Important safety information about our medical devices

For all medical devices, special contraindications and precautions must be observed. Below you will find the most important general information for the technologies available from us - separated by application in humans and in animal physiotherapy. Always speak with your doctor or veterinarian before use. We are happy to advise you on any questions regarding the devices and contraindications.

Important note: The following information describes the most important contraindications for each therapy form in general. However, individual devices and manufacturers may specify their own, additional, or different contraindications - for example, different age limits, additional taboo zones on the body, or special technical requirements. Therefore, always read the instructions for use or the user manual of the respective device before each application.

For humans (Human medicine)

Electrotherapy (EMS / TENS)

No significant side effects are known with intended use.

In particularly sensitive individuals, redness of the skin under the electrodes may appear after treatment. It usually disappears a few minutes after treatment. Consult a doctor if the redness persists.

In rare cases, stimulation in the evening leads to delayed sleep onset. In this case, move the application to daytime.

Do not use in case of:

• Pacemakers or other implanted electronic devices
• Heart disease and severe heart rhythm disorders
• Epilepsy (unless otherwise prescribed by a doctor)
• Pregnancy
• Tumor diseases (please consult the treating oncologist)
• Tuberculosis, juvenile diabetes, acute viral diseases, fungal infections, and dermatitis
• acute infections and acute trauma
• Pain of unknown origin
• Venous thrombosis and thrombophlebitis
• Wearers of magnetizable prostheses
• Children (unless otherwise prescribed by a doctor)

Do not use on the following areas:

• Front of the neck (carotid sinus), head and brain region, eyes
• Through the chest (never place electrodes so that the current passes through the heart)
• Wounds, skin diseases, skin lesions, fresh scars, genital area

Safety information: Never apply electrodes while driving or operating machinery. Do not use in the bathtub, shower, or sauna. Apply electrodes only to clean, dry, intact skin. Do not use simultaneously with high-frequency surgical devices. Always increase the intensity slowly - the stimulation should be clearly noticeable, but never painful.

Ultrasound therapy

Do not use in case of:

• severe heart rhythm disorders or pacemakers
• Heart disease and/or severe cardiovascular problems
• Epilepsy
• Progressive phlebitis, thrombophlebitis, venous thrombosis
• Fever, panic attacks, or severe illnesses
• Tuberculosis, spinal diseases (depending on the findings)
• Malignant tumors and neoplasms
• Local infections and inflammation, open wounds, and skin injuries
• Severe osteoporosis
• Arteriopathies (unless prescribed by a doctor)
• Pregnancy, children
• Metal implants (possible after medical consultation)

Do not use on the following areas:

• Eye region, mouth and oral area
• Neck area (carotid sinus and glandular areas, especially the thyroid - also avoid the back of the neck)
• Heart region, genital area, abdominal cavity, and uterine region
• Areas with reduced sensitivity

Safety information: Use exclusively with water-based ultrasound gel. The ultrasound head must be continuously guided in slow, circular, or vertical movements and must never stand still. Do not immerse in water without express approval. Stop immediately in case of pain, burning, or intense heat.

Magnetic field therapy

Do not use in case of:

• Pregnancy, children
• Pacemakers or other implanted electronic devices (e.g., insulin pumps, neurostimulators, cochlear implants)
• Heart disease and severe heart rhythm disorders
• Wearers of magnetizable prostheses and synthetic materials
• Malignant tumors and neoplasms
• Tuberculosis, juvenile diabetes, acute viral diseases, fungal infections, acute infections
• Epilepsy (unless otherwise prescribed by a doctor)
• Bleeding tendency and coagulation disorders
• Severe blood pressure fluctuations

Do not use on the following areas:

• Over ferromagnetic metal implants as well as near zones with magnetizable synthetic materials in the tissue (in case of doubt, clarify with a doctor beforehand)

Safety information: Remove magnetically sensitive objects before use: watches, hearing aids, cards with magnetic strips, data carriers, and jewelry. Do not use simultaneously with TENS or Holter devices.

More about this also in our articles on Side effects in magnetic field therapy and on the Effects of magnetic field therapy.

Laser therapy

Eye protection: Never point the laser beam directly into the eyes - the retina can be permanently damaged. During the entire application, certified laser safety goggles must be worn: by the person applying in case of danger of direct glare, by the treated person always in case of danger of direct exposure.

Absolute contraindications - treatment must not be performed in case of:

• Hemophilia and other blood and coagulation disorders
• Active bleeding (hemorrhage)
• Active epiphyses (open growth plates in children)
• Irradiation of the testicles
• Areas with locally injected medications

Precautions - only after consultation and with increased caution in case of:

• Pregnancy (no treatment near the abdomen, avoid large doses in the abdominal area)
• Cancer or suspected cancer (only by specialists, after written consent and in consultation with the treating doctor)
• Endocrine glands such as the thyroid and ovaries (do not irradiate directly)
• Transplants (do not apply laser therapy)
• Metal or plastic implants (do not irradiate areas in direct contact)
• Pacemakers (do not irradiate tissue in direct contact or immediate proximity)
• Photosensitizing medications
• Epilepsy (visible pulsating light in the range of 5–10 Hz can trigger seizures)
• Fever
• Freckles, moles, tattoos, skin lesions of unknown origin, dark/tanned complexion (higher risk of overheating and burns)
• Bleeding wounds (never treat directly, guide the laser approx. 1 cm above the wound, without direct skin contact)
• Children and infants (adjust the dose to the body weight)

Discontinuation criteria: Stop immediately in case of excessive heat or pain during treatment. If the lens/optics becomes hot, pause the treatment and turn off the device.

Shockwave therapy

Contraindications - systemic diseases and patient conditions:

• Blood coagulation disorders (e.g., hemophilia) or taking anticoagulants (anticoagulants such as Marcumar)
• Thrombosis or tendency for local thrombosis
• Pregnancy
• Tumor and cancer diseases as well as benign or malignant tissue growths in the treatment area
• Polyneuropathy (e.g., due to diabetes mellitus)
• Acute inflammation, abscesses, or bacterial/viral infections in the treatment area
• Unstable medical or psychiatric conditions as well as epilepsy
• Previous local cortisone therapy in the treatment area (usually up to 6 weeks before treatment begins)
• Hypersensitivity or allergies to lidocaine or corticosteroids

Anatomical taboo zones and sensitive tissues:

• Artificial/electronic implants in the application area (e.g., pacemakers, implanted defibrillators, neurostimulators)
• Sensitive organs: eyes and eye region, myocardium, spinal cord, gonads, kidneys, and liver
• Air- or gas-filled organs (e.g., lungs, intestines)
• Immediate proximity of large nerve bundles, major blood vessels, as well as the head and neck/nape
• Growth zones of bones (epiphyseal plates) in children and adolescents
• Open wounds without a sterile barrier between the applicator and the wound
• Skin areas with sensory deficit
• Pre-damaged/frayed tendons as well as areas after vascular reconstructions (e.g., with stents)

Possible side effects:

Shockwave therapy is considered a low-side-effect, non-invasive procedure. Any reactions that may occur are usually not severe and usually subside shortly (minutes to a few days):

• Local skin reactions: Redness (erythema) and swelling
• Vascular reactions: Punctate skin bleeding (petechiae) and superficial bruises (hematomas)
• Pain reactions during treatment or temporarily increased local pain/stinging afterwards
• Temporary numbness or slight tingling (hypesthesia, paresthesia)
• Increased risk of skin damage, especially after recent corticosteroid therapy

Precautions and application instructions:

• Always start with the lowest intensity level and increase gradually only after feedback from the patient
• Apply sufficient contact gel between the applicator and the skin to avoid air bubbles and transfer the energy completely
• Guide the applicator in light, circular movements so that a maximum of 300–400 strokes hit one spot
• In longer treatment series (e.g., radially after at most 6,000 strokes), take a break, as the applicator head can heat up
• If possible, do not apply to locally anesthetized tissue (lack of pain feedback)
• Do not unnecessarily direct the energy directly at unloaded bone structures (except for explicitly intended application, e.g., pseudoarthroses)
• Only by trained specialist personnel; check the applicator and cable for damage before each use

TECAR / Diathermy

Absolute contraindications - treatment must not be performed in case of:

• Pacemakers and other implantable electronic devices
• Pregnancy
• Tumors and neoplasms
• Local or systemic infections, fever
• Existing or imminent bleeding and hemorrhages, coagulation disorders
• Venous thrombosis and thrombophlebitis
• Ischemic tissue (insufficient blood supply)

Do not use on the following areas:

• Head area, eye area, abdomen, gonads, and genital organs

Relative contraindications - weigh individually, special caution in case of:

• Areas with reduced sensitivity (hypesthesia)
• Severely overweight patients
• Acute inflammatory conditions, skin lesions, and active dermatological diseases
• Hypersensitivity to heat or irritation
• Metal prostheses and metal implants (conduct heat)
• Growth plates in children and adolescents

Safety information: Only by qualified, trained specialist personnel. The treated person must be awake and responsive during the entire treatment. Remove metal objects (jewelry, piercings, hearing aids) before treatment. Keep the skin clean and dry beforehand. Check the device before each application, especially the capacitive electrodes for scratches/damage. Never treat unattended.

Pressotherapy

Do not use in case of:

• Acute deep venous thrombosis
• Vein inflammation (phlebitis, thrombophlebitis)
• Severe, decompensated heart failure
• Active infections in the treatment area
• Malignant tumors in the treatment area

Only use after medical consultation in case of:

• Severe arterial occlusive disease
• Open wounds in the treatment area
• Acute inflammation
• Nerve damage with impaired pressure perception

Safety information: Apply the cuffs only to intact skin. Start with low pressure - the compression should be clearly noticeable, but never painful. Stop immediately in case of pain, tingling, numbness, or skin discoloration.

Vagus nerve stimulation (tVNS)

Not intended for:

• Patients after cervical vagotomy
• Patients with diagnosed severe bradycardia
• Patients with permanently implanted metal or electronic devices or jewelry in the immediate vicinity of the ear tragus that cannot be removed before use
• Pregnant women¹

Further contraindications (except with express medical assessment and, if necessary, monitoring):

• Active implanted devices (e.g., cochlear implant, cerebral shunt, invasive VNS, pacemaker²) or metal implants with possible interaction with the nervous system
• Known severe coronary heart disease or myocardial infarction in the last 5 years
• Pediatric patients²

¹Pregnant women were not examined in clinical studies.
²Pediatric patients and pacemaker wearers were included in clinical studies with the Parasym technology; so far, no device-related disturbances have been observed in the clinical setting (research context).

Before use: Read the instructions for use completely, clarify individual questions with the doctor. Use Nurosym only according to the instructions or medical instructions. Remove jewelry that could impair electrode placement. Do not use on injured, cracked, or numb skin on the tragus.

Potential risks and side effects: With proper use, tVNS is classified as low risk. Adverse effects are rare, usually mild, and generally subside shortly after use. Most common local reactions: tingling, pressure/pain sensation, redness, itching at the electrode site with long-term use. In case of side effects: stop use and seek medical advice. If the intensity is permanently too high, there is a risk of local skin irritation up to burns. Further rare effects described in the literature: dizziness, fatigue, shortness of breath, headache, or irregular heart rhythm.

For animals (Veterinary medicine)

Electrotherapy in veterinary medicine

No application in sedated animals: The device must not be used on sedated animals. The intensity is adjusted based on the animal's reaction - only an awake animal indicates through visible discomfort that the stimulation is too strong.

Do not use in case of:

• Animals with pacemakers or other implanted electronic devices
• Heart rhythm disorders, pregnancy
• Pain of unknown etiology
• Wounds, skin lesions and dermatological conditions, acute trauma, fresh scars
• Tumors
• acute infections and fever
• Epilepsy
• Venous thrombosis and thrombophlebitis
• Puppies, kittens and foals

Do not apply to the following areas:

• front neck region (carotid sinus), head and brain region
• Eye area - strictly prohibited
• transthoracically (not simultaneously on the chest and back, risk of cardiac arrhythmias due to overlap with the heart rate)

Use with particular caution in cases of: capillary fragility (excessive stimulation can exacerbate capillary rupture) and areas with reduced sensitivity or neurological deficits.

Safety instructions: Shave the fur at the electrode sites to ensure secure skin contact. Apply electrodes only to clean, dry, intact skin. Increase the intensity slowly and monitor the animal. Do not use in wet environments. Do not leave the animal unattended during treatment.

Ultrasound therapy in veterinary medicine

Do not use on sedated animals: The animal expresses pain through visible discomfort - this feedback from the conscious patient is essential to immediately reduce the intensity or discontinue treatment.

Do not use in cases of:

• Neoplasms (tumors) - ultrasound could promote the spread of neoplastic cells
• Hematomas and fresh bleeding
• Thrombophlebitis and similar conditions (risk of embolism)
• acute infections in the affected area
• Pregnancy, fever
• severe osteoporosis (ultrasound can promote bone demineralization)
• Epilepsy
• Areas with reduced sensitivity or neurological deficits

Do not apply to the following areas:

• Heart region, endocrine glands, eyes and immediate surroundings
• irradiated areas (at least 6 months after radiotherapy)
• metaphysis (growth plate) in young animals during the bone growth phase
• over metal prostheses/metal synthesis material - risk of harmful heat accumulation, especially with non-titanium metals commonly used in veterinary medicine without reliable ultrasound studies; the manufacturer expressly advises against this

Safety instructions: Shave the fur or thoroughly work in sufficient water-based gel for secure coupling. Move the ultrasound head continuously in slow, circular or vertical movements; never leave it stationary. Only immerse in water with express approval. Monitor the animal throughout the entire treatment.

Magnetic field therapy in veterinary medicine

Absolute contraindication: Animals with pacemakers or other electrostimulation devices, e.g. on the spine.

Do not use in cases of:

• pregnant animals
• Puppies, kittens and foals
• Cardiac arrhythmias, severe ischemic heart disease
• Dermatitis and fungal infections
• Tendency to bleeding
• Fever, tumors
• severe blood pressure fluctuations

Do not apply to the following areas:

• over metal prostheses made of ferromagnetic material (e.g. screws, nails) as well as near zones with magnetizable synthetic materials (if in doubt, consult a veterinarian)
• over internal organs such as ovaries, heart and head

Safety instructions: Do not use simultaneously with TENS or Holter devices. Remove magnetically sensitive objects such as tracking chips, collar transmitters or hearing aids before use, where possible.

Laser therapy in veterinary medicine

Eye protection: Never direct the laser beam at the eyes - neither at the animal's nor at the eyes of people in the room (a blink reflex does not protect against therapy lasers). All persons present must wear certified laser safety goggles; the animal's eyes must be covered or kept out of the beam area. For devices of classes 3B and 4, the requirements for laser safety areas and laser safety officers also apply.

Absolute contraindications:

• Hemophilia and other blood and coagulation disorders
• active bleeding
• open growth plates (active epiphyses) in young animals
• Irradiation of the testicles
• Areas with locally injected medications

Precautions in cases of:

• Pregnancy (no treatment near the abdomen)
• Tumors/suspected tumors (only after veterinary examination; do not irradiate pigmented swellings - melanomas are common in dogs and horses)
• Endocrine glands (thyroid gland, ovaries) - do not irradiate directly
• Transplants, metal/plastic implants (do not irradiate contact points)
• Pacemakers and other implanted electronic devices
• Photosensitizing medications, epilepsy, fever
• Bleeding wounds (place the applicator approx. 1 cm above the wound, no direct contact)
• Young animals (adjust the dose to body weight)
• Sedated or anesthetized animals (lack of heat feedback - reduce the dose, continuously move over the area, regularly check the skin temperature)

Dark fur and pigmented skin: overheat significantly faster - reduce the power, move the applicator continuously or increase the distance; shave or part the fur in the treatment area.

Discontinuation criteria: Discontinue immediately at the first sign of heat, pain or restlessness. If the optic becomes hot, pause and switch off the device. For qualified, trained professionals only.

TECAR / Diathermy in veterinary medicine

Do not use on sedated animals: The animal must be awake and responsive throughout the entire treatment. Tecar therapy works through heat generation in the tissue - the only reliable feedback on the heat actually reaching the tissue is the animal's reaction. In a sedated/anesthetized animal, this feedback is absent; overheating will only be noticed once damage has already occurred.

Absolute contraindications:

• Pacemakers and other implantable electronic devices
• Pregnancy
• Tumors and neoplasms
• Local or systemic infections, fever
• Existing or imminent bleeding and hemorrhages, coagulation disorders
• Venous thrombosis and thrombophlebitis
• Ischemic tissue (insufficient blood supply)

Do not apply to the following areas:

• Head area, eye area, abdomen, gonads and genital organs

Relative contraindications in cases of:

• Areas with reduced sensitivity or neurological deficits
• Severely overweight animals
• Acute inflammatory conditions, skin lesions and active dermatological conditions
• Hypersensitivity to heat or irritation
• Metal prostheses, implants and osteosynthesis material (conduct and concentrate heat)
• Open growth plates in young animals
• The location of the microchip transponder (do not treat directly over it)

Preparation of the animal: Shave the fur in the treatment area or thoroughly work in the contact cream down to the skin. Place the neutral electrode over a large area, ensuring it lies flat and makes full contact (poor contact is the most common cause of burns). Remove metallic objects from the electrical circuit (collars, tags, harness/bridle parts with metal buckles). Ensure the skin is clean and dry beforehand.

Safety instructions: Only by qualified, trained professionals. Regularly check the skin temperature and move the electrode continuously. Check the device before each use. Never leave the animal unattended. Reduce the intensity or discontinue in cases of restlessness, avoidance movements or discomfort.

If you have questions about the contraindications, please fill out the form below, stating the therapy form in question. We will contact you as soon as possible. Please note that we cannot provide medical advice on its use in your specific case, but can only provide information on correct use and contraindications. Please consult your doctor or veterinarian before use.