage plans may provide more inclusive coverage rules for e-stim therapies, but these rules are determined by private insurers who are contracted to offer these Medicare benefits and enhancements. This coverage may also be limited to qualifying conditions and your doctor may need to provide documentation of this condition in addition to showing evidence that other treatments are not successful. Establishing medical necessity for e-stim therapy may be a common prerequisite for many different types of therapies and treatments.

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