Ultrasound Video Follows Detailing What Type Unit & Why - Rent An Ultrasound Unit
Many patients, either immediately after injury such as sprains, strains, muscle pulls, or muscle spasms find themselves in a physical therapy office, chiropractic or Doctor's office receiving ultrasound therapy. Few understand what is going on and why the ultrasound is being used, sometimes even the ones administering the ultrasound treatment.
This is a short introduction to what happens and also a video accompanying giving answers to what, why, how and even which ultrasound unit will meet the needs of the clinic and patient. Some patients prefer renting ultrasound rather than returning to clinics. This article explains.
Today there is a great deal of "Medical Buzz" about the onset of carryover pain relief, also known as residual pain relief, after using portable interferential equipment for treatment of chronic pain. This is not a new phenomenon but has been going on for more than half a century and quite successfully. The "newness" is the same clinical results are occurring but without having to go to a clinic or hospital.
Interferential therapy has been used by physical therapists, chiropractors, pain clinics, physicians since 1953 with the same carryover pain relief results. It has been the mainstay of those medical professionals in treating patients suffering from chronic pain diseases. Some of the best results have been obtained for those who have been unable to find adequate treatments and they are successfully treated by "alternate", non drug methods and interferential treatments are the mainstay for those treatments. These are the typical diagnoses that have been treated by interferential therapy:
RSD - Reflex Sympathetic Dystrophy
Chronic Low Back Pain
Post Herpetic Neuralgia
Phantom Limb Pain
Neck and Shoulder pain
Multiple Sclerosis Pain
and many other pain conditions where the patient has been doped out on drugs or told "there is nothing else we can do". Often the processes of rehabilitation, such as you see where one has suffered a "frozen shoulder", are enhanced and healing increased by using interferential therapy in conjunction with doing the painful exercises. The interferential helps to overcome the pain created by the exercises and shortens the pain that follows after the exercises are over. None of this is new though.
Let me describe the process that has been going on and on for decades and is totally dependent upon interferential providing carryover pain relief.
1. The patient enters the Chiropractic, Physical Therapy, Pain Clinic or Physician office. Generally at the time of entry the patient has been very uncomfortable due to pain. It has reached the point the patient needs help or it has reached the point the patient is tired of using drugs and not being able to live life due to the masking in the brain. The patient is not going to keep using the drugs but is now hurting and it's to the point of being unbearable.
The health care practitioner will normally greet the patient and begin to either, if chiropractic, do a manipulation if indicated, or if Physical Therapy, apply warm moist heat and soft tissue massage or stretching. Most chronic pain patients have already tried surgery, injections, pills, and conventional treatments to no avail. They are looking for something that just might work.
After the practitioner has completed the initial treatment the chances are excellent the patient will then lay on a treatment table and begin a 12 to 20 minute interferential treatment. There is a large clinical machine beside the table and the practitioner will apply 2 to 4 self adhering electrodes to the patient. The machine is turned on with the instructions to the patient to tell the practitioner when the patient "feels the sensation". The interferential machine is turned up till the patient declares it is feeling good to the patient and the pain has diminished. At this point the practitioner sets the timer on the interferential unit and will leave the room. The patient quietly lies on the table until the interferential machine stops treating. Once the machine stops then the patient in almost all cases actually feels better and the pain is either gone or severely diminished.
2. Now the "guessing game" begins. The patient, especially in the Chiropractic field, goes to the payment window and is asked to pay the bill. This is a crucial step in determining the efficacy of the interferential treatment. For many Chiropractic Physicians the service may not have been covered by insurance and the patient is paying out of pocket for the treatment.
If the treatment did not help the patient the patient will be:
1. Reluctant to pay the bill or,
2. Not come back for any future treatments
This is a critical moment for the patient and practitioner. In most cases due to the chronicity of the pain there will be follow up visits for care. The next appointment is also a guessing game. The guess is "when will the pain return" and a guess is made to have a return visit prior to the onset of pain, prevention is always the best course of action, or when will the patient be in so much pain an interferential treatment is needed. This isn't something to ignore.
It will help to understand the patient now feels much better but the key is how long will the treatment last and the pain stay away. That is the carryover or residual pain relief period that interferential is famous for. That is also the guessing part of when to reschedule the return. This protocol is based on carryover pain relief and has been such for the last 60+ years clinically. It is also the proof of interferential therapy efficacy. The pain free period has to last at least till the patient pays the bill, and hopefully much longer so the patient will return!!!
It's not only science but also patient success that matters. Did the interferential treatment work? If so the patient returns, if not,then good by or the next appointment is missed or not scheduled at all. That is the strength of interferential therapy over the decades. It has worked and worked well on the most difficult pain patients. The newness now is not that there is carryover pain relief, but with a patient being able to treat when needed with a portable interferential pain machine, then the carryover pain relief is getting extended over time. The newness of extended pain relief is what is and has emerged in the past 18 months.
It's the advent of self treatment with interferential, without drugs, that is now challenging the understanding of the medical community.
Is there a physiological answer as to why longer periods of no, or reduced pain, is occurring?
It's my contention there is.
As stated there is no surprise that interferential provides immediate and long lasting pain relief. What is surprising is how, with self treatments, the pain is prevented or treated and the treatments become less frequent.
There is an answer to the physiological side of electrical charges being used to heal. Nothing new as it's well known anytime positive and negative charges of electricity are applied to the body there are very distinct chemical changes occurring. These charges have been used beneficially therapeutically for decades.
For years positive and negative charges have been used to promote bone healing, non union fractures, so the chemical and physiological changes are known. For many patients suffering with crush injuries amputation was the normal course until it was learned to electrically stimulate for unionization. The use of electricity would restart the process of the bones merging together and effecting a functionally stable reunion.
Equally impressive is the continuing use of electricity for healing bed sores, decubitus ulcers, which started with the use of the form of electricity known as pulsed galvanic stimulation. In the physical therapy profession small, portable electrical devices have been used to make bed sores fill in with tissue and eventually to close and heal completely.
Of course with bones and soft tissue repair the body must have the necessary nutrients to effect the changes electricity can do. Electrical charges alone will not suffice since the electricity initiates the body's response to heal and the body requires the necessary nutrients and hydration to accomplish the task.
There is no doubt with the pain patient that there exists a chemical process that is causing the pain sensation to be created and transmitted to the brain. That process is indicative of sickness, since chronic pain of unsubstantiated cause, is unnatural and requires therapeutic healing to stop the injurious processes. Possibly the use of interferential with the positive and negative charges is chemically altering the pain stimulus area and the repeated usage of the interferential unit to stop and prevent pain, is altering the chemistry of the area. That alteration may become permanent and it is that permanency which is stopping the unnatural pain impulses. With preventive treatment the body is stopping the chemical changes before they can cause pain.
The electrical intervention is supporting the permanent change that we call carryover pain relief.
Enjoy this video further explaining the use of positive and negative electrical charges which the Infrex Plus produces with each pulse -
This video by a doctor's group on interferential current therapy is interesting and something we thought you might enjoy. Well done video on general information.
Only real caveat on what you see here is the electrodes are too small, therefore very high current density, and electrodes very close together which generally precludes treating entire area(s) of pain.
Below this video is our video explaining why interferential treatment requires larger electrodes.
Interferential therapy originated in Germany and was administered by an interferential physiotherapist originally in a physiotherapy department. In the U.S. it was about 1960 before there were interferential physical therapists using the new modality.
Enjoy this video on the actual combination interferential and tens therapy device, Infrex Plus, as used by a patient for two separate pain areas:
What does it involve?
Interferential therapy basically involved putting 4 electrodes on the outer edges of where a patient was feeling pain. The interferential current therapy consisted of one "channel -2 electrodes" going off and on 4,000 times per second ( referred to as PPS/Frequency/Rate/Pulses per Second). The other channel went off and on 4,001 to 4,150 PPS. The interferential therapy treatment was the crossing of the currents inside the patient which stopped the pain and also provided carryover pain relief following the treatment that lasted for some time period. In physical therapy journals there were interferential articles describing how the treatment worked and why interferential was most beneficial for chronic pain patients who were unable to find pain relief.
Often the chronic pain patient was referred to a Physical Therapist ( Physiotherapist ) by a physician for an "Evaluate and Treat" referral. The physicians were unaware of what the physical therapists were doing but they found that in many situations the physical therapist was able to provide pain relief when other methods had failed. The physical therapist often used a combination of hot cold interferential which was nothing more than applying warm moist heat in conjunction with interferential for immediate relief and to extend the carryover pain relief period. If the patient presented with an acute injury, less than 48 hours, then the physical therapist used cold interferential therapy employing ice to lessen the inflammation of recently injured tissues.
The reason for the warm moist heat, in conjunction with interferential treatments, was the heat attracted blood, a conductor of electricity, and enhanced the ability of the interferential current to penetrate into the body tissues and target the sensory nerves. When there is more heat in an area the body rushes blood to dissipate the heat. This creates a more electrical conductive environment internally and externally the moisture from the heating pad reduces the resistance of the skin for greater penetration. The physical therapist was using the natural phenomena to aid in overcoming the resistance of the skin.
In theory the crossing of the two currents from the two independent channels would produce a "new" current that was the sum of the two crossing currents. That was theory which later had to be modified since the body and the differing tissues had different abilities to store electrons before "filling up" and there was not a consistency of current distribution. However the science was correct even though the imagery was not. This "new current" was called a "vector current" and it moved around the painful areas. What was later revealed was the stimulation did indeed occur for the sensory nerves due to the crossing of the currents. The sensation was very relaxing and the effects of interferential currents were successful for pain relief.
Interferential therapy later moved to other medical disciplines and become an effective treatment for:
1. Urinary and Fecal Incontinency
3. Muscle Reeducation
4. Acute Edema
5. Muscle spasm and spasticity
6. Circulatory stimulation
7. Abdominal Organ stimulation
8. Acceleration of general healing.
Unfortunately during the time interferential was being used there was little research being done on the how and whys other than one book published in 1984 by Brenda Savage, physiotherapist, called "Interferential Therapy".
In 1987 Dr. Giovanni De Domenico came out with the literal "encyclopedia of interferential current therapy" called, "New Dimensions In Interferential therapy. A Theoretical & Clinical Guide". ( Note Dr. De Domenico was a consultant to MedFaxx on applications for interferential therapy - he passed away on April 10, 2010 at age 63 of cancer.)
Over the years study after interferential study has confirmed what Brenda Savage and Giovanni De Domenico pointed out decades earlier. Interferential therapy currents could produce outstanding clinical results for patients when other treatments had failed.
Interferential therapy contraindications are few,
1. Don't apply electrodes near heart if patient has a demand cardiac pacemaker
2. Don't apply electrodes over neck
3. Don't use interferential therapy on pregnant women,
Unlike tens units, transcutaneous electrical nerve stimulators, prior to January 2009 interferential units were not portable so any contraindication of sleepiness due to muscle relaxation was not hazardous since the patient had to be in a clinic or hospital to receive an interferential treatment. It was not unusual for a patient to fall asleep during an interferential treatment and have to be awakened upon completion by the clinician.
Today with the advent of at home, self treat, with a portable device the additional warning is to not operate an automobile or operate machinery when undergoing interferential treatment. Today, besides the physical therapy interferential office, the chiropractic clinic often uses interferential therapy as a complementary therapy to spinal manipulation and the Doctor of Chiropractic has become well versed in using interferential for pain relief.
The biggest problem with interferential therapy historically has been one had to get an appointment and go to a clinic for treatment. Today that is not the case and the ability to self treat has turned the tide on preventing pain, rather than treating pain.
Probably the principal advantage to the patient is today with self treatment interferential options, the residual or carryover pain relief seems to be extending from self treatment to self treatment and new parameters of health care are emerging due to the new portable modality..
In conclusion, even though the exact mechanisms of why interferential therapy worked were not known, the benefits were solid and the use of interferential currents for pain and other health issues has prospered. Interferential currents have helped many patients in clinics and now can help outside the clinic in the home setting. New knowledge is emerging as the results of preventing pain with self treatment is changing the understanding of interferential current therapy.
Enjoy this video on the actual combination interferential and tens therapy device, Infrex Plus, as used by a patient for two separate pain areas:
The only portable interferential unit that also has tens mode. The Infrex Plus comes with an AC adapter for plugging in the wall for unlimited treatment times. The Infrex Plus lasts for 80 minutes on rechargeable batteries. This is the longest of any portable interferential unit made.
Watch this video to see what comes with the Infrex Plus Portable Interferential Unit with Tens Mode.
Effective pain relief using a tens or an interferential unit only happens when the electrodes are placed to inundate the painful area with a pleasant, tingling, massaging type stimulus. The stimulus is creating nerve firings of NON PAIN FIBERS, sensory fibers, which makes those sensory nerves overpower the PAIN NERVES ( C-FIBERS), which are transmitting the pain stimulus. There is no magic, it's simply a process of understanding what is the purpose of placing the tens electrodes, generally self adhering reusable electrodes, in the proper place.
Unlike acupuncture where the needle is very small, a tens or interferential electrode has a much larger stimulation area and specificity of placement is not as critical. Needles in acupuncture often are intended to interrupt an electrical energy pain path, whereas electrical stimulation is intended to be offensive and invade the area thusly interrupting and altering the electrical energy. The surface of an electrode may be 2 inch x 2 inch or 4 square inches of surface area per electrode equaling a total of 8 sq. inches, where the acupuncture needles surface is that of the needle itself times the depth the needle is inserted.
Acupuncture is a process of finding and insertion into an area a needle(s) whereas electrical stimulation (e-stim) is a process of hovering over and transmitting electrical energy in an area. Interferential has a much greater frequency ( rate-how many times machine goes off and on per second). The higher the rate, the less the resistance is, and the greater the penetration of the electrical stimulus. Acupuncture needles have to be inserted past the point of most resistance ( skin or scar tissue ) to get into the area of electrical energy to interrupt the flow.
The dispersion of the energy with estim and reusable electrodes covers a much larger area and increases the chances of pain stimulus interruption.
Over the past 35 years there have been massive changes in new pain management technologies. Many of these new pain management technologies and devices evolved because patients were rejecting the use of drug medications that failed to address the causation of the pain. Patients and Physicians were realizing the brain is merely the receptor of the pain impulses and the method of doping the brain involved too many risks as well as terrible side effects for the chronic pain patient. Brain medicating is no longer in vogue.
Patients also witnessed many surgical interventions that not only did not reduce the severity, duration or frequency of pain but in many cases exacerbated the original pain problems. The underlying post surgical outcomes often introduced new pain issues such as scar tissue formation which exacerbated the problems, and with implanted devices, such as dorsal column stimulators ( spinal cord stimulators), added to non function over time. Often the underlying surgery would only last for short durations and more surgery was needed, or the complications from additional surgery was not warranted. Scar tissue build up made later surgeries even more risky.
For many chronic pain patients they have learned, after many failed attempts using new or more powerful drugs and surgical intervention, that the causation of the pain can not be determined, or treated, so they deal with symptomatic treatment of pain. The reality of chronic pain is it is symptomatic, however the causation can not be treated or determined, and some interventions do not help, but harm. Drug medicating and surgical procedures often fall into the latter category.
Some of the new pain management devices that have emerged are lasers - in varying frequencies, thermal devices for deeper tissue heating and recently portable interferential therapy. Most are merely new delivery devices that deliver proven therapeutic benefits for treating pain using conventional methods.
None of the devices are "experimental" but are now becoming available to be used to self treat, away from the hospital or clinical setting. The treating principles have been around and successful for long time periods. The problem has been to receive clinical success the patient had to be in a clinic. The new devices are making those treatments an option that can be self administered. By being able to self treat the new devices are producing some new beneficial results such as the residual pain relief occurring after treatment that are encouraging.
Many of the newer technologies do involve surgery and implants, such as the previously mentioned spinal cord stimulators (SCS) or, in the most severe cases, the deep brain stimulators (DBS). One major reason for the implantation devices is the practical need to reduce resistance to the treated area by moving the device closer to the nerve root. In today's environment that is beginning to look archaic because one of the sole purposes of interferential therapy is to increase the frequency ( times machine goes off and on in a second), so the treating impulses can be delivered to the pain site(s). The ability to increase the frequency now allows for targeting the nerve roots or other neural structures since the higher frequencies have reduced the electrical resistance of the skin and the body. The rationale for surgical intervention no longer applies since the new interferential modality overcomes the purpose of the surgical procedure.
Eventually it may be discovered that the newer external devices can be used in a complementary manner to enhance the new genetic treatments that are becoming available. The external devices will prepare areas of pain for absorption of new gene therapies, or as appears to be happening with the interferential carryover effects, the therapy itself may be changing the underlying physical chemical structure and altering the process of pain stimulus which resolves the pain issues.
For now though the most recent, effective, FDA approved and Medicare reimbursable pain management device is the combined tens and interferential treatment device. Tens provides sensory relief only if the interferential carryover pain relief period has not extended long enough for the patient. It appears initially a patient can self treat and the carryover pain relief period may be for short durations. Over time the carryover is extended with an eventual goal of weekly or monthly treatments. This is far more desirable for the pain patient than having to wear the unit and treat constantly as one does with a simple tens unit.
Interferential therapy's main strength is the new ability to self treat with a portable device and achieve the pain relief treatment that has been enjoyed for decades outside the clinic or hospital. It appears interferential is changing the concept of treatment options for the often overlooked and under treated chronic pain patient.
Free Consignment of Infrex Plus Combination Tens & Interferential Unit To Your Clinic or Office For Patient Trials.
Consignment Request Is Below The Video.
MedFaxx has historically consigned Tens units to clinics so patients can have a free tens trial to see if the unit helps with pain control or not.
With the advent of the Infrex Plus combination interferential and tens unit in one machine we consign one unit to the clinic so a patient can be referred to the clinic, physical therapy office, Doctor's office to try the Infrex Plus treatment. In most situations the doctor, physical therapist, chiropractor can determine after the intial treatment whether the pain machine will be beneficial or not. We will then ship the unit to the clinic or to the patient as directed.
If the clinic has need for more units on hand we will discuss the needs and address the situation individually.