Electrical Stimulation v. Pain Pills for Relief
Can't Find Relief? Can't Use Pills? BioWave Pro May Help
For over 30 years it has been well documented that utilizing electrical stimulation to areas of the body to reduce pain, edema, and improve range of motion. If you are subject to going to physical therapy due to some physical ailment, it is likely some kind of electrical stimulation will be incorporated into the physicians plan of treatment for you. There are many variables in how this may be applied or approached.
Are there limitations or contra-indicators for the use of electrical stimulation on patients? That is, are there times when a patient has conditions such that either electrical stimulation won't do them any good, or worse, could do them some harm? Yes, such as if the patient has an implanted defibrillator or pacemaker. In another condition, the patient may be pregnant - this is a caution, unlike the previous condition where it is a "NO" this is only a strong caution and should not be used anywhere near the baby. Leg cramps may be treated with some special care. Also, people with some forms of cancer should not use electrical stimulation.
Also, there is a region of the body where electrical stimulation should not be used by an individual that is not a trained medical provider - basically from just above the collar-bone in the front and up the neck to the head. In the back of the neck, it is fine below the hairline.
All other parts of the body offer opportunities to utilized this technology pre- and post- surgically, after trauma or bruising, during periods of excessive exercise or physical work. All of these times may cause muscle strains, swelling, stiffness and all descriptions of situations that otherwise will require some form of pain relief. Some people, either due to a medical condition, allergy or sensitivity, cannot take ansaids or other over-the-counter pain killers. Still others may need some kind of pain relief but they cannot take any kind of medication due to their job requirements - such as surgeons and other medical professionals. You really don't want you neurosurgeon using opiates while he is operating on your spine, do you?
Over the past several decades the use of electrical stimulation for treatment of pain has improved quite a bit. Being refined and improved to provide the end user with a product that they can utilize at the physical therapist level on a regular basis. The concept involves stimulating the area of pain to the point that first the "Gate Mechanism" sends the right message to the brain to quit recognizing and alerting you to the pain in your shoulder, knee, lower back etc. If this stimulation is long enough, and deep enough, then your brain may begin to provide endorphin relief - the "Endorphin Mechanism." Endorphins occur naturally, and when your body engages them, they are very powerful. They are produced by the pituitary gland and hypothalamus and are very similar to opiates or morphine in their ability to dull or eliminate pain.
Trans-cutaneous Electrical Nerve Stimulation (TENS) is one of the most common and oldest forms of portable e-stim, or electrical stimulation. Trans and cutaneous are the two main clues here. "Across the skin" is about as accurate a translation as you can expect here. Literally the electricity supplied uses the patients skin as a conductor between two electrodes. By supplying a controlled amount of electrical stimulation, the body reacts and sends messages to the brain to respond. The brain helps to moderate the area being stimulated - reducing any pain in the area, at least temporarily.
TENS has been around the longest for a portable treatment and is accepted by a lot of insurance companies as a modality of pain improvement. Generally speaking, TENS units operate in a range from 1-165 Hz, although some may go as high as 1000 Hz in energy. There are very cheap, ineffective, in some cases potentially dangerous models of TENS units available online that could cause negative effects such as burns, electrical shock and other issues if misused.
Interferential Current is one of the more "new" concepts of electrical stimulation. IFC operates at about 40 times the energy of TENS and the electrodes are placed in an X form instead of parallel as you would with TENS. Because the pattern crosses, the wave form interferes with each of the others and the patient receives the additional energy with much less discomfort than only the TENS units. The TENS can often feel a bit "prickly" where the IFC feels much more like a wave of vibration going through the muscles.
The intent is the same, to invigorate the site of pain to the point that the brain is engaged enough to provide endorphins to the area of pain. It generally takes about 30 minutes for this to occur in most people. Of course the level of stimulation will vary by individual too. Range of motion is one of the key aspects and helping someone with low back pain, or neck pain. Edema, or swelling, as in post-surgical situations or irritated joints can be reduced by invigorating the "pumps" that work within the cells that reduce the swelling. IFC works to do just that and can improve pain and edema through this type of stimulation.
Neuro-Muscular Electrical Stimulation is not just stimulating a muscle to get a brain reaction that may encourage some relief. NMES can re-educate muscles post-surgically or post trauma or even in situations where due to age or condition someone may be losing muscle tone or strength - atrophy.
NMES works mostly with the larger muscle groups and stimulates those muscles, much like a deep tissue massage, and encourages the muscles to strengthen.
There are several suppliers of TENS units in the marketplace. R.S. Medical, Zynex Medical, Empi (division of Donjoy) and others have quality TENS units available. As mentioned about, other internet companies sell TENS units for personal use. Some companies have gone to the extent of providing more than one modality, that is something other than TENS like IFC or NMES, in one unit. There are combinations of IFC and NMeS, or maybe TENS and IFC, but only the NexWave has all three in one unit, TENS, IFC and NMES. This gives a patient access to all three modalities for in-home care. Because the patient may be getting some one or two forms or modalities at physical therapy, they can now reach for a NexWave instead of a bottle of pills when they have pain after PT and are back home.
Peripheral Nerve Electrical Stimulation provided using a cutting edge electrode with 1,014 micro-needles 0.7mm long that actually penetrate skin providing a localized harmonic wave of electrical energy beneath the electrode. This product has been used for providing treatment to patients, but now is utilized to determine if further use of either a peripheral nerve or spinal cord stimulator will benefit from the implant. The testing is twice a week for up to about 4 weeks and can be covered by Medicare in most instances. After all, it is a lot cheaper for Medicare to confirm the patient will benefit from a procedure for a few thousand dollars than have them undergo a specialized procedure next to the spinal cord that costs tens of thousands of dollars as well as the risk and time involved.
Your doctor must request the procedure and if you have insurance may have to have the testing prequalified before you are allowed to be tested. Featherbone Medical, LLC is a distributor your doctor can call to get more information.
The same company that manufactures the NexWave featured in the photo, has added another conservative treatment option available in a large number of states from their own "Pharmazy." Compound pharmaceuticals utilize specialized carriers that need to "hold" the pharmaceutical ingredients that are combined and bring them to the site of treatment - which may be a knee, elbow, hip or lower back - or anywhere someone has pain. Depending on what kind of pain, various APIs are utilized to change nerve signals allowing the patient to gain some relief without taking a pill (although a compound may be offered in a pill form in some instances).
There are literally dozens if not hundreds of compound pharmacies that have popped up across the country. In the case of Pharmazy - the practitioner can decide to have the Rx default to a NexWave or estim unit if insurance won't pay for the compound - or they can prescribe both compound and e-stim unit (better for the patient long term).
Compounds can be more financially effective if a reputable compounding pharmacy is utilized although some insurance companies have chosen to bury their heads in the sand here. Some people can't, don't need to, get sick from or don't want to take another oral medication. In the case of these products, they stay pretty much where they are applied - that is they are not systemic in nature. It can also reduce the incidence of exposure of younger patients to opiates at a young age.
Any reduction in the use of highly addictive pain relievers would be a good thing. Being able to offer pain relief to diabetics, surgeons, cardiac care patients, RA sufferers, all who may be restricted in the kinds of pain relief meds they can take. This offers a new - first line of pain relief to anyone.
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