Patent Publication Number: US-2021178158-A1

Title: Wearable system for an electrotherapy device

Description:
CROSS-REFERENCE TO RELATED APPLICATION 
     This application is a continuation-in-part of U.S. patent application Ser. No. 16/661,728 filed Oct. 23, 2019 which claims priority to U.S. Provisional Patent Application Ser. No. 62/749,233 filed Oct. 23, 2018, the entirety of which is incorporated herein by reference. 
    
    
     TECHNICAL FIELD 
     The present disclosure generally relates to the technical field of pain treatment. More particularly, the present disclosure is directed to a garment for providing electrotherapeutic treatment to a localized portion of the body. 
     BACKGROUND 
     Traditionally, electrotherapy devices have generated alternating current frequencies using a variety of different methods. For example, Matthews&#39; U.S. Pat. No. 5,269,304 issued on Dec. 14, 1993 discloses an electrotherapy apparatus that includes at least two electrodes adapted to feed oscillating current to selected sites on or beneath the epidermal or mucous surface remote from the treatment site. The Matthews&#39; Patent uses a common return electrode provided at the treatment site that is subjected to the sum of the currents from the two feed electrodes. The feed electrodes may be contact feed electrodes or capacitive feed electrodes. The feed electrodes may operate at different frequencies so that the treatment site is stimulated by the beat frequency. This may be about 80 or 130 Hz, if an anaesthetizing effect is required. Disclosed embodiments provide electrotherapeutic devices and wearable systems adapted to provide signals from the electrotherapeutic device to a user. 
     SUMMARY 
     In some embodiments, the present disclosure includes a wearable garment including a flexible material configured to wrap around a portion of a user&#39;s body. The flexible material may include an interior surface configured to contact the user&#39;s body and an opposite exterior surface. The garment may further include a first electrode positioned at the interior surface and configured to contact a targeted part of the user&#39;s body and a second electrode positioned at the interior surface and configured to contact a targeted part of the user&#39;s body. The garment may also include a first electrode connector positioned at the exterior surface and operably connected to the first electrode and a second electrode connector positioned at the exterior surface and operably connected to the second electrode. The first and second electrodes are configured to deliver a therapeutic signal from an electrotherapeutic device via the first and second electrode connectors. 
     In other embodiments, the present disclosure includes a wearable system including a garment. The garment includes a flexible material configured to wrap around a portion of a user&#39;s body. The flexible material includes an interior surface configured to contact the user&#39;s body and an opposite exterior surface. The garment may also include a first electrode positioned at the interior surface and configured to contact a targeted part of the user&#39;s body and a second electrode positioned at the interior surface and configured to contact a targeted part of the user&#39;s body. The garment may further include a first electrode connector positioned at the exterior surface and operably connected to the first electrode, and a second electrode connector positioned at the exterior surface and operably connected to the second electrode. The wearable system may also include an electrotherapeutic device configured to deliver a therapeutic signal to the first and second electrodes via the first and second electrode connectors. 
     In other embodiments, the present disclosure includes a method for providing therapeutic electric current to a treatment site of a patient. The method includes providing a flexible garment comprising a first electrode and a second electrode, providing an electrotherapeutic device operably connected to the first electrode and the second electrode, positioning the flexible garment with respect to a user&#39;s body such that the first electrode and the second electrode are each in contact with a targeted part of the user&#39;s body, forming a therapeutic signal configured to reduce pain at a treatment site by simultaneously sending a first signal from the first electrode to the second electrode and sending a second signal from the second electrode to the first electrode, and then simultaneously sending the first signal from the second electrode back to the first electrode and the second signal from the first electrode back to the second electrode. 
    
    
     
       BRIEF DESCRIPTION OF DRAWINGS 
       Various aspects of the present disclosure will be or become apparent to one with skill in the art by reference to the following detailed description when considered in connection with the accompanying exemplary non-limiting embodiments. 
         FIG. 1  illustrates the hyperpolarization mechanism of pain reduction in accordance with some embodiments of the present disclosure. 
         FIG. 2  illustrates the gate control mechanism of pain reduction in accordance with some embodiments of the present disclosure. 
         FIG. 3  illustrates output portions of an electrotherapeutic device in accordance with some embodiments of the present disclosure. 
         FIG. 4  illustrates the coupling of Sine wave  1  and Sine wave  2  to the electrodes when the apparatus is constructed around ground reference (local Apparatus ground) linear power amplifiers in accordance with some embodiments of the present disclosure. 
         FIG. 5  illustrates the structure of an electrotherapeutic apparatus in accordance with some embodiments of the present disclosure. 
         FIG. 6  illustrates the general block structure of an electrotherapeutic apparatus in accordance with some embodiments of the present disclosure. 
         FIG. 7  illustrates the general block structure of an electrotherapeutic apparatus in accordance with some embodiments of the present disclosure. 
         FIG. 8  illustrates the general block structure of an electrotherapeutic apparatus in accordance with some embodiments of the present disclosure. 
         FIG. 9  is a depiction of an electrotherapeutic device in accordance with some embodiments of the present disclosure. 
         FIG. 10A  is a block diagram of a wearable system for applying an electrotherapeutic signal to a user in accordance with some embodiments of the present disclosure. 
         FIG. 10B  is a profile view of an exemplary electrode including a raised area due to underlying memory foam material; 
         FIG. 10C  is a depiction of various views of a stud and rivet that make up an exemplary electrode connector; 
         FIG. 10D  is a depiction of the stud portion of the electrode connector on an outer surface of an exemplary garment; 
         FIG. 10E  is a depiction of a rivet portion of the electrode connector on an inside surface of the exemplary garment; 
         FIG. 11  illustrates an embodiment of a wire that may be used in conjunction with the wearable system of  FIG. 10  in accordance with some embodiments of the present disclosure. 
         FIG. 12A  is an inside view of a lower back wearable system in accordance with some embodiments of the present disclosure. 
         FIG. 12B  is an outside view of the lower back wearable system in accordance with some embodiments of the present disclosure. 
         FIG. 13A  is an inside view of a lower back wearable system in accordance with some embodiments of the present disclosure. 
         FIG. 13B  is an outside view of the lower back wearable system in accordance with some embodiments of the present disclosure. 
         FIG. 14A  is a front view of the lower back wearable system on a user prior to tightening secondary straps in accordance with some embodiments of the present disclosure. 
         FIG. 14B  is a front view of the lower back wearable system on a user after tightening secondary straps in accordance with some embodiments of the present disclosure. 
         FIG. 15  is a rear view of the lower back wearable system on a user in accordance with some embodiments of the present disclosure. 
         FIG. 16A  is an inside view of a knee wearable system in accordance with some embodiments of the present disclosure. 
         FIG. 16B  is an outside view of the knee wearable system in accordance with some embodiments of the present disclosure. 
         FIG. 16C  is a depiction of the knee wearable system on a right leg of a user in accordance with some embodiments of the present disclosure. 
         FIG. 16D  is a depiction of the knee wearable system on a left leg of a user in accordance with some embodiments of the present disclosure. 
         FIG. 17A  is an inside view of a knee wearable system in accordance with some embodiments of the present disclosure. 
         FIG. 17B  is an outside view of the knee wearable system in accordance with some embodiments of the present disclosure. 
         FIGS. 18A-18E  are a depiction of the knee wearable system on a right leg of a user in accordance with some embodiments of the present disclosure. 
         FIG. 19A-19E  are a depiction of the knee wearable system on a left leg of a user in accordance with some embodiments of the present disclosure. 
         FIG. 20A  is an inside view of an ankle/foot wearable system in accordance with some embodiments of the present disclosure. 
         FIG. 20B  is an outside view of the ankle/foot wearable system in accordance with some embodiments of the present disclosure. 
         FIG. 21A  is an inside view of an ankle/foot wearable system in accordance with some embodiments of the present disclosure. 
         FIG. 21B  is an outside view of the ankle/foot wearable system in accordance with some embodiments of the present disclosure. 
         FIG. 22  is a depiction of the ankle/foot wearable system on a right leg of a user in accordance with some embodiments of the present disclosure. 
         FIG. 23  is a depiction of the ankle/foot wearable system on a left leg of a user in accordance with some embodiments of the present disclosure. 
         FIG. 24  is an inside view of an elbow wearable system in accordance with some embodiments of the present disclosure. 
         FIG. 25  is an outside view of the elbow wearable system in accordance with some embodiments of the present disclosure. 
         FIG. 26  is a depiction of the elbow wearable system on a right arm of a user in accordance with some embodiments of the present disclosure. 
         FIG. 27  is a depiction of the elbow wearable system on a left arm of a user in accordance with some embodiments of the present disclosure. 
         FIG. 28  is an inside view of a wrist/hand wearable system in accordance with some embodiments of the present disclosure. 
         FIG. 29  is an outside view of the wrist/hand wearable system in accordance with some embodiments of the present disclosure. 
         FIG. 30  is a depiction of the wrist/hand wearable system on a right hand of a user in accordance with some embodiments of the present disclosure. 
         FIG. 31  is a depiction of the wrist/hand wearable system on a left hand of a user in accordance with some embodiments of the present disclosure. 
         FIG. 32A  is an inside view of a shoulder wearable system in accordance with some embodiments of the present disclosure. 
         FIG. 32B  is an outside view of the shoulder wearable system in accordance with some embodiments of the present disclosure. 
         FIG. 33A  is an inside view of a shoulder wearable system in accordance with some embodiments of the present disclosure. 
         FIG. 33B  is an outside view of the shoulder wearable system in accordance with some embodiments of the present disclosure. 
         FIG. 34  is an inside view of a head/neck wearable system in accordance with some embodiments of the present disclosure. 
         FIG. 35  is an outside view of the head/neck wearable system in accordance with some embodiments of the present disclosure. 
         FIG. 36  is a diagram showing an example placement of electrodes using the head/neck wearable system. 
     
    
    
     DETAILED DESCRIPTION 
     With reference to the figures, where like elements have been given like numerical designations to facilitate an understanding of the drawings, various embodiments of an apparatus for a multi-purpose handheld tool are described. The figures are not drawn to scale 
     The following description is provided as an enabling teaching of a representative set of examples. Many changes can be made to the embodiments described herein while still obtaining beneficial results. Some of the desired benefits discussed below can be obtained by selecting some of the features discussed herein without utilizing other features. Accordingly, many modifications and adaptations, as well as subsets of the features described herein are possible and can even be desirable in certain circumstances. Thus, the following description is provided as illustrative and is not limiting. 
     This description of illustrative embodiments is intended to be read in connection with the accompanying drawings, which are to be considered part of the entire written description. The drawing figures are not necessarily to scale and certain features of the invention can be shown exaggerated in scale or in somewhat schematic form in the interest of clarity and conciseness. In the description of embodiments disclosed herein, any reference to direction or orientation is merely intended for convenience of description and is not intended in any way to limit the scope of the present disclosure. Relative terms such as “horizontal,” “vertical,” “up,” “down,” “top,” and “bottom” as well as derivatives thereof (e.g., “horizontally,” “downwardly,” “upwardly,” etc.) should be construed to refer to the orientation as then described or as shown in the drawing figure under discussion. These relative terms are for convenience of description and normally are not intended to require a particular orientation. Terms including “inwardly” versus “outwardly,” “longitudinal” versus “lateral,” and the like are to be interpreted relative to one another or relative to an axis of elongation, or an axis or center of rotation, as appropriate. Terms concerning attachments, coupling, and the like, such as “connected” “interconnected,” “attached,” and “affixed,” refer to a relationship wherein structures are secured or attached to one another either directly or indirectly through intervening structures, as well as both movable or rigid attachments or relationships, unless expressly described otherwise. The terms “operatively connected” or operatively coupled” are such an attachment, coupling or connection that allows the pertinent structures to operate as intended by virtue of that relationship. The term “adjacent” as used herein to describe the relationship between structures/components includes both direct contact between the respective structures/components referenced and the presence of other intervening structures/components between respective structures/components. 
     As used herein, use of a singular article such as “a,” “an” and “the” is not intended to exclude pluralities of the article&#39;s object unless the context clearly and unambiguously dictates otherwise. 
     In various embodiments, a differentially-applied frequency-separated electrotherapy apparatus and method is disclosed for providing therapeutic electric current to a treatment site of a patient. The apparatus and method include having at least two individually generated and amplified oscillating or pulsing alternating currents, of frequencies which differ from each other by as a little as 1 Hz and up to about 300 Hz, wherein the base frequency value of the two frequencies can be between 200 Hz and 500 KHz. The apparatus and method require at least two electrodes adapted to act as pain site and return electrodes which provide electric current beneath the epidermal or mucous surface of the patient, directly over the source of pain. 
     In some embodiments, the method of electrotherapy includes providing two individually generated and amplified signals with a frequency difference between them which is applied to one or more pairs of electrodes placed on the body directly over locations of pain and/or over the origin of the pain. According to various embodiments, as will be described in further detail below, since the signals share a common power supply return path, each signal&#39;s electrode acts as the return path for the opposing signal. Advantageously, the signals non-linearly mix on polarizable weakly rectifying structures along the current path to evoke a neuro-stimulated pain signal transmission blocking effect by interfering with nerve impulse signal transmission. 
     In various embodiments, at least one pair of electrodes are placed directly over locations of pain, on or beneath the epidermal or muscular surface of a patient coupled to a generator feeding via the at least one pair of electrodes with two or more oscillating or complex morphology electric currents to a patient. In some embodiments, the respective selected electrode placement locations are opposite one another on the patient&#39;s body with a pain site located on a line vector in between the electrodes with the line vector perpendicular to each skin surface on which the electrodes reside. In various embodiments, as described below, the at least one pair of electrodes may be placed directly over a single location of pain. In some embodiments, the currents generated by the at least one pair of electrodes are a frequency of at least about 1 KHz and have a current difference between each electrode respectively as little as 1 Hz by up to about 300 Hz. As described in part above, a non-linear action of nerve fiber membranes causes a multiplication of the two independent high frequency signals in a volume of tissue surrounding and beneath each of the at least two electrodes to produce a therapeutic effect in the hemisphere surrounding and beneath each of the at least two electrodes. The multiplication yields a distribution of synthesized sum and difference frequencies among which is a therapeutic low frequency signal that is equivalent to a beat frequency of the signals. 
     A described in part above, two high frequency electronic wave-forms are introduced into the body non-invasively through at least one pair of disposable electrodes placed on the skin directly over the pain site, according to some embodiments. In various embodiments, for two locations of pain, each electrode is placed directly over a painful area. In some embodiments, for one location of pain, one electrode is placed directly over a single location of pain, the second electrode may be placed over a bony area which is a comfortable location to receive stimulation. 
     The Feed Signals are exponentially multiplied by materials within the body giving rise to a low frequency component, the beat frequency, in the form of an electric field within the volume of tissue the shape of a hemisphere beneath as well as surrounding the electrode, the size of which is defined by the geometry of the electrode. The size and shape of the volume of tissue affected can be changed and is dependent upon electrode placement, geometry and materials, as well as the amplitude of the Feed Signals. 
     The disclosed embodiments further apply to an electrode garment that may be placed and held against a selected body part. The disclosed garments may be designed as part of a neurostimulation system to provide relief of chronic, acute or post-operative pain. The size and location of each electrode is designed and optimized to deliver a summed high frequency alternating current neurostimulation into deep tissue in the body. Such garments cannot be used with conventional TENS devices. 
     In the disclosed embodiments, electrode size and location depend upon the part of the body being treated. In some embodiments electrode sizes might range from 4″×5″ on the lower back to 3″×3.5″ for the knee to 1.5″×8″ electrodes that can encompass the wrist and hand or foot and ankle. Electrodes are designed to be located over common body locations where pain presents. Electrode sizes are configured to accommodate the magnitude of intensity that can be tolerated by a patient. Patients can typically increase the output of a BioWave neurostimulator to higher voltages (22-25V) on knees, ankle and feet, mid range voltages (13-15V) on back and shoulders and lower range voltages (8-13V) on elbow, wrist, hand and neck treatments. 
     Physiological Application 
       FIG. 1  illustrates the hyperpolarization mechanism of pain reduction according to various embodiments. Pain signals from receptors that are large enough to exceed the trigger threshold for the exchange of sodium and potassium ions across a nerve cell membrane do so through changes in the ion permeability of this membrane. This ion exchange causes a polarity change across and along the cell wall of the nerve fiber affecting the transmission of pain information along certain C type fibers as shown in Part A of  FIG. 1 . Several mechanisms of action caused by the Beat Frequency to reduce pain, namely (1) Frequency Conduction Block (also called Hyperpolarization), (2) Gate Control, (3) increased blood flow and (4) the release of endorphins or other opiate-like analogs. 
     Frequency Conduction Block. In Part B of  FIG. 1 , with the low frequency electric field in place, the membranes of C fibers that fall within the electric field are hyperpolarized. As a result, the sodium/potassium ion exchange is inhibited and the cell wall is prevented from changing polarity (from a negative potential to a positive potential) thus impeding the transmission of action potentials. As a result, pain impulses along the C fibers are blocked—similar in action to local chemical anesthesia, except without any deleterious side effects. 
     A further explanation of the therapeutic Hyperpolarization mechanism is that the resulting beat frequency, its signal morphology and current densities within the volume of tissue around and below each electrode, causes an alteration in the nerve cell membrane&#39;s sodium/potassium ion concentrations or ion exchange kinetics. As a result, the charge polarity of the nerve cell wall is prevented from changing and is therefore unable to transmit pain impulses. 
     Empirically, the difference signal does affect the sensory fibers, as some loss of proprioception at the skin as well as induction of hypoesthesia in the region of the active low frequency electrical field occurs about 5 minutes into the treatment, similarly to but not as absolute as a chemical anesthetic. Following a 30-minute treatment, hypoesthesia remains typically for up to 20 minutes post treatment. 
     Empirically, the difference signal also affects muscle tissue, which is polarized, in that it holds muscle tissue in tension during the treatment, which results in the patient feeling a deep, smooth sensation from the electrical field which is comfortable and provides for excellent patient compliance using the device. 
     Gate Control. Gate Control focuses on interactions of four classes of neurons in the dorsal horn of the spinal cord as shown in  FIG. 2 : (1) C fibers which are unmyelinated, (2) Aβ/Aδ fibers which are myelinated, (3) projection neurons whose activity results in the transmission of pain information, and (4) inhibitory interneurons which inhibit the projection neuron, thus reducing the transmission of pain information. 
     The projection neuron is directly activated by both Aβ/Aδ and C fibers. However, only the Aβ/Aδ fibers activate the inhibitory interneuron. Thus, when Aβ/Aδ fibers are stimulated by the beat frequency from the electric field, the inhibitory interneuron is activated and prevents the projection neuron from transmitting pain information to the brain. The  C fiber  is left in a state analogous to an open electrical circuit so that transmission of the sensation of pain is suppressed. 
     Increased Blood Flow. An additional mechanism of action is that the resulting low frequency electrical field that forms beneath and surrounding both electrodes can accelerate any charged species under its influence. This may lead to an increase in local blood flow. Medical studies have shown that proper blood flow is required for the healing of any wound or injury. With the treatment application of the apparatus, there appears to be a concomitant increase in blood flow in the volume of tissue where the electric field is present that accelerates healing. Clinical evidence shows there is also a concomitant increase in range of motion and reduction of stiffness for up to 24 hours following the treatment. 
     Release of Endorphins or Other Opiate-like Analogs. Empirical evidence suggests that residual pain relief and an increase in range of motion can last for up to 24 hours following a thirty (30) minute treatment. The residual effect involves either a refractory mechanism involving the membrane itself or the local release of endorphins, enkaphlins or other opiate-like analogs. 
     Unique Control and Management Apparatus and Method 
     According to various embodiments of the present disclosure, the electro therapy device controls the output of a handheld high frequency neurostimulator for providing a therapeutic treatment inside the body to treat pain and other conditions by utilizing a digital amplifier, feedback control utilizing filters, and other circuitry to provide comfortable treatment to patients. Advantageously, the electrotherapy device described in the present disclosure eliminates electrical spikes and jolts regardless if the patient is siting or moving about during the treatment. 
     One embodiment of the electrotherapeutic apparatus involves two signals: S 1  represents a first signal at a first frequency and S 2  represents a second signal at a second frequency. S 1  and S 2  are linearly independent AC signals. At any given instant one electrode can act as the source of the signal while the other electrode can serve as its return. Due to the AC nature of the signal these roles become reversed as a function of the instantaneous polarity of said signal. The time dependent roles of the electrode vary for the two signals as they are not in phase. It will be appreciated that the effect within the body from the combination of S 1  and S 2  passing through the body to the respective electrodes produces the pain-relieving effects described above. 
       FIG. 3  illustrates output portions of an electrotherapeutic device in accordance with some embodiments of the present disclosure. More specifically,  FIG. 3  depicts a sub-system  50  for converting Signal  1  and Signal  2  to sine wave signals. As discussed above, the ultimate output signals of the electrotherapy device need to be as close to a pure sine wave as possible. Signal  1  and Signal  2  are initially logic level square-type waves. These signals are limited to 0.6V amplitude by the transistor limiters. The outputs of these limiters are applied independently to high-order low pass filters  52  and  54 . The filter clock  36 , if switched capacitor filters are used, output is coupled to each of the filters. These filters suppress the higher order harmonics present in the limited square waves leaving low distortion sine waves at the reference frequencies. These sinusoidal signals are amplified and applied to electronic attenuators or programmable amplifiers  56  and  58  (under microprocessor  12  control) to control the level of the signal applied to the power amp stage, discussed below, and ultimately to the patient. The signals are then buffered  60  and  62  and applied to a power gain stage. The power stage consists of one or more amplifiers  67 ,  69  capable of supplying a wide range of voltages into any physiological and electrode load over the frequency ranges used. Depending on the desired level of system integration and/or portability required, this amplifier stage can be either of the linear Classes A or AB 1  or the nonlinear switching Class D type. In various embodiments, use of the Class D amplifier, as discussed in further detail below, provides the efficiency and in turn, minimal heat generation properties, to allow enclosure of the therapeutic device for water resistant properties. 
     For Class D amplifiers a high-speed comparator varies the pulse width of a switching power transistor (MOSFET type). This modulation is called pulse width modulation and is driven by the original signal&#39;s frequency, amplitude and desired gain. The sampling of the reference signal, derived from either a PLL reference or DDS, is sampled at a rate at several orders of magnitude higher than the highest frequency component in said reference. The output of the power transistor is low-pass filtered by a passive LC network to yield the amplified signal. The mode of amplifier operation is particularly attractive since power conversion efficiencies of over 90% can be obtained as opposed to the efficiencies of linear amplifiers which are between 40% to 70%. The microcontroller  12  sets, via electronic switching  68 , whether the signals are summed at an amplifier to create the mixed signal or applied individually to the power stage and thereby allows the mixing to take place within the patient&#39;s body. Additionally, one or more channels and/or return signal paths can be multiplexed with electronic power switching during zero crossing of the sine wave signals (via processor control). This multiplexing or switching allows multiple electrodes to be fed from the amplifiers or connected to an analog return. This is done to synthesize a larger effective target region on or within the patient. The patient is electrically isolated from leakage to power mains by the isolated plastic housing of the Apparatus and by the use of a battery power supply. 
       FIG. 4  illustrates the coupling of Sine wave  1  and Sine wave  2  to the electrodes when the apparatus is constructed using around ground referenced (local Apparatus ground) linear power amplifiers in accordance with some embodiments of the present disclosure. The sine wave signal is coupled from the junction of current monitor  76  or  78  and voltage monitor  80  or  82  or  82  to a DC isolation capacitor  88  or  92 . This capacitor removes any remaining DC component on the sine wave signal. The sine wave signal is coupled to transformer  90  or  94 . The output of the transformer  90  is coupled to the patient electrodes. One output of each transformer  96  or  100  is coupled to a large signal electrode and the other to a small return electrode  98  or  102 . The transformer provides voltage gain and patient/apparatus isolation. With bridged amplifiers or in Class D operation no such transformers are required unless additional voltage gain is needed. In various embodiments, the Dispersive electrode has a much larger surface area contacting the patient than the Pain Site electrode. This size ratio of the Dispersive electrode to the Pain Site electrode is at least 2:1. In some embodiments, the electrodes are the same size and act as both pain site and return electrodes for each other depending on the opposing delivery of the signals. 
     In some embodiments, a feedback network is disclosed. In various embodiments, the feedback network consists of two functional parts: 1) a circuit (Hardware), that monitors the patient-applied current and possibly voltage and 2) software that determines if the values measured require an output level change (Software). The parameter derived from the current and voltage is the impedance across the patient-applied electrodes. This parameter has been found by studies to be essentially invariant at a given frequency (frequency interval for this device) and over the range of applied potentials used clinically. Further, any impedance change due to a change in patient position essentially disappears when he or she either returns to the position held before the impedance change or after there is an equilibration of blood flow. 
       FIG. 5  illustrates the structure of an electrotherapeutic apparatus according to some embodiments of the present disclosure. In various embodiments, a microcontroller  12  supervises the entire operation of the apparatus. The microcontroller  12  is responsible for interpreting operator commands and for displaying system status on the display panel  14 . Additionally, the processor controls the frequencies of the signal sources, their levels and compensates for any variation in system load. This last function is important since changes in patient electric load can affect the signal level and the perceived sensation of the apparatus effect. The microcontroller  12  uses feedback to control signal levels by comparing the immediate electrical load to previously “learned” characteristic rules for a particular patient. The microcontroller  12  provides input to the digital gain control unit  58 . Additionally, the microcontroller  12  receives operation instructions from software containing algorithms and control routines stored in memory  18 . In various embodiments, memory  18  may be pre-programmed by an operator. The microcontroller  12  provides instructions to various portions of the signal generation system. The signal system generates two signals. In some embodiments, microcontroller  12  is also responsible for displaying alarms and indications via an indicator unit  15 . In some embodiments, this includes an LED display unit having different colors. By way of example, the indicator unit  15  may display Green for indicating battery strength or charge level of the portable unit. Other parameters may identify Bluetooth capability, signal intensity, treatment time, and/or indicate errors or aid in troubleshooting. One of ordinary skill in the art will appreciate that the indicator unit  15  may display various visual indicators useful to a patient for displaying alarms and operations of the electrotherapeutic unit. 
     The microcontroller supervises the operation by adjusting the digital gain control  58  for the apparatus. As described above, the signals from above are buffered  60  and  62  and applied to a power gain stage. The power stage consists of one or more amplifiers  67 ,  69  capable of supplying a wide range of voltages into any physiological and electrode load over the frequency ranges used. The second class of amplifiers, which also improves performance in a portable system, is that of Class-D. 
     As described above, there are several ways of generating and amplifying signals. All methods rely on individual oscillators and amplifiers. Class AB 1  amplification is a well-known method for amplifying sinusoidal signals. In the present disclosure the input to these amplifiers are controlled-amplitude sinusoidal signals of differing frequencies. Regulation of the output signal, as a function of load impedance, is achieved by the close-looped feedback network which also can either alter the gain of the power amplifier or the amplitude of the power amplifier&#39;s input signal. 
     Another method uses Class D switching amplifiers. There are two ways these amplifiers can be used to generate the signals. In one method pulse width modulated signals, representing the two frequencies is generated by a microcontroller  12 . The width of the pulses defines the amplitude of the final signals and the rate of the pulse packet defines the frequency. These pulse packets drive a set of field effect switching transistors. The output of these transistors is low-pass filtered, reconstructing the sinusoidal signal of the desired amplitude. The second method uses a comparator, connected to a reference sinusoidal signal of set amplitude and a triangular ramp signal. The output of the comparator is a pulse width modulated signal that drives the same circuit, as mentioned above, to generate the output signal. Regulation of the output signal can be achieved by a feedback loop from the output to a summing circuit at the input or monitoring the output using an analog-to-digital circuit on the system&#39;s microcontroller  12 . The microcontroller  12  can use the digital values of the changes in the output signal, due to changes in load impedance, to adjust the pulse width modulation signal to compensate for these variations. 
     The unique third method is one derived from high-efficiency radio frequency amplifiers—Class E. Class E is a switching amplifier where a power MOS field effect transistor is driven by a square wave signal whose repetition rate corresponds to the desired output frequency. The amplified pulse is bandpass-filtered recreating an amplified sinusoidal signal. The amplitude of the signal is set by the power supply voltage level. Regulation of the output is achieved by sampling the output signal and using it to control the power supply voltage level to maintain fixed output signal amplitude independent of load impedance. The regulation circuit can be realized by direct hardware feedback or by using the microcontroller&#39;s  12  analog-to-digital converter to measure the output amplitude and using the difference between desired amplitude and actual amplitude to set the control voltage on the power supply. 
     Advantageously, the ability to regulate the output of a digital amplifier into a dynamic load makes for a much more comfortable smooth treatment sensation as the patient moves during treatment. This ultimately results in excellent patient compliance using the device. Regulation of the output signal can be achieved by a feedback loop from the output to a summing circuit at the input or monitoring the output using an analog-to-digital circuit on the system&#39;s microcontroller. The microcontroller can use the digital values of the changes in the output signal, due to changes in load impedance, to adjust the pulse width modulation signal to compensate for these variations. 
       FIGS. 6-8  illustrate the general block structures of an electrotherapeutic apparatus in accordance with some embodiments of the present disclosure. In  FIG. 6 , according to some embodiments, S 1  represents a sine wave reference signal generated by an analog oscillator  106 . S 2  represents a sine wave reference signal which is derived from low-pass filtered  104  pulses generated by the pulse width modulation (PWM)  105  module within the microcontroller  12 . These are two possible ways of producing the reference signals. Attenuator  101  controls the amplitude of the reference sine wave which is fed to a class AB power amplifier  70 . The output of the power amplifier  70  is applied to the patient-connected electrode  103 . According to some embodiments, each channel requires (either  106  or  104 ),  101 ,  70 ,  12  and  103 . 
     In  FIG. 7 , according to various embodiments, microcontroller  12  generates a PWM signal where the relative widths of the pulses control the ultimate amplitude of the final signal. A MOSFET transistor bridge switching network  203  is driven by the PWM signal described above. The output of this bridge is a large-signal replica of the original PWM signal—Class D. This signal is passed to a low-pass filter  203  network with a cutoff frequency much lower than the pulse rate of the PWM signal. The transformer supplies voltage gain to enable the use of low voltage power supplies and low voltage monolithic or discrete device class D amplifiers. Two forms of feedback, for signal regulation, can be used: 1. A direct feedback network in the loop between the output of the switching MOSFETs to the input or 2. Using the microcontroller&#39;s  12  analog-to-digital converter to sample  204  the analog output voltage and correct this voltage by dynamically varying the PWM signal. Each channel requires  201 ,  203 ,  204  and  205 . 
     In  FIG. 8 , according to various embodiments, a Class E embodiment is disclosed. Class E is a switching amplifier where 50% duty-cycle pulses drive a power switch. The pulse repetition rate is at the frequency of interest. Microcontroller  12  generates the logic-level pulses. This signal drives a MOSFET power  301  transistor whose output swings between the power supply rail and near ground. This output signal is applied to an inductor/capacitor network  302  resonant at the frequency of interest. This signal is applied to the patient-connected electrode  305 . Output amplitude is entirely set by the power supply rail voltage  304 . The output signal is sampled and converted to a DC correction voltage  303 . This voltage is used to trim the power supply voltage thereby regulating the output signal. Each channel individually requires  301 ,  302 ,  303 ,  304  and  305 . 
     Class E amplifiers are characterized by simple design, construction and relatively high efficiency (&gt;=90%). Our therapeutic signal difference of around 122 Hz can be delivered over a band of frequencies ranging from around 1 KHz to 30 KHz. As the frequency rises the body-load impedance drops. Therefore, for a given delivered power a lower output voltage is required. Class E amplifiers require 2 amplifier channels each separately applied to one of the two electrodes. The second electrode acts as the return path for each signal. Class E amplifiers are pulse-switched tuned-output devices where the load impedance is matched to the tuned output network of the amplifier. The design of the amplifiers as disclosed according to some embodiments requires that each amplifier be tuned to some mid-band frequency (e.g.) 10 KHz and 10.122 KHz at the average body load impedance. The operational voltage is set by the amplifier&#39; MOSFET drain voltage. If the patient load varies it will be reflected in the measured applied voltage and current. These voltages and currents are monitored by the system microcontroller  12 . The contents of look-up tables, indexed by the desired voltage and expected current, are compared to the drain voltage and the measured voltage and current. The error in expected and measured voltage and current are used by an algorithm to determine what change in operating frequencies would be required to return the output signal to its proper power density. Since, as indicated above, we have a fairly broad available frequency range it should be possible to dynamically correct for the impedance mismatch and apply the proper power to the patient load. 
     Transformer 
     For both safety and economic reasons, it is desirous to operate the device&#39;s power amplifier section at lower output voltages. In terms of safety, the use of low voltage power amplifiers guarantees that a harmless D.C. voltage level would be applied to the patient if the D.C. isolation mechanism should fail. Additionally, the use of lower supply rails lessens the complexity and cost of the power amplifier&#39;s power supplies and greatly broadens the number and types of power amplifier topologies and/or devices that can be used. This allows for more choice in determining the best power amplifier for a given price and performance. In the device transformers can supply either D.C. isolation and/or voltage gain. In one embodiment, a high coupling toroidal transformer was used to increase the device output voltage by a factor of 2.4. This kept the power supply design simple and inserted a magnetic isolation barrier between the patient and the device. In another embodiment, as discussed in more detail below, an autotransformer configuration is used to boost the output voltage from 6 V RMS to 36 V RMS. However, the inherent losses and non-linear responses found with any transformer causes its output voltage to vary as a function of the load it is connected to. This failure-to-follow or poor regulation can and does lead to patient discomfort. In order to take advantage of a transformer&#39;s voltage gain it is necessary to compensate for poor regulation. 
     Poor regulation can be overcome via two methods: 1. Electronically—where a sample of the output controls the gain of the output circuitry; and 2. Utilizing the microcontroller  12 —where a sample of the output is converted and used by the microcontroller  12  to determine a correction to the setting of the digital intensity control. 
     For the configuration where the transformer has isolated primary and secondary windings, the output is sampled and returned to the amplifier section through an isolation amplifier. This is required in order to maintain the D.C. isolation barrier created by the transformer. The output of the isolation amplifier is used to either vary the bias on a transconductance amplifier or the resistance of an attenuator which controls the gain of the device&#39;s preamplifiers or power amplifier directly, in response to deviations in the output signals relative to a reference. For the autotransformer configuration, no isolation amplifier is used since this transformer-type is inherently non-isolating. In this case capacitors are used to isolate the D.C. from the output. Regulation for this transformer output is maintained by connecting the transformer primary tap or an attenuated signal developed from the high voltage tap back to the inverting input of the power amplifier. This closes the amplifier loop thereby dynamically compensating for the transformer&#39;s non-ideal behavior. 
     Safe Operating Limits 
     Paramount to any medical electrical device is the prevention or discontinuation of device&#39;s operation when it encounters an unsafe condition. For the electrotherapy device we have developed, the major unsafe condition arises when the applied current causes a rise of skin temperature above 41° C. causing a thermal burn. Another condition, which is more unpleasant than dangerous, is when the output voltage abruptly changes as a function of load change. This is perceived by the patient as a surge-like feeling. This condition is normally not associated with an increase of skin current density and as such cannot cause injury. 
     There are two methods which have been used to ameliorate the burn-mode of device operation. One method uses the microcontroller  12  and its software to determine if the current flow exceeds a pre-programmed limit. The output current is sampled either by a small-valued series resistor or a resistor terminated current transformer. The analog level which represents the output current is converted to a digital value and compared continuously with the preset limit. When this limit is exceeded the software turns off the power amplifier(s) or their power supplies and signals the user to the over-current condition. 
     The second method of safe operational control also uses a measure of the output current or a measure of the load impedance as determined from this current and applied voltage. Current monitoring is affected as with the limit control above. Voltage monitoring is performed by sampling the output voltage and converting it to a digital representation of the RMS applied voltage. Software uses these values to determine if operation is exceeding safety guidelines. For example, a drop in load impedance increases the output current. Impedance values derived from low output-level startup current and voltage values are used to determine impedance measures. An algorithm sets the allowed current limits for a given output level. If device operation falls outside of these limits, for a predetermined period, the device can shut down the device or the ability to increase signal intensity can be disabled. The use of an operational-limit algorithm and time measure is critical since there can be situations (for example, output settling or momentary electrode condition changes) where operation falls outside certain limits but are not a reflection of a device failure or other unsafe condition. Further, dynamic lowering of the device output level is used when for a given intensity the impedance changes outside of predetermined limits for a given period. This mode of operation is used to lessen or eliminate the chance of a burn when the power density rises above guideline limits. The operator can still bring down the intensity and need not stop operation as long as the maximum allowed current is never exceeded. Normal device operation is restored when the measured impedance returns to within pre-determined operational limits. If this fails to happen within a predetermined elapsed time the device is disabled, and the condition is indicated to the operator. 
     Timer 
     According to various embodiments, a timer, which can be auto-loaded with a default treatment time or have the treatment time set by the operator, is initialized and maintained by the device&#39;s system software. This timer has several uses. It shuts off the device at the end the elapsed treatment time and it acts as a reference for the safe-operation-limits software to help determine whether a time-dependent excursion outside of normal impedance boundaries is interpreted as a failure or transient event. This could include limiting the number of treatments a patient can receive within a pre-determined period. The timer can also be used to change the device output intensity as a function of a pre-loaded time-sequenced treatment protocol. The amount of aggregate treatment time accumulated by the device is updated by the timer at the end of each treatment session. This information is used to determine when battery replacement or other service procedures should be performed. 
     Autotransformer 
     It is useful if the operating voltage of the output power amplifier could remain low. This lessens losses in the switching power supply that increase as the voltages needed rise. Additionally, higher voltage amplifiers are more expensive and usually physically larger. In various embodiments, one method to achieve voltage gain is by using a transformer. Typical transformers have a primary winding and a secondary winding. They offer voltage or current gain while isolating the input circuit from the output circuit. Unfortunately, there are losses associated with the core of the transformer, the winding resistance and imprecise coupling (magnetic) between the primary and secondary winding. One way to utilize the voltage gain capabilities of a transformer is through the use of the autotransformer configuration. Here the primary and secondary share the same winding. For voltage gain assume that the input signal, in closed feedback loop with the output amplifier, is applied to N turns of wire wrapped around a ferromagnetic core (ideally a toroid) the secondary winding is just a continuation of the primary winding (electrically the same wire). To get twice the voltage from the secondary the winding is continued for another N turns on the same core. The output is taken from the end of the secondary winding. In this configuration there is tighter magnetic coupling and good output regulation (as opposed to what is found with isolated primary and secondary windings). Additionally, the autotransformer is cheaper, electrically better and smaller than a normal transformer. If desired, the output at the secondary can be attenuated and if need be phase-shifted and used to close the loop of the power amplifier. The attenuation is necessary to maintain the amplifier&#39;s differential input voltages close in value as the feedback loop requires. 
     Construction 
       FIG. 9  is a depiction of an electrotherapeutic device according to some embodiments of the present disclosure. According to various embodiments, the electrotherapy device includes an option for physically manipulating the intensity of the treatment. In some embodiments, the electrotherapy device includes a communications unit for communicating with a client device to adjust the parameters remotely. For example, the electrotherapy device may be operated remotely using a client device connected via Bluetooth or WiFi communications. It should be appreciated to one of ordinary skill in the art that a client device may remotely connect to the electrotherapy device in various ways for operation. In some embodiments, the electrotherapy device may include an angled female port for connecting the electrodes. The angled port advantageously permits ease of access and wearable functionality for the electrotherapy device. In various embodiments, the angled port includes a depression for recessing the connection of the electrodes. In some embodiments, the recessed port includes a plurality of indentations configured to receive a cable attached to the male connector such that the cable is located against the side edges of the substantially rectangular device when the male connector is inserted into the female port 
     It may be emphasized that the above-described embodiments, are merely possible examples of implementations, and merely set forth a clear understanding of the principles of the disclosure. Many variations and modifications may be made to the above-described embodiments of the disclosure without departing substantially from the spirit and principles of the disclosure. All such modifications and variations are intended to be included herein within the scope of this disclosure and the present disclosure and protected by the following claims. 
     Embodiments of the subject matter and the functional operations described in this specification may be implemented in electrical or electromechanical means, including the structures disclosed in this specification and their structural equivalents, or in combinations of one or more of them. Embodiments of the subject matter described in this specification may be implemented as an electrical or electromechanical unit. 
     Wearable System 
     The disclosed embodiments describe an electrotherapeutic apparatus in various configurations. Disclosed embodiments of the electrotherapeutic apparatus include features to apply a treatment to a user, including different options and controls for applying different treatments depending on particular applications. For example, disclosed embodiments may include electrotherapeutic treatment options for various users and parts of the user&#39;s body, depending on various factors. Further disclosed embodiments include wearable systems for positioning and applying the features of the disclosed electrotherapeutic devices to a user. The wearable systems may include various features for enabling an electrotherapeutic apparatus to be applied to different parts of the body, depending on a desired application. 
       FIG. 10A  is a block diagram of an exemplary wearable system  400 , according to disclosed embodiments. The wearable system  400  includes and/or is useable with an electrotherapeutic device  405 . The electrotherapeutic device  405  may be a device disclosed herein, such as a device illustrated and described in relation to  FIGS. 1-9 . The electrotherapeutic device  405  may include electronics  407  configured to supply an electric pulse via a device connector  409 . The device connector  409  may be a removable mechanical and electrical connector configured to attach to a portion of the wearable system  400 . An electric pulse applied by the electrotherapeutic device  405  may be a therapeutic dose consistent with disclosed embodiments and may be particularly configured according to a target area of the user&#39;s body. 
     The wearable system  400  may include a garment  410 . The garment  410  may be configured to be worn by a user/patient. The garment  410  may include, for example, a material body in the form of wrap-like or sleeve-like material construction configured to be worn in close contact to a targeted body part, such as a back, elbow, knee, wrist, or ankle of a user. The garment  410  may be configured to be positioned with respect to a user&#39;s body. For example, the garment  410  may be wrapped around a waist, limb, hand, foot, etc. of the user and held in place. In other embodiments, the garment  410  may be a sleeve with a built-in elastic property such that the sleeve is pulled over a part of the user&#39;s body until held in place by the elastic property at a targeted body part. 
     The wearable system  400  may further include one or more electrodes  420 . In an exemplary embodiment, the one or more electrodes include a first electrode  420 A and a second electrode  420 B. Each electrode  420  may include a conductive electrode element, such as a conductive fabric electrode patch configured to apply an electrotherapeutic pulse to the wearer of the garment  410 . The electrodes  420  may be integrally formed with the garment  410  in some embodiments. For example, the electrodes  420  may be a conductive fabric material making up all or a portion of the garment  410 . In other embodiments, the electrodes  420  may be permanently or removably attached to the garment  410 . The electrodes  420  may include a silver fabric in contact with the wearer as a conductive surface. The electrodes  420  may be strategically positioned to target a particular location on the user&#39;s body when the garment  410  is worn. In some embodiments, the electrodes  420  may be used in conjunction with a cream, gel, or other product that is applied to the skin at the targeted area to increase skin conductivity. According to disclosed embodiments, the electrode size and location for each electrode are designed to optimize delivery of high frequency signals and allow the formation inside the body of the active low frequency electrical field in the optimized desired location that would encompass and block the transmission of pain signals travelling along pain nerves. 
     In at least some embodiments, the electrodes  420  are raised off the inside surface of the electrode garment by placing a compression material (e.g., memory foam) under the conductive fabric. This ensures that when the garment  410  is compressed around the area to be treated, the compression material further presses the conductive fabric against the skin to ensure a good electrical connection.  FIG. 10B  shows the profile of an exemplary electrode  420  from the side, illustrating the raised contact surface  422  of the conductive fabric  424  due to the thickness of the compression material (e.g., memory foam) placed underneath. This construction may be applied to any of the disclosed wearable systems and associated garments. Each disclosed garment  410  provides compression in addition to delivering pain relief into the body. Compression may act as an additional benefit to the patient, in addition to providing enhanced electrical conduction between the silver fabric and the skin. 
     The wearable system  400  may further include one or more electrode connectors  430 . The electrode connector  430  may include a physical connector configured to connect the electrode  420  to another component, such as the electrotherapeutic device  405 . The electrode connector  430  may be, for example, a metal snap connector configured as a male/female feature configured to mate with a corresponding male/female connector. The electrode connector  430  may be configured to directly or indirectly attach to the device connector  409  to complete a circuit between the electrotherapeutic device  405  and the electrode  420 . 
       FIG. 10C  further illustrates an exemplary embodiment of the electrode connector  430 , which may be a two-part connector including a stud  432  and a rivet  434 . The stud  432  sits on the outside of the garment and the rivet  434  is inserted through the garment into the stud  432  and makes an electrical connection between the silver fabric and the stud  432 .  FIG. 10D  illustrates the stud  432  on the exterior surface of the garment  410 . 
     In an exemplary embodiment, the electrode  420  and electrode connector  430  may be configured to prevent the connector from being in a contact surface area of the electrode  420 . If the electrode connector  430  were to contact the wearer, a hot spot or stinging sensation may be experienced by the wearer. The garment  410  may be configured to help prevent this occurrence. In one example, the bottom side of the rivet  434  which is exposed on the conductive fabric  424  may be coated with a nonconductive coating to prevent stinging. In another embodiment, the contact surface  422  of the electrode  420  (e.g., silver fabric) is extended off of the raised compression material and the electrode connector  430  (e.g., the rivet  434 ) is located at this recessed level  426  on the conductive fabric  424  below the raised contact surface  422  portion of the conductive fabric  424  that touches the skin.  FIGS. 10B and 10E  further illustrates this feature. A cover material  428  may be non-conductive and configured to cover the recessed level  426  of the conductive fabric  424  of the electrode  420 . 
     The wearable system  400  may also include an intermediate wire  440  configured to connect the electrode connector  430  to the device connector  409  of the therapeutic device  405 .  FIG. 11  is an embodiment of an exemplary intermediate wire  440 . The intermediate wire  440  may include a first wire connector  442  configured to operably attach to the electrode connector  430  and a second wire connector  444  configured to operably attach to the device connector  409 . For example, the first wire connector  442  may be a connector configured to removably “snap” to the electrode connector  430 . The second wire connector  444  may be a buckle-type connector in some embodiments configured to attach to mating device connector  409  (e.g., in the form of a similar buckle-type connector). 
     In some embodiments, the wearable system  400  may further include a wire management feature  450 . The wire management feature may include a built-in feature of the garment  410  configured to receive and/or manage at least a portion of a connection between the electrode  420  and the electrotherapeutic device  405 . For example, the wire management feature  450  may include a channel configured to receive and route the intermediate wire  440  from the electrode connector  430  to the electrotherapeutic device  405 . 
     In some embodiments, the wearable system  400  may further include a carrier  460  for the electrotherapeutic device  405 . For example, the garment  410  may include a pocket, pouch, or other storage and/or attachment feature configured to hold and/or store the electrotherapeutic device of  FIG. 9 . In this way, the electrotherapeutic device  405  may be readily accessible and carried by the garment  410 . In some embodiments, the electrotherapeutic device  405  may be built-in and/or integrally formed with the garment  410 . For example, the garment  410  may include built-in circuitry and/or processing components for routing electrical pulses to the electrode  420 . 
     In some embodiments, the wearable system  400  may also include an attachment mechanism  470 . The attachment mechanism  470  may include, for example, an elastic strap, mechanical connector, loop, hook and loop fastener, etc. that holds the garment  405  in place on the user&#39;s body. The attachment mechanism  470  may be particularly configured depending on the targeted part of the body. The attachment mechanism  470 , in at least some embodiments, provides compression directly over the application area (e.g., the area corresponding location of the one or more electrodes  420 ) to maintain electrical contact with targeted part of the user&#39;s body. 
     The wearable system  400  encompasses multiple embodiments that may include configurations that are tailored to certain parts of the body. For example, embodiments, may include a lower back wearable system  500 , knee wearable system  600 , ankle/foot wearable system  700 , elbow wearable system  800 , wrist/hand wearable system  900 , shoulder wearable system  1000 , and head/neck wearable system  1100 . However, it should be understood that other embodiments may be formed to target other parts of the body. 
     The wearable system  400  is configured to provide a therapeutic signal to the targeted area of the user through the first and second electrodes  420 A,  420 B. The therapeutic signal may be as described herein with respect to  FIGS. 1-9 . For example, the therapeutic signal may be a combination of a first and second signal that is delivered through the electrode  420 . The therapeutic signal may include a voltage level. In some embodiments, the user increases the voltage to tolerance at whatever location is being treated. As the body adapts to the electrical field, the sensation felt by the patient diminishes and the user needs to increase the voltage to maintain a strong steady state sensation from the electrical field. The rate of increase in voltage may be greater in the first 5 minutes of treatment; then the rate of increase in voltage may decrease over the remainder of a 30-minute treatment, for example. The voltage may also be selected based on the target area. For example, some patients can tolerate a higher voltage (high level of stimulation) in the foot-ankle and knee areas; a medium voltage level (medium level of stimulation) in the low back and shoulder areas; and a lower voltage level (lower level of stimulation) in the hand-wrist, elbow and neck areas. 
       FIGS. 12A and 12B  are front and back views of a first exemplary embodiment of the lower back wearable system  500 . The lower back wearable system  500  may include a garment  510 . The garment  510  may be constructed as a belt configured to be worn around a waist of a user. The garment  510  may include a fabric material and include a tapered design to include a larger surface area at an application area  512  configured to be positioned adjacent to the lower back of a user. The garment  510  may include attachment mechanism  514  in the form of mating hook and loop fasteners  516  and/or optional tightening straps  518 . It is also contemplated that garment  510  may be constructed as a sleeve, and made of stretch material, such that garment  510  can be pulled onto the waist of a user, without the need to wrap garment  510 , where the stretch material secures garment  510  into place. For example, in some embodiments, the attachment mechanism  514  may be a built-in elastic property, such as may be present in a sleeve embodiment, and not necessarily an additional feature such as fasteners  516  and/or straps  518 . 
     The garment  510  may include an interior surface  520  configured to contact the user and an opposite exterior surface  522 . The lower back wearable system  500  may further comprise one or more electrodes  524  on the interior surface  520  and configured to contact the user. The electrodes  524  may be built-in conductive fabric electrodes, for example. The one or more electrodes  524  may include two electrode pads positioned in the application area  512  and configured to contact a lower back area of a user. In an exemplary embodiment, the one or more electrodes  524  are positioned on opposing sides of a center line  526  of the garment  510  to provide two spaced-apart electrotherapeutic locations for the lower back wearable system  500 . While two electrodes  524  are shown, it should be understood that disclosed embodiments are not limited to any particular number of electrodes. 
     The garment  510  may further include at least one electrode connector  528 . The garment  510  may include an electrode connector  528  for each electrode  524 . The electrode connector  528  may include a mechanical and electrical connection point for the respective electrode  524 . In an exemplary embodiment, the electrode connector  528  is a snap connector, such as a male snap element configured to mate with a female snap element. The electrode connector  528  may include a conductive material (e.g., metal) such that a functional electrical connection may be established with the electrode  524  via the electrode connector  528 . In an exemplary embodiment, the electrode connector  528  may have a non-conductive coating on the bottom side of the snap connector (e.g., the rivet) that is exposed on the face of the electrode  524 . This non-conductive coating helps to prevent the patient from feeling a hot spot or stinging sensation at the location of the electrode connector  528 . In an exemplary embodiment, the electrode connectors  528  are exposed on the exterior surface  522  to facilitate connection to an intermediate wire  440 . 
     In an exemplary embodiment, the electrode connectors  528  are positioned on the exterior surface  522  above or below the location of the compression material (e.g., memory foam) which sits beneath and raises the electrode surface above the interior surface  520 . The conductive surface of the electrode  524  continues above or below the compression material directly onto the interior surface  520 . The electrode connector  528  may be placed at this location through the electrode surface but off of and away from the compression material. A nonconductive material may be applied to cover up the portion of the conductive fabric and the electrode connector  528  that sits recessed below the compression material. This type of construction helps to eliminate stinging and leave a smooth raised surface for the conductive electrode  524 . 
     The garment  510  may further include channels  530 . The channels  530  may be wire management features configured to receive and route a wire connector between the electrode connectors  528  and an electrotherapeutic device. For example, each channel  530  may be positioned adjacent to a respective electrode connector  528  and configured to route intermediate wire  440  from the electrode connector  528  to another position (e.g., beneath or above the garment  510 ). The first wire connector  442  of each intermediate wire  440  may be configured to attach to a respective electrode connector  528 . 
       FIGS. 13A and 13B  include another exemplary embodiment of a lower back wearable system  500 A, including another design with similar features. For examples, the lower back wearable system  500 A may include a different design for tightening straps  518 A and a centered location for a connection to the intermediate wires  440 . 
       FIGS. 14A, 14B, and 15  further illustrate the lower back wearable system  500  being worn by a user. The garment  510  is held in place by the attachment mechanism  514  such that the electrodes  524  are positioned at a target area—the lower back of the user. A shown in  FIG. 14A , the user can pull the tightening straps  518  toward the front of the user and re-attach them to the exterior surface  522 , as shown in  FIG. 14B . Tightening straps  518  start at the centerline of the back of the device over the user&#39;s spine and provide compression directly over the back side of both electrodes  524 , as well as cover over the intermediate wires  440 , electrode connectors  528  and channels  530 . 
     Intermediate wires  440  are connected to the electrode connectors  528  and routed through the channels  530 . The second wire connectors  444  are easily accessible for functional connection to an electrotherapeutic device according to disclosed embodiments. 
       FIGS. 16A and 16B  are front and back views of a first embodiment of the knee wearable system  600 . The knee wearable system  600  may include a garment  610 . The garment  610  may be constructed as a flexible wrap configured to be worn around a knee area of a user. The garment  610  may include a fabric material and include an application area  612  configured to be positioned adjacent to a knee area of a user. The garment  610  may further include attachment mechanism  614  in the form of an elastic strap  616  attached to the application area  612  for securing the garment  610  in place. The elastic strap  616  also provides compression directly over the electrodes  624  and as a result it provides better electrical conduction through the skin. The garment  610  may also include one or more loops  618  for routing the elastic strap  616  and a fastener  619  (e.g., hook and loop fastener) for securing the elastic strap  616  to the application area  612 . It is also contemplated that garment  610  may be constructed as a sleeve, and made of stretch material, such that garment  610  can be pulled onto the knee of a user, without the need to wrap garment  610 , where the stretch material secures garment  610  into place. For example, in some embodiments, the attachment mechanism  614  may be a built-in elastic property, such as may be present in a sleeve embodiment, and not necessarily an additional feature such as strap  616 , loops  618  and/or fastener  619 . 
     The garment  610  may include an interior surface  620  configured to contact the user and an opposite exterior surface  622 . The knee wearable system  600  may further comprise one or more electrodes  624  on the interior surface  620  and be configured to contact the user. The electrodes  624  may be built-in conductive fabric electrodes, for example. The one or more electrodes  624  may include two electrode pads positioned in the application area  612  and configured to contact a knee area of a user. In an exemplary embodiment, the one or more electrodes  624  are positioned on opposing sides of a knee cap hole  626  built-in to the garment  610  to provide two spaced-apart electrotherapeutic locations for the knee wearable system  600 . The electrodes  624  may be rectangular-shaped with cutout-portions  627  configured to follow an outline of the knee cap hole  626 . In this way, the electrodes  624  may be positioned such that treatment is not applied directly to the user&#39;s knee cap. While two electrodes  624  are shown, it should be understood that disclosed embodiments are not limited to any particular number of electrodes. 
     The garment  610  may further include at least one electrode connector  628 . The garment  610  may include an electrode connector  628  for each electrode  624 . The electrode connector  628  may include a mechanical and electrical connection point for the respective electrode  624 . In an exemplary embodiment, the electrode connector  628  is a snap connector, such as a male snap element configured to mate with a female snap element. The electrode connector  628  may include a conductive material (e.g., metal) such that a functional electrical connection may be established with the electrode  624  via the electrode connector  628 . In an exemplary embodiment, the electrode connector  628  may have a non-conductive coating on the bottom side of the snap connector (e.g., rivet) that is exposed on the face of the electrode  624 . This non-conductive coating helps to prevent the patient from feeling a hot spot or stinging sensation at the location of the snap connector. In an exemplary embodiment, the electrode connectors  628  are positioned on the exterior surface  622 . 
     In an exemplary embodiment, the electrode connectors  628  are positioned on the exterior surface  622  above or below the location of the compression material (e.g., memory foam) which sits beneath and raises the electrode surface above the interior surface  620 . The conductive surface of each electrode  624  may continue above or below the memory foam directly onto the interior surface  620 . The electrode connector  628  may be placed at this location through the electrode surface, spaced from the compression material. A nonconductive material may be applied to cover up the portion of the conductive fabric and the electrode connector  628  that sits recessed below the compression material. This type of construction eliminates stinging and leaves a smooth raised surface for the conductive electrode  624 . 
     The garment  610  may further include channels  630 . The channels  630  may be wire management features configured to receive and route a wire connector between the electrode connectors  628  and an electrotherapeutic device. For example, each channel  630  may be positioned adjacent to a respective electrode connector  628  and configured to route intermediate wire  440  from the electrode connector  628  to another position (e.g., beneath or above the garment  610 ). The first wire connector  442  of each intermediate wire  440  may be configured to attach to a respective electrode connector  628 . 
       FIGS. 16C and 16D  further illustrate the knee wearable system  600  being worn by a user. The garment  610  is held in place by the elastic strap  616  such that the electrodes  624  are positioned at a target area—the front leg around the area of the knee of the user. The user&#39;s knee cap is positioned in the knee cap hole  626 . Intermediate wires  440  are connected to the electrode connectors  628  and routed through the channels  630 . The second wire connectors  444  are easily accessible for functional connection to an electrotherapeutic device according to disclosed embodiments.  FIG. 16C  is an illustration of a right leg of a user and  FIG. 16D  is an illustration of a left leg of a user. The application area  612  may be generally symmetrical across a vertical center line through the knee cap hole  626  such that the knee wearable system  600  is configured to be worn on either the right or left leg as shown. 
       FIGS. 17A and 17B  are front and back views of a second embodiment of the knee wearable system  650 . The knee wearable system  650  may include a garment  660 . The garment  660  may be constructed as a flexible wrap configured to be worn around a knee area of a user. The garment  660  may include a fabric material and include an application area  662  configured to be positioned adjacent to a knee area of a user. The garment  660  may further include attachment mechanism  664  in the form of a first elastic strap  666  attached to the application area  662  and a second elastic strap  667  attached to the application area  662  for securing the garment  660  in place. The elastic straps  666  and  667  also provide compression. The elastic strap  667  provides compression directly over the electrodes  674  to provide better electrical conduction through the skin. The garment  660  may also include one or more loops  668  for routing the elastic straps  666 ,  668  and a fastener  669  (e.g., hook and loop fastener) for securing the elastic straps  666 ,  667  to the application area  662 . It is also contemplated that garment  660  may be constructed as a sleeve, and made of stretch material, such that garment  660  can be pulled onto the knee of a user, without the need to wrap garment  660 , where the stretch material secures garment  660  into place. For example, in some embodiments, the attachment mechanism  664  may be a built-in elastic property, such as may be present in a sleeve embodiment, and not necessarily an additional feature such as straps  666 ,  667 , loops  668  and/or fastener  669 . 
     The garment  660  may include an interior surface  670  configured to contact the user and an opposite exterior surface  672 . The knee wearable system  650  may further comprise one or more electrodes  674  on the interior surface  670  and be configured to contact the user. The electrodes  674  may be built-in conductive fabric electrodes, for example. The one or more electrodes  674  may include two electrode pads positioned in the application area  662  and configured to contact a knee area of a user. In an exemplary embodiment, the one or more electrodes  674  are positioned on opposing sides of a knee cap hole  676  built-in to the garment  660  to provide two spaced-apart electrotherapeutic locations for the knee wearable system  650 . The electrodes  674  may be generally shaped similar to a quarter-circle, with two straight edges connected by a curved edge. It should be understood, however, that the electrodes  674  can take other shapes depending on the application and/or size of the area to be contacted. While two electrodes  674  are shown, it should be understood that disclosed embodiments are not limited to any particular number of electrodes. 
     The garment  660  may further include at least one electrode connector  678 . The garment  660  may include an electrode connector  678  for each electrode  674 . The electrode connector  678  may include a mechanical and electrical connection point for the respective electrode  674 . In an exemplary embodiment, the electrode connector  678  is a snap connector, such as a male snap element configured to mate with a female snap element. The electrode connector  678  may include a conductive material (e.g., metal) such that a functional electrical connection may be established with the electrode  674  via the electrode connector  678 . In an exemplary embodiment, the electrode connector  678  may have a non-conductive coating on the bottom side of the snap connector (e.g., rivet) that is exposed on the face of the electrode  674 . This non-conductive coating helps to prevent the patient from feeling a hot spot or stinging sensation at the location of the snap connector. In an exemplary embodiment, the electrode connectors  628  are positioned on the exterior surface  672 . 
     In an exemplary embodiment, the electrode connectors  678  are positioned on the exterior surface  672  above or below the location of the compression material (e.g., memory foam) which sits beneath and raises the electrode surface above the interior surface  670 . The conductive surface of each electrode  674  may continue above or below the memory foam directly onto the interior surface  670 . The electrode connector  678  may be placed at this location through the electrode surface, spaced from the compression material. A nonconductive material may be applied to cover up the portion of the conductive fabric and the electrode connector  678  that sits recessed below the compression material. This type of construction eliminates stinging and leaves a smooth raised surface for the conductive electrode  674 . 
     The garment  660  may further include channels  680 . The channels  680  may be wire management features configured to receive and route a wire connector between the electrode connectors  678  and an electrotherapeutic device. For example, each channel  680  may be positioned adjacent to a respective electrode connector  678  and configured to route intermediate wire  440  from the electrode connector  678  to another position (e.g., beneath or above the garment  660 ). The first wire connector  442  of each intermediate wire  440  may be configured to attach to a respective electrode connector  678 . 
       FIGS. 18A-E  and  19 A-E further illustrate the knee wearable system  650  being attached and worn by a user. The garment  650  is held in place by the elastic straps  666 ,  667  such that the electrodes  674  are positioned at a target area—the front leg around the area of the knee of the user. The user&#39;s knee cap is positioned in the knee cap hole  676 . Intermediate wires  440  are connected to the electrode connectors  678  and routed through the channels  680 . The second wire connectors  444  are easily accessible for functional connection to an electrotherapeutic device according to disclosed embodiments.  FIGS. 18A-E  are illustrations of attachment of the garment  650  to the right leg of a user and  FIGS. 19A-E  are illustrations of attachment of the garment  650  to a left leg of a user. 
       FIGS. 20A and 20B  are front and back views of a first exemplary embodiment of the ankle/foot wearable system  700 . The ankle/foot wearable system  700  may include a garment  710 . The garment  710  may be constructed as a flexible wrap configured to be worn around at least a portion of the ankle and/or foot of a user. The garment  710  may include a fabric material and include an application area  712  configured to be positioned adjacent to an ankle and foot area of a user. The garment  710  may further include attachment mechanism  714  in the form of one or more elastic straps  716  attached to the application area  712  for securing the garment  710  in place. The garment  710  may also include one or more loops or rings  718  for routing a respective elastic strap  716  and a fastener  719  (e.g., hook and loop fastener) for securing each elastic strap  716  to the application area  712 . It is also contemplated that garment  710  may be constructed as a sleeve, and made of stretch material, such that garment  710  can be pulled onto the foot and ankle of a user, without the need to wrap garment  710 , where the stretch material secures garment  710  into place. For example, in some embodiments, the attachment mechanism  714  may be a built-in elastic property, such as may be present in a sleeve embodiment, and not necessarily an additional feature such as strap  716 , loops  718 , and/or fastener  719 . 
     The garment  710  may include an interior surface  720  configured to contact the user and an opposite exterior surface  722 . The ankle/foot wearable system  700  may further comprise one or more electrodes  724 ,  725  on the interior surface  720  and configured to contact the user. The electrodes  724 ,  725  may be built-in conductive fabric electrodes, for example. The one or more electrodes  724 ,  725  may include two electrode pads positioned in the application area  712  and configured to contact a foot and/or ankle area of user. While two electrodes  724 ,  725  are shown, it should be understood that disclosed embodiments are not limited to any particular number of electrodes. 
     In an exemplary embodiment, each electrode  724 ,  725  is configured as a rectangular strip configured to wrap around a portion of the user to provide a wide contact area. For example, the electrode  724  may be configured to wrap just at or above an ankle of a user and the electrode  725  may be configured to wrap around a portion of the foot of the user. 
     The garment  710  may further include a heel hole  726  to receive and accommodating a heel of the user. The heel hole  726  may be positioned between the electrodes  724 ,  725 . The application area  712  may be generally symmetrical about a vertical axis passing through the heel hole  726 . In this way, the garment  710  may be worn on either the left or right foot of a user. The garment  710  may include an hourglass shape with a larger bottom portion for wrapping around the foot of wearer and a relatively smaller top portion for wrapping around an ankle/lower leg of the user. 
     The garment  710  may further include at least one electrode connector  728 . The garment  710  may include an electrode connector  728  for each electrode  724  and  725 . The electrode connector  728  may include a mechanical and electrical connection point for the respective electrode  724  and  725 . In an exemplary embodiment, the electrode connector  728  is a snap connector, such as a male snap element configured to mate with a female snap element. The electrode connector  728  may include a conductive material (e.g., metal) such that a functional electrical connection may be established with the electrode  724  and  725  via the electrode connector  728 . In an exemplary embodiment, the electrode connector  728  may have a non-conductive coating on the bottom side of the snap connector (e.g., rivet) that is exposed on the face of each electrode  724 ,  725 . This non-conductive coating helps to prevent the patient from feeling a hot spot or stinging sensation at the location of the snap connector. In an exemplary embodiment, the electrode connectors  728  are positioned on the exterior surface  722 . 
     In an exemplary embodiment, the electrode connectors  728  are positioned on the exterior surface  722  above or below the location of the compression material (e.g., memory foam) which sits beneath and raises the electrode surface above the interior surface  720 . The conductive surface of each electrode  724 ,  725  may continue above or below the memory foam directly onto the interior surface  720 . The electrode connector  728  may be placed at this location through the electrode surface, spaced from the compression material. A nonconductive material may be applied to cover up the portion of the conductive fabric and the electrode connector  728  that sits recessed below the compression material. This type of construction eliminates stinging and leaves a smooth raised surface for the conductive electrodes  724 ,  725 . 
     The garment  710  may be configured to operate in conjunction with one or more of the intermediate wires  440 . The intermediate wires  440  may be positioned to extend from each electrode connector  728  to another position (e.g., beneath or above the garment  710 ). The first wire connector  442  of each intermediate wire  440  may be configured to attach to a respective electrode connector  728 . The electrode connectors  728  may be positioned to be covered by the elastic straps  716  such the elastic straps may act as a hold-down for at least a portion of the intermediate wires  440 . 
       FIGS. 21A and 21B  include another exemplary embodiment of an ankle/foot wearable system  700 A, including another design with similar features. For example, the ankle/foot wearable system  700 A may further include channels  730 . The channels  730  may be wire management features configured to receive and route a wire connector between the electrode connectors  728  and an electrotherapeutic device. For example, each channel  730  may be positioned adjacent to a respective electrode connector  728  and configured to route intermediate wire  440  from the electrode connector  728  to another position (e.g., beneath or above the garment  710 ). 
       FIGS. 22 and 23  further illustrate the ankle/foot wearable system  700  being worn by a user. The garment  710  is held in place by the elastic straps  716  such that the electrodes  724 ,  725  are positioned at a target area—the area at or above the ankle and a portion of the foot, respectively. The elastic straps  716  also provide compression directly over the electrodes  724  and  725  to provide better electrical conduction through the skin. The user&#39;s heel is positioned in the heel hole  726 . Intermediate wires  440  are connected to the electrode connectors  728  and are held down by the elastic straps  716 . The second wire connectors  444  are easily accessible for functional connection to an electrotherapeutic device according to disclosed embodiments.  FIG. 22  is an illustration of a right leg and foot of a user and  FIG. 23  is an illustration of a left leg and foot of a user. As described, the application area  712  may be generally symmetrical across a vertical center line through the heel hole  726  such that the ankle/foot wearable system  700  is configured to be worn on either the right or left leg and foot as shown. 
       FIGS. 24 and 25  are front and back views of an exemplary embodiment of the elbow wearable system  800 . The elbow wearable system  800  may include a garment  810 . The garment  810  may be constructed as a flexible wrap configured to be worn around an elbow area of a user. The garment  810  may include a fabric material and include an application area  812  configured to be positioned adjacent to an elbow area of a user. The garment  810  may further include attachment mechanism  814  in the form of an elastic strap  816  attached to the application area  812  for securing the garment  810  in place. The garment  810  may also include one or more loops or rings  818  for routing the elastic strap  816  and a fastener  819  (e.g., hook and loop fastener) for securing the elastic strap  816  to the application area  812 . It is also contemplated that garment  810  may be constructed as a sleeve, and made of stretch material, such that garment  810  can be pulled onto the elbow of a user, without the need to wrap garment  810 , where the stretch material secures garment  810  into place. For example, in some embodiments, the attachment mechanism  814  may be a built-in elastic property, such as may be present in a sleeve embodiments, and not necessarily an additional feature such as strap  816 , loops  818 , and/or fastener  819 . 
     The garment  810  may include an interior surface  820  configured to contact the user and an opposite exterior surface  822 . The elbow wearable system  800  may further comprise one or more electrodes  824  on the interior surface  820  and configured to contact the user. The electrodes  824  may be built-in conductive fabric electrodes, for example. The one or more electrodes  824  may include two electrode pads positioned in the application area  812  and configured to contact an elbow area of a user. In an exemplary embodiment, the one or more electrodes  824  are positioned on opposing sides of an elbow hole  826  built-in to the garment  810  to provide two spaced-apart electrotherapeutic locations for the elbow wearable system  800 . The electrodes  824  may be rectangular-shaped with cutout-portions  827  configured to follow an outline of the elbow hole  826 . In this way, the electrodes  824  may be positioned such that treatment is not applied directly to the elbow joint (e.g., the bony portion at the corner of the elbow). While two electrodes  824  are shown, it should be understood that disclosed embodiments are not limited to any particular number of electrodes. 
     The garment  810  may further include at least one electrode connector  828 . The garment  810  may include an electrode connector  828  for each electrode  824 . The electrode connector  828  may include a mechanical and electrical connection point for the respective electrode  824 . In an exemplary embodiment, the electrode connector  828  is a snap connector, such as a male snap element configured to mate with a female snap element. The electrode connector  828  may include a conductive material (e.g., metal) such that a functional electrical connection may be established with the electrode  824  via the electrode connector  828 . In an exemplary embodiment, the electrode connector  828  may have a non-conductive coating on the bottom side of the snap connector (e.g., rivet) that is exposed on the face of the electrode  824 . This non-conductive coating helps to prevent the patient from feeling a hot spot or stinging sensation at the location of the snap connector. In an exemplary embodiment, the electrode connectors  828  are positioned on the exterior surface  822 . 
     In an exemplary embodiment, the electrode connectors  828  are positioned on the exterior surface  822  above or below the location of the compression material (e.g., memory foam) which sits beneath and raises the electrode surface above the interior surface  820 . The conductive surface of each electrode  824  may continue above or below the memory foam directly onto the interior surface  820 . The electrode connector  828  may be placed at this location through the electrode surface, spaced from the compression material. A nonconductive material may be applied to cover up the portion of the conductive fabric and the electrode connector  828  that sits recessed below the compression material. This type of construction eliminates stinging and leaves a smooth raised surface for the conductive electrode  824 . 
     The garment  810  may further include channels  830 . The channels  830  may be wire management features configured to receive and route a wire connector between the electrode connectors  828  and an electrotherapeutic device. For example, each channel  830  may be positioned adjacent to a respective electrode connector  828  and configured to route intermediate wire  440  from the electrode connector  828  to another position (e.g., beneath or above the garment  810 ). The first wire connector  442  of each intermediate wire  440  may be configured to attach to a respective electrode connector  828 . 
       FIGS. 26 and 27  further illustrate the elbow wearable system  800  being worn by a user. The garment  810  is held in place by the elastic strap  816  such that the electrodes  824  are positioned at a target area—a forearm area adjacent to the user&#39;s elbow, for example. The elastic strap  816  serves the dual of purpose of securing the garment  810  in the proper position around the elbow and in addition provides compression directly over the electrodes  824  and as a result it provides better electrical conduction through the skin. The user&#39;s elbow joint is positioned in the elbow hole  826 . Intermediate wires  440  are connected to the electrode connectors  828  and routed through the channels  830 . The second wire connectors  444  are easily accessible for functional connection to an electrotherapeutic device according to disclosed embodiments.  FIG. 26  is an illustration of a right arm of a user and  FIG. 27  is an illustration of a left arm of a user. The application area  812  may be generally symmetrical across a vertical center line through the elbow hole  826  such that the elbow wearable system  800  is configured to be worn on either the right or left arm as shown. 
       FIGS. 28 and 29  are front and back views of an exemplary embodiment of the wrist/hand wearable system  900 . The wrist/hand wearable system  900  may include a garment  910 . The garment  910  may be constructed as a flexible wrap configured to be worn around at least a portion of the wrist and/or hand of a user. The garment  910  may include a fabric material and include an application area  912  configured to be positioned adjacent to a wrist and hand area of a user. The garment  910  may further include attachment mechanism  914  in the form of one or more elastic straps  916  attached to the application area  912  for securing the garment  910  in place. Both elastic straps  916  also provide compression directly over the electrodes  924  and  925  and as a result it provides better electrical conduction through the skin. The garment  910  may also include one or more loops or rings  918  for routing a respective elastic strap  916  and a fastener  919  (e.g., hook and loop fastener) for securing each elastic strap  916  to the application area  912 . It is also contemplated that garment  910  may be constructed as a sleeve, and made of stretch material, such that garment  910  can be pulled onto the hand/wrist of a user, without the need to wrap garment  910 , where the stretch material secures garment  910  into place. For example, in some embodiments, the attachment mechanism  914  may be a built-in elastic property, such as may be present in a sleeve embodiment, and not necessarily an additional feature such as strap  916 , loops  918 , and/or fastener  919 . 
     The garment  910  may include an interior surface  920  configured to contact the user and an opposite exterior surface  922 . The wrist/hand wearable system  900  may further comprise one or more electrodes  924 ,  925  on the interior surface  920  and configured to contact the user. The electrodes  924 ,  925  may be built-in conductive fabric electrodes, for example. The one or more electrodes  924 ,  925  may include two electrode pads positioned in the application area  912  and configured to contact a wrist and/or hand area of user. While two electrodes  924 ,  925  are shown, it should be understood that disclosed embodiments are not limited to any particular number of electrodes. 
     In an exemplary embodiment, each electrode  924 ,  925  is configured as a rectangular strip configured to wrap around a portion of the user to provide a wide contact area. For example, the electrode  924  may be configured to wrap just at or above a wrist of a user and the electrode  925  may be configured to wrap around a portion of the hand of the user. 
     The garment  910  may further include a thumb hole  926  to receive and accommodating a thumb of the user. The thumb hole  926  may be positioned between and to one end of the electrodes  924 ,  925 . The garment  910  may include a C-shape with a lower portion for wrapping around the hand of a user and a top portion for wrapping around the wrist of the user. 
     The garment  910  may further include at least one electrode connector  928 . The garment  910  may include an electrode connector  928  for each electrode  924 . The electrode connector  928  may include a mechanical and electrical connection point for the respective electrode  924 . In an exemplary embodiment, the electrode connector  928  is a snap connector, such as a male snap element configured to mate with a female snap element. The electrode connector  928  may include a conductive material (e.g., metal) such that a functional electrical connection may be established with the electrode  924  via the electrode connector  928 . In an exemplary embodiment, the electrode connector  928  may have a non-conductive coating on the bottom side of the snap connector (e.g., rivet) that is exposed on the face of the electrode  924 . This non-conductive coating helps to prevent the patient from feeling a hot spot or stinging sensation at the location of the snap connector. In an exemplary embodiment, the electrode connectors  928  are positioned on the exterior surface  922 . 
     In an exemplary embodiment, the electrode connectors  928  are positioned on the exterior surface  922  above or below the location of the compression material (e.g., memory foam) which sits beneath and raises the electrode surface above the interior surface  920 . The conductive surface of each electrode  924  may continue above or below the memory foam directly onto the interior surface  920 . The electrode connector  928  may be placed at this location through the electrode surface, spaced from the compression material. A nonconductive material may be applied to cover up the portion of the conductive fabric and the electrode connector  928  that sits recessed below the compression material. This type of construction eliminates stinging and leaves a smooth raised surface for the conductive electrode  924 . 
     The garment  910  may be configured to operate in conjunction with one or more of the intermediate wires  440 . The intermediate wires  440  may be positioned to extend from each electrode connector  928  to another position (e.g., beneath or above the garment  910 ). The first wire connector  442  of each intermediate wire  440  may be configured to attach to a respective electrode connector  928 . The electrode connectors  928  may be positioned to be covered by the elastic straps  916  such the elastic straps may act as a hold-down for at least a portion of the intermediate wires  440 . 
       FIGS. 30 and 31  further illustrate the wrist/hand wearable system  900  being worn by a user. The garment  910  is held in place by the elastic straps  916  such that the electrodes  924 ,  925  are positioned at a target area—the area at or above the wrist and a portion of the hand, respectively. The user&#39;s thumb is positioned in the thumb hole  926 . Intermediate wires  440  are connected to the electrode connectors  928  and are held down by the elastic straps  916 . The second wire connectors  444  are easily accessible for functional connection to an electrotherapeutic device according to disclosed embodiments.  FIG. 30  is an illustration of a right wrist and hand of a user, and  FIG. 31  is an illustration of a left wrist and hand of a user. The wrist/hand wearable system  900  is configured to be worn on either the right or left hand and wrist as shown. 
       FIGS. 32A and 32B  are front and back views of an exemplary embodiment of the shoulder wearable system  1000 . The shoulder wearable system  1000  may include a garment  1010 . The garment  1010  may be constructed as a flexible wrap configured to be worn around at least a portion of the shoulder and/or upper arm of a user. The garment  1010  may include a fabric material and include an application area  1012  configured to be positioned adjacent to a shoulder area of a user. The garment  1010  may further include attachment mechanism  1014  in the form of one or more elastic straps  1016 ,  1036  attached to the application area  1012  for securing the garment  1010  in place. The secondary elastic strap  1026  provides compression directly over the electrodes  1024  and as a result it provides better electrical conduction through the skin. The garment  1010  may also include one or more loops or rings  1018 ,  1038  for routing a respective elastic strap  1016 ,  1036  and a fastener  1019 ,  1039  (e.g., hook and loop fastener) for securing each elastic strap  1016 ,  1036  to the application area  1012 . In an exemplary embodiment, the strap  1016  wraps around a neck/opposite shoulder of the wearer and the strap  1036  wraps around an upper arm of the applied shoulder. It is also contemplated that garment  1010  may be constructed as a sleeve, and made of stretch material, such that garment  1010  can be pulled onto the arm/shoulder of a user, without the need to wrap garment  1010 , where the stretch material secures garment  1010  into place. For example, in some embodiments, the attachment mechanism  1014  may be a built-in elastic property, such as may be present in a sleeve embodiments, and not necessarily an additional feature such as straps  1016 ,  1036 , loops  1018 ,  1038 , and/or fastener  1019 ,  1039 . 
     The garment  1010  may include an interior surface  1020  configured to contact the user and an opposite exterior surface  1022 . The shoulder wearable system  1000  may further comprise one or more electrodes  1024  on the interior surface  1020  and configured to contact the user. The electrodes  1024  may be built-in conductive fabric electrodes, for example. The one or more electrodes  1024  may include two electrode pads positioned in the application area  1012  and configured to contact a targeted portion of a shoulder of user. While two electrodes  1024  are shown, it should be understood that disclosed embodiments are not limited to any particular number of electrodes. The electrodes  1024  may include any shape to target application to a shoulder, such as having at least one curved edge in a semi-circle shape. 
     The garment  1010  may further include a protective portion  1026  on the exterior surface  1026 . The protective portions  1026  may be attached to portions of the attachment mechanism  1014  and be centered opposite the electrodes  1024 . 
     The garment  1010  may further include at least one electrode connector  1028 . The garment  1010  may include an electrode connector  1028  for each electrode  1024 . The electrode connector  1028  may include a mechanical and electrical connection point for the respective electrode  1024 . In an exemplary embodiment, the electrode connector  1028  is a snap connector, such as a male snap element configured to mate with a female snap element. The electrode connector  1028  may include a conductive material (e.g., metal) such that a functional electrical connection may be established with the electrode  1024  via the electrode connector  1028 . In an exemplary embodiment, the electrode connector  1028  may have a non-conductive coating on the bottom side of the snap connector (e.g., rivet) that is exposed on the face of the electrode  1024 . This non-conductive coating helps to prevent the patient from feeling a hot spot or stinging sensation at the location of the snap connector. In an exemplary embodiment, the electrode connectors  1028  are positioned on the exterior surface  1022 . 
     In an exemplary embodiment, the electrode connectors  1028  are positioned on the exterior surface  1022  above or below the location of the compression material (e.g., memory foam) which sits beneath and raises the electrode surface above the interior surface  1020 . The conductive surface of each electrode  1024  may continue above or below the memory foam directly onto the interior surface  1020 . The electrode connector  1028  may be placed at this location through the electrode surface, spaced from the compression material. A nonconductive material may be applied to cover up the portion of the conductive fabric and the electrode connector  1028  that sits recessed below the compression material. This type of construction eliminates stinging and leaves a smooth raised surface for the conductive electrode  1024 . 
     The garment  1010  may be configured to operate in conjunction with one or more of the intermediate wires  440 . The intermediate wires  440  may be positioned to extend from each electrode connector  1028  to another position (e.g., beneath or above the garment  1010 ). The first wire connector  442  of each intermediate wire  440  may be configured to attach to a respective electrode connector  1028 . The electrode connectors  1028  may be positioned to be covered by the elastic straps  1016  such the elastic straps may act as a hold-down for at least a portion of the intermediate wires  440 . 
       FIGS. 33A and 33B  include another exemplary embodiment of a shoulder wearable system  1000 A, including another design with similar features. For example, the shoulder wearable system  1000 A may include rectangular electrodes  1024 A and an alternative protective portion  1026 A. 
       FIGS. 34 and 35  are front and back views of an embodiment of the head/neck wearable system  1100 . The knee wearable system  1100  may include a garment  1110 . The garment  1110  may be constructed as a flexible wrap configured to be worn around a head/neck area of a user. The garment  1110  may include a fabric material and include an application area  1112  configured to be positioned adjacent to a head and/or neck area of a user. The garment  1110  may further include attachment mechanism  1114  in the form of an elastic strap  1116  attached to the application area  1112  for securing the garment  1110  in place. The garment  1110  may also include a first fastener  1118  and a second fastener  1119  (e.g., hook and loop fastener) for securing the elastic strap  1116  to the application area  1112 . The elastic strap  1116  also provides compression directly over the electrodes  1124  and as a result it provides better electrical conduction through the skin. It is also contemplated that garment  1110  may be constructed as a sleeve, and made of stretch material, such that garment  1110  can be pulled onto the head/neck area of a user, without the need to wrap garment  1110 , where the stretch material secures garment  1110  into place. For example, in some embodiments, the attachment mechanism  1114  may be a built-in elastic property, such as may be present in a sleeve embodiment, and not necessarily an additional feature such as strap  1116  and/or fasteners  1118 ,  1119 . 
     The garment  1110  may include an interior surface  1120  configured to contact the user and an opposite exterior surface  1122 . The neck wearable system  1100  may further comprise one or more electrodes  1124  on the interior surface  1120  and be configured to contact the user. The electrodes  1124  may be built-in conductive fabric electrodes, for example. The one or more electrodes  1124  may include two electrode pads positioned in the application area  1112  and configured to contact a head and/or neck area of a user. In an exemplary embodiment, the one or more electrodes  1124  may be configured to contact the back of a user&#39;s neck, just above the collar. In another example, the electrodes  1124  may be configured to contact the back, top or forehead of the user. The electrodes  1124  may be circular shaped. While two electrodes  1124  are shown, it should be understood that disclosed embodiments are not limited to any particular number, shape or size of electrodes. 
     In some embodiments, the head/neck wearable system  1100  may be used to reduce pain that results from headaches including cervicogenic headaches which appear to transform into migraines; chronic cervicalgia, occipital neuralgia and pain which originates in the posterior of the neck and travels up into the head. In an exemplary embodiment, the electrodes  1124  are placed bilaterally at the occiput on either side of the cervical spine on the posterior of the skull (as shown in the illustration of  FIG. 36 ). The inside edges of the electrodes  1124  may be about 0.5″ apart from each other, which may be a minimum distance between the electrodes  1124 . Edges of the electrodes  1124  do not touch. In some examples, users need to shave the hair line at the base of the skull so electrodes can be placed on clean intact skin. Patients can rest their head on a pillow with their neck bent slightly forward. Generally having the tissue be a little taut in the region treated allows for deeper penetration of the active electrical field. In one example, each treatment is 30 minutes in duration. Initially, 3 treatments are performed with 30 minutes to 2 hours in between each treatment. 
     The garment  1110  may further include at least one electrode connector  1128 . The garment  1110  may include an electrode connector  1128  for each electrode  1124 . The electrode connector  1128  may include a mechanical and electrical connection point for the respective electrode  1124 . In an exemplary embodiment, the electrode connector  1128  is a snap connector, such as a male snap element configured to mate with a female snap element. The electrode connector  1128  may include a conductive material (e.g., metal) such that a functional electrical connection may be established with the electrode  1124  via the electrode connector  1128 . In an exemplary embodiment, the electrode connector  1128  may have a non-conductive coating on the bottom side of the snap connector (e.g., rivet) that is exposed on the face of the electrode  1124 . This non-conductive coating helps to prevent the patient from feeling a hot spot or stinging sensation at the location of the snap connector. In an exemplary embodiment, the electrode connectors  1128  are positioned on the exterior surface  1122 . 
     In an exemplary embodiment, the electrode connectors  1128  are positioned on the exterior surface  1122  above or below the location of the compression material (e.g., memory foam) which sits beneath and raises the electrode surface above the interior surface  1120 . The conductive surface of each electrode  1124  may continue above or below the memory foam directly onto the interior surface  1120 . The electrode connector  1128  may be placed at this location through the electrode surface, spaced from the compression material. A nonconductive material may be applied to cover up the portion of the conductive fabric and the electrode connector  1128  that sits recessed below the compression material. This type of construction eliminates stinging and leaves a smooth raised surface for the conductive electrode  1124 . 
     The garment  1110  may be configured to operate in conjunction with one or more of the intermediate wires  440 . The intermediate wires  440  may be positioned to extend from each electrode connector  1128  to another position (e.g., beneath or above the garment  1110 ). The first wire connector  442  of each intermediate wire  440  may be configured to attach to a respective electrode connector  1128 . The electrode connectors  1128  may be positioned to be covered by the elastic straps  1116  such the elastic straps may act as a hold-down for at least a portion of the intermediate wires  440 . 
     While this specification contains many specifics, these should not be construed as limitations on the scope of any invention or of what may be claimed, but rather as descriptions of features that may be specific to particular embodiments of particular inventions. Certain features that are described in this specification in the context of separate embodiments may also be implemented in combination in a single embodiment. Conversely, various features that are described in the context of a single embodiment may also be implemented in multiple embodiments separately or in any suitable subcombination. Moreover, although features may be described above as acting in certain combinations and even initially claimed as such, one or more features from a claimed combination may in some cases be excised from the combination, and the claimed combination may be directed to a subcombination or variation of a subcombination. 
     Similarly, while operations are depicted in the drawings in a particular order, this should not be understood as requiring that such operations be performed in the particular order shown or in sequential order, or that all illustrated operations be performed, to achieve desirable results. In certain circumstances, multitasking and parallel processing may be advantageous. Moreover, the separation of various system components in the embodiments described above should not be understood as requiring such separation in all embodiments, and it should be understood that the described program components and systems can generally be integrated together in a single software product or packaged into multiple software products. 
     While various embodiments have been described, it is to be understood that the embodiments described are illustrative only and that the scope of the subject matter is to be accorded a full range of equivalents, many variations and modifications naturally occurring to those of skill in the art from a perusal hereof