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Tammy Boucher, BSc. PT
April 06, 2021

Top 5 Electrode Tips for a Successful TENS & NMES Treatment

Nerve stimulation is a painless procedure that can help many people accelerate recovery and provide much needed relief from uncomfortable or painful symptoms.  In order to achieve successful a TENS & NMES treatment outcome, proper use and care of electrodes is important. Did you know that proper electrode placement can make a huge difference in patient comfort and significantly affect the clinical outcomes? 


Here are our top 5 tips to keep in mind when applying electrodes. 


Tip #1: Pay attention to the patient’s skin condition 

A common complaint from patients when applying TENS and NMES is a feeling of burning or stinging called “edge biting”. This uncomfortable feeling is caused by a concentration of electrical current within a certain part of the electrode instead of it being evenly distributed throughout its entire surface. To avoid this unwelcoming feeling, make sure that the electrodes being used have a nice even film of moist hydrogel and that there is complete contact with the skin. Hydrogel that is pitted or dried out can create areas of incomplete contact and cause “edge biting”. It’s also very important to inspect the skin closely for any abrasions or open wounds and disinfect the skin prior to applying the electrodes. 



Tip #2: Test different electrode placement areas 

For optimal results, when applying NMES treatment to your patients, take the time to identify the best placement for the electrodes.  Ideally the electrodes are placed on the motor point of the targeted muscle.  Finding the best placement will require moving the electrodes until the proper response is elicited. This takes a bit of time but worth the effort!   



Tip #3: Inform yourself on proper electrode placement  

Therapists will want to glance at the Electrode Placement and Functional Movement series, presented by Dr. Lucinda Baker, Associate Professor at USC Division of Biokinesiology and Physical Therapy. It is a must for any therapist looking to fine-tune their electrode placement skills. You can access it now at OrthoCanada's Axelgaard Academy. 



To help healthcare professionals optimize their nerve stimulation treatments, OrthoCanada has launched the Axelgaard Academy, a complete training program on electrode placement that includes 41 video training sessions for you to view for FREE.



Tip #4: Familiarize yourself with electrode types and features 

There is a wide range of electrodes that can be used for nerve stimulation treatments, however, their features and costs vary. Choosing the right electrodes for therapy is important for patient comfort, adhesion, durability and flexibility. Comparison Chart and Care Guide


Tip #5: Caring for your electrodes is important

Never use electrodes that show wear and tear. They can compromise your treatments and cause "edge biting" as described in Tip #1.


You can extend the life and efficacy of your electrodes with proper care. It’s very important to secure the electrodes back onto the “ON” side of the Mylar liner when not in use.  The “ON” side is coated with a layer of silicone which will make it easier to remove the electrodes when needed next without damaging the Hydragel.  Also, when not in use, always reseal the electrodes in their original package and store at room temperature.  Placing the electrodes back onto the Mylar liner and into their original packaging will help protect the hydragel and prevent it from drying.  If the adhesive gel becomes dry, re-hydrate it with a droplet of water. 



Need more information on selecting the best electrodes for your practice?  Please refer to our Product Guide, Comparison Chart and Care Guide




SHOP our complete selection of Axelgaard electrodes



Please refer to the following electrode FAQs for additional information or visit our website!



Electrode FAQs


How many times can self-adhesive the electrodes be used?

We are often asked about the on/off performance of our electrodes. The answer is very simple: the durability of electrodes depends entirely on the application, storage, humidity and care on the part of the therapist.


Do Axelgaard electrodes contain latex?

All products manufactured by Axelgaard Manufacturing are latex free. The company does not use latex of any kind in the electrodes or their packaging.


Are electrodes disposable?

Yes. When electrodes show wear and tear, or are no longer comfortable for the patient, simply replace them with a new set.


Can electrodes be used by more than one patient?

For proper hygiene, electrodes are intended for single patient use only. By sharing electrodes, you are subjecting patients to cross contamination. All electrodes are disposable and should be discarded, if compromised.


Is the gel hypoallergenic?

The definition of hypoallergenic is "less likely to cause an allergic reaction than other comparable goods." There is no scientific formula to measure or test this; therefore, Axelgaard’s gel is not labeled as hypoallergenic.


How do I apply an electrode?

Before each electrode application, the skin must be cleaned with water and soap to remove any lotions, skin oils, make-up, and dead skin. Any debris on the skin will be transferred to the gel of the electrode thereby compromising the integrity of the gel's adhesiveness. Therefore, a clean surface is the most important factor in the number of applications for an electrode.


How do I remove an electrode from the skin?

Always lift electrodes from the edge, NOT the lead wire.


Can I use hot or cold packs?

The use of heat or cold can damage the gel on self-adhesive electrodes and reduce their lifespan.  If used in combination with hot or cold therapy, electrodes with foam backing will provide a bit more protection to the adhesive gel against extreme temperatures versus electrodes with cloth backing.


How do I store an electrode?

After every use, the electrode must be returned to the "ON" side of the Mylar liner, and placed in the original, re-sealable package to prevent loss of moisture. The electrodes should be stored at room temperature with humidity at 35-50%. DO NOT: Store in freezer/refrigerator, leave in extreme heat, submerge in water, or leave outside of the package.


How do I care for an electrode?

After usage, if the electrode picks up small amounts of debris, you may use a drop of water on your finger to gently rub the debris off the electrode. Most important to the care of the electrode is applying it to a clean surface with each use. DO NOT: Use soap, alcohol, submerge in water, or scrub with abrasive material.


Where are Axelgaard’s electrodes made?

They are made in the USA.


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