Professional Documents
Culture Documents
Contraindications
There has been on ongoing controversy over the various and diverse contraindication for electrotherapy modalities over recent
years. Many of the widely held beliefs in this area have been challenged in that there appears to be little by way of 'concrete
evidence' for many and a lot of anecdotal evidence and supposition about some of the others. If you look in a selection of the
major texts, they tend to provide a 'sircular reference list' in that they all X refer to each other without getting to grips with the
original work.
A group, under the auspices of the Chartered Society of Physiotherapy in the UK have spent some time working through as
much of the original evidence as we could find in order to establish what actually is and what is not a contraindication for the
most commonly employed modalities. A group in Aurstralia have undertaken a similar exercise.
The CONTRAINDICATION GRID is probably the most useful quick reference guide, and although I used to have it up on the
web page, it seems like this new format really does not like large tables, so have given up trying to reproduce it here for the
moment. It is still available as a download file (.pdf - good for printing if you want a copy for the department / clinic).
The information below is a summary of the CSP group outcomes (published in October 2006) - contact the CSP (www.csp.org.
uk)or sue.finley@heartofengland.nhs.uk if you want a copy - which is fully referenced. For copyright reasons, I can't reproduce
it is full here.
I have a lot of additional material; that I am trying to pull together to explain some of the commonly held misconceptions with
regards the contraindications, precautions and dangers relating to electrophysical agents, but in the meantime, the grid that
follows will provide a quick and easy summary about the key issues.
NOTES :
Where there is no entry in the grid below, it means that there is no known / demonstrated detrimental effect
Where an entry relates to a 'LOCAL CI' in relates to whether the applied energy would reach the tissue in question
The current issues regarding the use of TENS during pregnancy is dealt with in some considerable detail in a specific TENS
During Pregnancy document which can be obtained from the download page.
Laser
Wax Biofeedback
TENS
Shortwave (Continuous / Pulsed - Thermal) Cold Therapy
Interferential
Ultrasound (continuous / Thermal) Ultra Violet Radiation
Pregnancy (general)
Epilepsy
Malignancy
CI Devitalised Tissues PREAUTION
Metal Implant
Sharp/Blunt Skin Tests
Pregnancy (general)
CI Epilepsy
Malignancy
CI Devitalised Tissues PREAUTION
Specialised Tissues
EYE, TESTIS Active Epiphysis LOCAL CI
Metal Implant
PRECAUTION Sharp/Blunt Skin Tests
Laser Therapy
Pregnancy (general)
Epilepsy
Malignancy
LOCAL CI Devitalised Tissues PREAUTION
Specialised Tissues
EYE, TESTIS Active Epiphysis LOCAL CI
Tissue Bleeding
CI Thermal Skin Test
Metal Implant
PRECAUTION Sharp/Blunt Skin Tests
Electrical Stimulation
TENS
Pregnancy (general)
Epilepsy CI NECK
Malignancy
LOCAL CI Devitalised Tissues PREAUTION
Tissue Bleeding
CI Thermal Skin Test
Metal Implant
Sharp/Blunt Skin Tests YES
Interferential
Pregnancy (general)
Epilepsy CI NECK
Malignancy
LOCAL CI Devitalised Tissues PREAUTION
Tissue Bleeding
CI Thermal Skin Test
Metal Implant
Sharp/Blunt Skin Tests YES
Pregnancy (general)
Epilepsy CI NECK
Malignancy
LOCAL CI Devitalised Tissues PREAUTION
Tissue Bleeding
CI Thermal Skin Test
Metal Implant
Sharp/Blunt Skin Tests YES
Heat
Infra Red
Pregnancy (general)
Epilepsy
Malignancy
LOCAL CI Devitalised Tissues PREAUTION
Specialised Tissues
EYE Active Epiphysis
Tissue Bleeding
CI Thermal Skin Test YES
Metal Implant
Sharp/Blunt Skin Tests
Wax
Pregnancy (general)
Epilepsy
Malignancy
LOCAL CI Devitalised Tissues PREAUTION
Specialised Tissues
EYE Active Epiphysis
Tissue Bleeding
CI Thermal Skin Test YES
Metal Implant
Sharp/Blunt Skin Tests
Pregnancy (general)
CI Epilepsy
Malignancy
LOCAL CI Devitalised Tissues PREAUTION
Tissue Bleeding
CI Thermal Skin Test YES
Metal Implant
CI Sharp/Blunt Skin Tests
Pregnancy (general)
Epilepsy
Malignancy
LOCAL CI Devitalised Tissues PREAUTION
Tissue Bleeding
CI Thermal Skin Test YES
Metal Implant
CI LOCAL Sharp/Blunt Skin Tests
Microwave
Pregnancy (general)
CI Epilepsy
Malignancy
LOCAL CI Devitalised Tissues PREAUTION
Tissue Bleeding
CI Thermal Skin Test YES
Metal Implant
CI Sharp/Blunt Skin Tests
Hot Pack
Pregnancy (general)
Epilepsy
Malignancy
LOCAL CI Devitalised Tissues PREAUTION
Specialised Tissues
EYE Active Epiphysis LOCAL CI
Tissue Bleeding
CI Thermal Skin Test YES
Metal Implant
PRECAUTION Sharp/Blunt Skin Tests
Others
CAUTION WITH
Pregnancy (general) Epilepsy VISUAL FEEDBACK
MODES
Malignancy
Devitalised Tissues
Specialised Tissues
Active Epiphysis
Tissue Bleeding
Thermal Skin Test
Metal Implant
Sharp/Blunt Skin Tests
Cold Therapy
Pregnancy (general)
Epilepsy
Malignancy
LOCAL CI Devitalised Tissues PREAUTION
Specialised Tissues
EYE Active Epiphysis
Tissue Bleeding
Thermal Skin Test YES
Metal Implant
PRECAUTION Sharp/Blunt Skin Tests
Ultraviolet Radiation
SEE MODALITY
Pregnancy (general) SPECIFIC
ADVICE Epilepsy CI
Malignancy
LOCAL CI Devitalised Tissues LOCAL CI
Specialised Tissues
EYE Active Epiphysis
Tissue Bleeding
CI Thermal Skin Test SPECIALIST
SKIN
SENSITIVITY
TESTS
REQUIRED
Metal Implant Sharp/Blunt Skin
Tests