Contraindications and Precautions when using Electrical Stimulation: NMES and TENS

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Who should NOT use electrical stimulation?

This list is a guide only, please consult your own health professional before using any form of electrical stimulation.

Do Not use electrical stimulation  (NMES ) if  you have any of the following. Seek medical advice first:

• Active implants - Cardiac pacemaker/defibrillator or cardiac arrhythmia
• Pregnant (do not use over the pregnant uterus)  or planning a pregnancy (speak to your health professional)
• Seizure/epilepsy and dementia conditions
• Local malignancy – do not use in that area
• Over an epiphysis
• Actively bleeding tissue
• Over eyes/testes
• Sensation is poor in the area
• Haemorraghic conditions
• Infection, TB, osteomyelitis 
• Recently radiated tissue
• Recent fracture, osteoporosis
• Impaired circulation
• DVT
• Impaired cognition or communication
• Over anterior neck /carotid sinus region. Chest /intercostal muscles/heart
• Transcranially

Additionally do not use with an internal electrode if you have:

• Broken/irritated skin in the rectal, vaginal or perineal area
• Rectal bleeding or haemorrhoids
• Bladder or vaginal infections
• Unexplained/undiagnosed bleeding from the vagina or rectum

CAUTION check with your health professional before using internal electrical stimulation if you have:

• an IUD - do not use with a copper IUD
  Check with your doctor if you have a Mirena or similar. One of the concerns is you may accidentally pull the device out when you remove the electrode from the vagina.
• a pessary in place, you can remove it before and then replace it afterwards if you have been taught how - check with your treating health professional
• vaginal atrophy
  
  

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Do Not use TENS if you have any of the following. Seek medical advice first:

• Pregnancy, over pregnant uterus
• Active implants (pacemaker; defibrillator; IPG -when on)
• Epilepsy
• Impaired sensation
• Skin disease, damaged or at risk skin
• Recently radiated tissue
• Infection, TB, osteomyelitis
• Haemorraghic conditions
• DVT
• Over anterior neck /carotid sinus region.

Local contra-indications:

• Actively bleeding tissue
• Malignancy
• Eyes, testes
• Active epiphysis

Care if using TENS with:

• A passive metal implant eg knee replacement. TENS may distort the current. Cease if any unusual sensation
• Local circulatory insufficiency and devitalized tissues
• Chest /intercostal muscles/heart

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The material presented in this information sheet is intended as an information source only. The information is provided solely on the basis that readers will be responsible for making their own assessment of the matters presented herein and are advised to verify all relevant representations, statements and information. The information should not be considered complete and should not be used in place of the advice of a health care provider. Pelvic Floor Exercise does not accept liability to any person for the information or advice provided in this sheet, or for loss or damages incurred as a result of reliance upon the material contained herein.

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