Biological and clinical reactions to electrotherapy (defined as electric currents, ultrasound, pulsed electromagnetic fields and low level laser therapy) and their clinical use were reviewed. Evidence from non-clinical trials suggested that excitation of an action potential in peripheral nerves by electrical currents, or local non-thermal effects on cellular metabolism were the most important biological reactions produced by electrotherapy. The findings also suggested that all four electrotherapy interventions can produce significant clinical effects as reduction of pain and improved mobility in randomised controlled trials. Clinical evidence in favour of ultrasound was weak. Restrictions to suitable indications, optimal dosage and adequate treatment procedures seem to be necessary to achieve clinical effects. Electrotherapy refunds amounts to 17.7 percent of the total expenditure on physiotherapy for out-patients in Norway. Our findings suggest that a revision of current indication lists and treatment procedures for electrotherapy are needed.

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