How should you respond if the patient reports burning or significant discomfort during NMES?

• A. Immediately reduce intensity
• B. Immediately increase amplitude to test tolerance
• C. Ignore and continue
• D. Stop and schedule for another day

Answer: (A)

Burning or significant discomfort signals that the current density at the skin is too high. Safety and comfort come first, so the immediate step is to reduce the stimulation intensity to a level the patient can tolerate. While doing this, reassess electrode placement and skin condition, and check impedance. Make sure the skin is properly prepped, there’s good electrode contact, and consider using larger electrodes or adjusting the pulse duration and ramp time to spread the current more evenly. If burning continues despite reducing intensity, stop the session and re-evaluate before continuing to prevent tissue injury. Once comfort is restored, progress gradually within the patient’s tolerance.