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Glial Cell Theory Might Explain Carryover Pain Relief As Revealed in This MedFaxx Video
All pain is in the head, which is the only place pain can be perceived, but what are the mechanisms that deliver the impulse to the brain is the answer to understanding how to control pain. Bob Johnson of MedFaxx describes the 3 leading chronic pain theories in this video, including the latest glial cell theory. The Glial cell theory may be the leading theory for explaining how interferential therapy is capable of providing extended carryover pain relief for many chronic pain patients.
Wake Forest, N.C. October 6, 2009 --
The chronic pain patient who suffers from diagnosis such as sciatica, osteoarthritis, RSD, phantom limb pain, low back pain, neck and shoulder pain and certain neuropathic conditions is often told "it's all in your head" according to reports over 30 years by chronic pain patients to MedFaxx. "It's all in your head" is an accurate statement, but is not beneficial to helping the patient.
Many health care providers are not willing to cope with the understanding that any patient who is suffering chronic pain is basically a failure of past treatments and now the patient is in constant unremitting pain. The past methods did not work therefore the symptom has become the diagnosis, ie. chronic pain due to XYZ.
Conventional medical procedure has been to attack the pain receptor sites in the brain but so often this is doing nothing but changing the perception of not only pain but also reality for the patient. As an example many outpatient procedures requiring some form of sedation such as surgical molar removal at the dentist or colonoscopy require sedation and the patient is not allowed to drive home following the procedure. The logic is simple and the concern is safety. The patient's mental state has been altered to deal with the pain sensation that would be experienced during the procedure but there are consequences to that method such as inability to function without help and supervision.
Unfortunately chronic pain patients are treated in a similar manner by the use of drugs thus altering consciousness. The chronic pain patient does not feel pain due to the medications but the chronic pain patient also is not a functioning member of our society.
Many chronic pain patients reject that method of treatment over time. They want options that do not leave them incapable of maintaining some semblance of a normal life doing everyday activities.
One option is the use of "How Does Interferential Therapy Work". Interferential is many times over more powerful than the use of a TENS unit, transcutaneous nerve stimulators. This is a non drug method intended to stop the pain impulse at it's source before it can be transmitted to the brain for the hurting sensation. The benefit of this treatment is the use of perception altering drugs is eliminated, or the dosage reduced so the patient can function, yet be relatively pain free.
Effective Jan. 2009 it is now possible for the patient to do interferential treatments at home as needed using a portable device, the Infrex Plus, which also has a tens unit mode to use when needed. The interesting phenomena that is developing is with multiple treatments administered as needed, the patients are finding they need less treatments since there develops what is called "carryover or residual pain relief", extending the pain free periods from hours to days or in some situations weeks.This video explores how pain is felt, the three leading theories of pain transmission, and how the carryover pain relief being experienced may possibly be due to the new glial cell theory of pain. Glial cell involvement in pain management has been advanced by Linda Watkins, Ph.D - Univ. of Colorado
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As we all know paralysis is a major problem for not only the patient but also for all those who care about the patient. Electro stimulation is being recognized as being able to help patients overcome certain paralysis.
In recent years we've seen the quick use of chilling agents to slow down the inflammatory processes resulting in prevention but that is new and requires knowledgeable clinicians with the necessary equipment. What is missing is those preponderant situations where the damage has been done and the patient is left paralyzed post injury.
It has been known for many decades that the electrical reactions in our body are precursors to any chemical changes occurring. We use electricity to facilitate bones healing and bed sores healing so to use e-stim for assistance in teaching our brain new pathways to accomplish functional movement should not be surprising. Many times if we use estim as a precursor for chemical changes and then couple that with use of estim for functional motor nerve stimulation it appears we actually are helping the brain learn new electrical discharge patterns that could result in ambulation, movement etc.
Here is article recently published at UCLA on getting step closer to helping the patient in paralysis. This is about progress with paralysis of rats but the basics are advancing.
Let's keep our fingers crossed more research done quickly will result in advances.
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Wound Healing For Decubitus Ulcers Protocols Are Predicated Upon An Old Technology - Hot and Cold Quartz Lamps Which Led To The Wound Healing Protocol For the V-254 Ultraviolet LampThe original ultraviolet C lamps, Birtcher Hot and Cold Quartz Lamps, took almost a minute to "warm up" before the lamp was emitting it's full dose of ultraviolet, 254 nanometer energy. It was due to this outdated technology that the treatment time was listed as 2-3 minutes per ulcer. The issue was not how much energy was being transmitted but how long it would take the lamp to generate the uv rays.
The V-254 does not use Quartz bulbs but uses a form of mercury vapor in a fluorescent tube. Due to this the treatment protocol can be reduced to 1 minute, 1 inch away, and afterwards "wand*" the skin around the wound to kill any pathogens that are alive and could migrate into the wound bed.
*( The V-254 wound lamp is the only ( at this time, 2009) lamp authorized by the U.S. F.D.A. for dermatological pathogen eradication.)
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Topical Pain Relievers - What Works Best?
With over 30+ years helping patients with chronic pain we are often asked "what will work best for me?". Honestly we don't know but what we do know is what has worked best for the vast preponderance of our 10,000+ patients over time.
Let's take a moment to explain the process that evolved. All our patients suffer from some form of chronic pain, sciatica, neck pain, shoulder pain, neuropathy, shingles, cancer pain, even RSD and Fibromyalgia. There has never been one "magic bullet" for any patient, nor has one topical pain product been the best at all times for any pain the patient experienced. Pain moves, the sensation changes, and sometimes a couple of products are necessary.
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Pain diagnosis of all sorts are searched constantly trying to find a solution. Medfaxx, having been in the chronic pain business for decades, always is monitoring the activity levels of chronic pain patients seeking relief and watching what types of pain are most common. It can be shoulder pain, back pain, chronic pain, arthritis pain, and sciatica pain and the below pain widget monitors and updates every 7 days.
Here is a free comparison tool we use to monitor internet activity for different types of pain. You can use it also to see how your diagnosis of a chronic pain condition compares to others also seeking relief.....
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Diabetic nerve pain can be crippling pain for many diabetic patients. Often the pain is exacerbated by lack of blood flow, less muscle elasticity due to inactivity, and a continuing chronic pain that disturbs one's ability to sleep, work or play.
There are several advantages of using electrotherapy such as interferential or TENS for decreasing the pain and for increasing blood flow to the painful area.
Tens or interferential therapy in the range of 75+ pulses per second, pps ( referred to as rate or cycles ) in a tens unit and in interferential the range of 8,075 - 8,150 pps is the desired range to combat the pain being felt. The higher frequencies are used to stimulate non-pain fibers so the pain is not felt unless some action is taken to cause further injury or pain. If that happens then the new pain stimulus is felt and neither the tens or interferential unit overcomes the new pain that is created by the injury. By activating non-pain nerve fibers the pain message is not allowed to be transmitted and without transmission there is no pain.
A patient is looking for some permanent change that will facilitate the permanent elimination of the pain, and to increase blood flow to the painful area, can add curative effects diminishing the pain as well as facilitating greater motion. This is accomplished by setting the rate at 1-35 pulses per second with a tens unit, or 8,001 - 8,0035 with an interferential unit. The amplitude ( intensity) is then raised to the point that visible motor (muscle) twitching is seen. The "muscle pumping" increases the blood flow to the area and with new nutrients and oxygen now starting there is possibility of tissue healing eliminating the pain. Lack of blood flow to an area for many diabetics is an ongoing problem and there must not have been a permanent impediment to restoring circulation in the affected area.
Reason for the lower pulses per second is the rate of conduction of muscle nerves is in range of generally accepted 1 - 35 pulses per second. At 35+ pulses per second the motor nerves create what is called a "fused contraction" and the motion is lost. When asked to "make a muscle" that is an example of fusing the muscle which can only be held for short periods of time before the muscle fatigues. The actual "pumping" of the muscle restores blood flow since our body is basically a contained system, within our skin, and the "pumping" in a confined area means something has to physically move. Easiest thing to move is the blood thus the patient has increased blood blow in the area.
With interferential the reason for the increased pulses per second in the 8,000 range is the 8,000 pulses are there only to reduce resistance of the skin so the stimulatory pulses can better target the nerves needed to achieve pain relief and increased blood flow.
Often it is beneficial for the patient to use a moist heat during the interferential treatment to increase blood flow and facilitate less resistance due to the higher moisture content on the surface, plus higher blood flow in the treated area as the body tries to dissipate the heat by increasing the blood flow to the area.
A FREE Trial is available for your patient, with a prescription from licensed M.D..
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MedFaxx's Role in Tens and Infrex Consignment For Free Trial Video By Chronic Pain Patients
Free Tens (Transcutaneous Electrical Nerve Stimulator) - Infrex Trial - How Did It Get Started?
One of the unheard of practices in most hospitals and physical therapy clinics across the U.S. is the practice of allowing a chronic pain patient the free trial of a tens unit to see if the unit helps alleviate the pain. It's a nice practice that originated in early 1976 and has continued until today.
The basic premise of allowing a patient, who had endured failure after failure of traditional treatments for their pain, to get a free trial was based upon the premise of the belief in the technology.
In 1976 most manufacturers of these "pain machines" were trying to sell their units to physical therapy depts., chiropractic clinics, pain clinics and neurosurgeons who dealt with chronic pain patients. Somehow the industry felt that a take home, use as needed product, should be purchased by the institution to "try on a patient in the clinic". This was contrary to the purpose of the TNS unit. A TNS unit was designed to be used in most any setting and worn all day if necessary. The patient would turn the unit on when the pain was starting or when undertaking a task that normally resulted in pain. The patient then had self control of their chronic pain by being able to treat as needed without being in a hospital or clinical setting.
In late 1977 the consignment of tens was started in physical therapy depts. in North Carolina after copying the practice of a company out of La Jolla, Ca., N-Tron, who had begun to experiment with the concept. MedFaxx actually purchased the units and then consigned to physical therapy clinics so a patient could try the unit to determine if it would help or not. If it helped then the unit was purchased or rented depending on the diagnosis being a chronic or acute pain situation.
Many chronic pain patients had basically given up on trying new treatments since many had been willing to try drugs, surgeries, and other modalities yet they still continued to be in pain. To say it mildly they had lost tolerance with the traditional treatments for acute pain and ended up with a diagnosis of chronic pain.
Physical Therapists were the one health care profession that had the training and understanding on basic electricity and how our bodies work electrically and were chosen based upon their education and experience in working with electrical modalities.
The practice has continued and now is the standard for the use of interferential units which are outperforming the traditional tens units for pain relief.
For some manufacturers and distributors the message of believing in the product never caught on and they went to the wayside. For others it was a belief in a new technology that would help and the distributors took a chance, patient by patient, resulting in a new fair way of patient trials.
Today no patient should be expected to buy a tens or interferential unit unless the patient has been given a chance to try the unit for a week or more. We do require a security deposit, or permission to charge credit card if the tens, Infrex unit is not returned. Tens and Interferential units are consigned liberally across the U.S. by MedFaxx for free trials.
The practice of consigning tens units to clinics was novel at the time but it turned out to be the right and fair way, if you believed in your product. Now to apply that to the drug industry..(:)
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Tennis Elbow Can Be Treated With Iontophoresis Rather Than a Painful Shot or Injection
Cortisone injections are often used for conditions such as "tennis elbow" and that entails a painful needle in the elbow procedure that is not fun and is indeed painful, but does not have to be that way.
There's a non painful process called "iontophoresis" that will drive the cortisone into the joint capsule while you read a book. Heck if it's a boring book you might sleep through the process!!
Iontophoresis is the introduction of medicinal ions by electricity. The physical therapist does this as part of their treatments they are licensed to do because:
1. Not painful,
2. Does not require having to overdose using a systemic orally ingested drug in order to get the correct amount to the affected area,
3. Localizes drug into area where it is needed,
4. Drug can remain in affected area for longer time periods increasing absorption by tissues needing the medication.
Let me elaborate on this.
The physical therapist applies two stick-on electrodes, that have the medicine in the electrode pad along with what is called a "buffering" agent which is generally water, on each side of the elbow. The water allows the dispersement of the medical ions within the pad so the medication is administered evenly under the self adhering electrode. The patient feels nothing other than the sticking of the electrode on; which is equivalent to putting on a band aid. Contrast this with a needle inserted into the joint!!
Since the medication is being administered directly to the joint tissue a larger dose is not needed compared to oral drugs. With oral drugs it's necessary to administer much higher doses since much of the actual drug is lost in our digestive system and does not get to the area it is needed. The larger doses lead to adverse reactions and other complications. Generally speaking the dosage for an iontophoresis treatment is 5 - 7% that of an ingested drug.
Often a second medication is used, such as epinephrine (epi). Epi is a vasoconstrictor which constricts the vein so the medication remains in the affected area for longer periods of time for tissue absorption. This process elevates the relief from the treating medication, cortisone.
The basic principle behind iontophoresis is like charges repel and unlike charges attract. The cortisone ions have a specific charge, either positive or negative, and the iontophoresis machine is set to be the same charge as the ions. If a negative (-) ion then the negative charge of the iontophoresis unit will repel the ions into the body and to the targeted joint.
If this is so much less painful and easier for the patient then why is it not done more often?
The reimbursement rate for the procedure does not justify the time of the treating physical therapist or physician therefore it's rarely used. That is unfortunate since many patients refuse to do treatments after the first one due to the pain of the injection itself.