Apparently there is no evidence that electrotherapy does work and I do not use a lot of it anyhow since I found as many others that in general we have a lot of options which give better or faster results.
Having said this I think we all have to understand that we all have our preferances on how to address problems and that for some of us it does work(allthough there is no evidence) I think the reason for it is far more complicated.
One of the modalities, I suppose, the majority of physios do use (now and then) is TENS. We have low TENS and high TENS which ought to stimulate different nerves with different responses (central pain reduction 2-4HZ and perifical pain reduction 100-120HZ) I personaly found that a stimulation of 70HZ and wave amplitude height (mju) of 150 works in many cases far better. Why? it is not supported by theories of conduction (none sheeted nerves versus sheeted). What happens is in principle that a patient feels something is going on and may respond possitive on stimulus. This could well be placebo.
A problem arises here, because how are we going to find out if it is placebo? When looking at the way medication is researched it becomes obvious we are unable to do the same: We cannot give a placebo treatment (no sugarlumps available I am afraid) because as soon as we talk, explain what we are doing and why we influence already the brain (Pain is in the brain!) then the next step is physical assessment and treatment which will give the body a stimulus anyhow. (with acupuncture one could use the handle of a needle or a toothpick and this stimulates as well).
So it seems to me very tricky to say what is placebo and what is not. I read e.g. 2 researches which seemed at the tme sound on the use of short wave for arthrosis of the knee. one claimed a succes rate of 10% the other 90% with more or less the same set up of the machines. 10% was though someone rather sceptical about short wave the other not.
And here lies actualy the problem: do you believe as a therapist what you are doing or do you just do someting?
THere is only, to my opinion, one way out of this mess and to review how research is performed within physiotherapy. It seems to me far better to set up some form of date base where as many physiotherapists put in what they do and why(recepies like in a cooking book) and the results because only then we can exclude the influence on the brain of the patient by the therapist as well as we might be able to understand better how it works.
As many of my colleagues pointed out why do you want to use electrotherapy while there is no evidence to support this choice I would like to respond (note I am not keen on electrotherapy) why do you use mobilisations manipulations and exercises? (as I do as well)? Is there sufficient evidence to support your choice?(on mobilisations there is a dought as well on the effectiveness and it can even be dangerous in some cases (Spinal stroke).
Get the cooking guide ready!