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Most therapeutic ultrasound machines come with a choice of 1 or 3 megahertz frequencies and the clinician is left determining which of those frequencies is needed. This is a definition of megahertz and which frequency is indicated in ultrasound therapy.
A megahertz is defined as, abbreviated MHz, a unit of alternating current (AC) or electromagnetic (
The frequency of therapeutic ultrasound is important, depending on the area being treated for pain relief, or for accelerating healing due to injury. There is an inverse relationship between higher frequency and depth of penetration. As the frequency increases from 1 to 3 MHz, the depth of penetration decreases, ie. higher the frequency the less penetration.
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Many patients receive ultrasound therapy in the clinic, outpatient ER, or doctor's office yet do not know how or why it works, or doesn't work. This is a general discussion of what is ultrasound and how does ultrasound work.
Ultrasound units operate on production of sound waves that can produce heat in one mode yet in another mode create physiolgical change on a cellular level. Sounds good but what does that mean?
If you take your hands and rub them together very rapidly you will create friction which produces heat. When ultrasound is used on the patient in the clinic on "continuous" mode the same type physiological occurrence is happening, except on a deeper level within the structure being treated such as elbow, low back, leg etc. The ultrasonic energy is moving the cells back and forth deeper inside the tissue and creating heat. From heat flows other therapeutic benefits such as increased blood flow which often reduces pain during the treatment and for some residual or carryover pain relief post treatment.
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MedFaxx is located at:
525 South White Street
Wake Forest, N.C. 27587
Fax: 919- 570-0354
Hours of Operation are:
8:30 a.m. to 5:30 p.m. EST ( U.S.) Eastern Standard Time
We try to answer all phone calls live, but if we can not do so we provide answering machines for each of our employees and direct phone numbers to our employees to use if, or when necessary.
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Chronic pain management often consists of a protocol of "drug management". Many adverse effects result from not monitoring how the drugs affect the patient.
Chronic pain complaints can be low back pain, sciatica, RSD, Fibromyalgia, Arthritis pain and psychogenic pain ( pain not resulting from any past disease or injury). The essence of the diagnosis is to treat the patient as best can since the symptom has now become the diagnosis.
Unless the treating physician is well versed in treating chronic pain patients one of the most used methodologies for treatment is simply to prescribe pharmaceutical products and anticipate positive results. The training of most physicians is to take acute pain situations such as muscle sprains, strains, bruises, broken bones, post surgical pain and prescribe anti-inflammatories, anti-histamines, and pain medications until the underlying pain problem heals or the disease process is over. The normal process of dealing with pain is the pain is caused by disease or injury and is residual to the disease/injury. The pain is a necessary and wanted symptom to alert the patient to the injury or sign of disease.
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Tens machines (pain machine), tns machine, basically exist in either of two forms, analog or digital. Almost all units have 3-4 major components to use to control pain. Those are:
* rate ( how many times the machine goes off and on per second - generally 1- 150 times)
* width ( when machine comes on how long does it stay on - measured in millionths of a second, and most tens units stay on from 50 to 350 millionths of a second)
* amplitude - power ( how much amperage/wattage being used so patient feels some sensation)
As long as those three controls exist then the units are pretty much the same but you want each of the above to be able to change independently by the patient. After those conditions are met then it becomes a choice of size, and for many what type display they want.
A digital display in a tens machine is simply a screen and as the buttons are pushed the picture on the screen changes and the patient can view what is changing. As an example if the patient pushes a button to go from a new "rate" to a new "width" the screen will show width on it and rate disappears. This is nice but for many the screen on the pain machines are too small and not easily seen so the patient does not want digital since the patient may not be able to see the small screen. Also many elderly patients were not brought up using digital devices so they prefer to use what they are familiar with, buttons to turn left and right to turn on, off, and adjust.
An analog tns machine is simply the same controls but the same results are accomplished by turning knobs, not pushing buttons. Analog tens does not have a screen and the patient simply turns the know and feels the difference. An example is a TV where for sound the patient is not interested in a note on the screen saying the volume is being turned up but they just want to hear the sound without being told the sound was turned up. The turning of the knob increases the volume and that is sufficient. Many older patients have used analog devices all their lives and that is their preference in a tens unit.
Of course most patients prefer small, easily carried units since tens is designed to be worn and carried on the body so size is important.
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Below is a letter from a MS patient who has successfully used the Infrex Plus for multiple sclerosis pain and now wants to use the water therapy techniques for interferential treatments with the pain limb submerged in water using the water as electrode tens - interferential technique. Original email listed at bottom of this article.
Thanks DA patient ( name withheld) again for the nice comments and referral to your Massage Therapist, M.T.. I'm happy you're continuing to benefit however there are some integrative approaches to be used that may help on the bottom of foot pain you are experiencing. I put up an article on our web site this week on "attacking the layers of pain" which is an interim article until we do the video. Click on the below to see the article:
Also we only have some brochures on the Infrex that actually show the last prototype we used before the final product which is the one you have now. Infrex image not as it is but he verbiage is still correct.
Let me address each of your questions you've asked. Your need of the Infrex Plus treatments less frequently is totally consistent with what we have seen and we attribute it to the creation of longer carryover pain relief.
(1) when used in water, does the unit only uses two electrodes instead of four? Can use two or four as will get the interferential therapy either way.
(2) are the special electrodes just put in the water loose, not applied to the skin? Yes do not apply to skin but put on far ends of container with water. Reason for this is now the electricity travels across the water in shortest path, and we want your foot, lower leg, in the middle of that direct path - Electricity takes path of least resistance and will go directly to your extremity but now all the water is an electrode.
Can they be put on the skin (feet)? Yes can do but not sure if will be as effective but if I were you I would try and see if works better. Simply because the foot is now wet, better conduction throughout, and may work better than electrodes off foot but in water. IF you do this I would put one electrode on the bottom of your foot and the other up on your calf.
(3) can I put one electrode in one bucket of water for one foot and the other electrode in a different bucket of water for the other foot? Very innovative and great thinking on your part. Well done!!!
Yes you can and reason is now your body is the "path". Electricity comes out of Electrode A in water where left foot is, goes up leg and over to bucket B where Electrode B is ( actually this is the "ground electrode", "circuit completer") and now the electrons pass into that electrode. Now this is interesting placement but two things to remember.
· The Infrex Plus has two separate amplitude/power controls so you can treat two separate feet at same time but more power in one channel than other. You could put two electrodes in one bucket, same channel, the other two in the other bucket, same channel and adjust the power for each bucket. Benefit is pain varies and more power may be necessary for one foot than the other. You have the option to adjust based upon pain level.
· The above now stops the transfer of power ( flow of electrons) across your body but confines it to each foot as the channels are set up for each bucket and that is where the circuit exists versus the previous idea of one channel with one electrode in each bucket.
Hope the above not too technical but you've raised an interesting concept. If confused call me - 800-937-3993.
(4) if I find a bucket large enough, can I put both electrodes in the water with both feet in it and get the same benefit?" Yes you should be able to and remember you may not need a bucket but can also use bathtub.
Last thing MS patient, has your Dr. checked your legs for vascular insufficiency? Reason for asking is often pain of lower extremities can be due to vascular insuff. Another option then would be use of EMS type stockings for constriction and/or an extremity pump to move fluids to help stop pain. Also elevation helps ( above heart). Just a fyi.
I wanted you to know that, thankfully, the Infrex unit that I got from your company at the end of December 28, 2009 has gotten the throbbing pain I had in my ankles under control and I now use it only occasionally, as needed. My (nerve) pain is now localized to just the bottoms of my feet but nothing seems to help there, and I still have some lower leg swelling. Recently at a weekend retreat for people with multiple sclerosis, I had a complimentary massage. The massage therapist decided to try "Manual Lymphatic Drainage" (MLD) on my feet and legs. To my surprise, it did not hurt and it actually helped to temporarily reduce the pain on the bottoms of my feet and gave me additional hope (I've been in a wheelchair for one year now and am still hopeful that I will one day reach my goal of being able to walk without pain on the bottom of my feet).
Since the massage therapist did MLD to my legs and feet, it gave me more hope of attaining my goal mentioned above so I saw her a few more times and continued to get temporary relief. She is such a good and caring person that she recently came to my house to show me how I could do it myself using household items such as a rolling pin, tennis and golf balls, etc. Previously I had told her about the Interferential unit and how it has been very beneficial to me in controlling the ankle throbbing pain over the last five months, allowing me to no longer have to take the pain medications. She was very interested in it so, while she was at my home, I showed her the Infrex unit and demonstrated it. She was very impressed and noted your company name on the blue pack the Infrex is kept in. I spoke very highly of you and your company and even mentioned that you have a positive (A) rating with the BBB that I find so important. She is all for alternative treatments so I am certain that she will share this information about the MedFaxx Infrex unit with others who she may come across that she thinks might benefit from it in the future. In the meantime, do you have any brochures, business cards, and/or pieces of literature about the MedFaxx Infrex that you could send to me so that I can put them into the hands of those that are interested? I have told my doctor and many people at my support group about the MedFaxx Infrex but it would be nice to be able to give them something to refer to if they were interested, as was the massage therapist; it might help facilitate referrals.
The massage therapist asked me if the unit could be used in water and I said yes but that I was waiting to hear from you for instructions, once you finished creating an instructional video for your website. I did tell her that I understood that it could be used with water only with special electrodes and only using the batteries. Last night I decided to check your website and found a video on "Using Hot or Cold Water As An Electrode System for Pain Relief", I assume this is the one you had been working on? After watching the video I have some questions about it:
(1) when used in water, does the unit only uses two electrodes instead of four?
(2) are the special electrodes just put in the water loose, not applied to the skin? Can they be put on the skin (feet)?
(3) can I put one electrode in one bucket of water for one foot and the other electrode in a different bucket of water for the other foot?
(4) if I find a bucket large enough, can I put both electrodes in the water with both feet in it and get the same benefit?
Please let me know your thoughts on this. I would like to try the Infrex with water but want to make sure that I use it correctly so as to obtain the optimal benefit from it. Thank you.
D.A., Patient (name withheld)
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Tens has been effective for Crohns disease pain but with the advent of take home, treat as needed, interferential therapy for carryover pain relief; the Infrex Plus on interferential mode, or using the tens mode, may be the most effective non-drug treatment for patients suffering pain from Crohns disease.
Tens Machine for Crohns flare up pain
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Defeating The Chronicity of Pain
The patient who suffers from such chronic pain diagnosis as , Multiple Sclerosis pain, RSD, Fibromyalgia, Neuropathy, Sciatica, Chronic low back pain and degenerative disc disease to name a few is not experiencing typical cause and effect pain symptoms. These patients have had to learn to live with pain, generally becoming worse over time. Some of the specific pain etiologies of these diagnoses begin as less difficult, less painful beginning points and over time, due to the pain, these patients develop what are called “guarding” or “shielding” behaviors in order to cope with the condition.
One of the easiest examples is the patient who has been diagnosed with chronic low back pain, CLBP, and due to the pain the patient limits their activities, favors one side of the other due to the pain, and becomes sedentary and so on. The behavior changes due to the pain impulse result in physical changes such as loss of elasticity in muscles due to inactivity, poor circulation, stress on certain muscle groups by shifting the weight of movement to a non-painful area, muscle spasms which add another level, and loss of muscle tone. Each time the patient changes their physical patterns it is common to now introduce another level of pain. It is common to see the CLBP patient develop a secondary pain referred to as sciatica. The pain is due to shielding and guarding by the patient to lessen the severity of the pain from the CLBP.
When a patient begins using interferential therapy the main purpose is not total elimination of all pain levels but to begin to reduce the multi levels of pain one by one. As an example the Neuropathy patient may have painful areas in more than one part of the body. There generally is a primary area which was the precursor to the diagnosis of the original problem, but through shielding and guarding other areas of his/her body develop pain.
The interferential therapy is intended to:
· Reduce the severity of the pain impulses position by position,
· If inflamed reduce some of the inflammation
· Stop the progression of muscle tightness and in some situations cramping
· Relax the muscles
· Increase blood flow to the area for greater metabolic processes
· Allow limited range of motion/stretching exercises to increase elasticity of the tissues and cells
Once the treatments begin it’s not an all or nothing approach and it’s rarely solely one treatment method. The patient may experience muscle cramping and the interferential therapy wards off the cramps however the post treatment may include using some topical analgesic or sports rub to maintain the therapeutic effects. In almost all situations it is necessary to begin some form of stretching exercise to increase the tissue elasticity, and range of motion of any body part affected. The stretching which is beneficial, however also painful, can be overcome using interferential to lessen the pain so greater range can be reached quicker. It’s a multi function integration of treatment methods to achieve elimination of pain levels.
The chronic pain patient simply wants restoration of most functional ability and if he/she can eliminate pain levels on a weekly basis then progress is being made.
For many chronic pain patients the principal difficulties may be muscle related, ie, muscle pain due to cramping, tightness, spasms. The patient dreads the recurrence of the muscle pain and will work to eliminate that level. By using interferential as a precursor to stop the progression of the tightness the cycle can be stopped, however besides stretching to avoid future occurrences the patient may use an anti-inflammatory such as ibuprofen, or hot moist heat, or arnica skin pain patches. Levels of pain require levels of treatment options resulting in elimination of most pain, step by step, level by level.
The chronic pain patient should always be remembered and treated with full knowledge that any chronic pain diagnosis is the result of failure to successfully treat the pain for greater than 6 months. The methods for treating acute pain have failed and new levels of pain stimulus emerge which requires treatment with goals of pain level elimination, one by one.
Chronic pain requires integration of treatment modalities and methods to achieve beneficial results. For the chronic pain patient there is no “magic bullet”, only the will to get better and education on methods, options and clearly defined goals to achieve that success.