New Askdrgion Blog

Dr. Giovanni De Domenico has written some interesting articles on electrotherapy for MedFaxx. He also is in process of creating online education materials with PowerPoint and mp3 audio for the following:

1. ‘A Healthy Body is an Electric Soup’
2. Electrophysical Agents: What are they and what are they used for ?
3. A brief History of Electrotherapy
4. Basic Concepts in Electrotherapy
5. ‘Sensory’ Stimulation
6. ‘Painful’ Stimulation
7. ‘Motor’ (muscle) Stimulation
8. Traditional ‘Low Frequency’ Currents
9. Medium Frequency Currents
10. Interferential Therapy - History and Basic Concepts
11. Interferential Therapy - Methods of Application
12. Interferential Therapy - Management of Acute Pain
13. Interferential Therapy - Management of Chronic Pain
14. Interferential Therapy - Muscle stimulation

You can find more about your specific diagnosis by using Dr. DeDomenico's blog, AskDrGion.

Cheapest Tens Unit On The Internet

Looking for best price or best value? Go MedFaxx Web Site to find both if you need pain relief.

Point Locators/Stimulators for Pain

Point Locators/Stimulators

A point locator/stimulator is nothing more than a device that emits a small electrical current and then monitors the resistance or conductance of the area beneath the point of the device.

Most of these devices have a light ( visual cue ) and an audible cue ( sound ) so the technician can hold the wand/pen and receive signals visually and audibly as they treat the patient. The price of these devices can range from $100 up to several thousand dollars. The devices can be small hand held, not much larger than a ball point pen, to a clinical unit that is 24" long, 12" tall and 18" deep with many bells and whistles.

The general method of operation is when the conductance of a point on the skin is high the machine emits a higher pitched sound and also the light bar races to the top of the scale. This indicates to the technician to treat this area. The device is then switched from monitoring the area to treating the area. The intensity of the current is increased and the point is stimulated generally for no more than 60 seconds. Upon completion of the stimulatory session the area is
checked again to see if the resistance has increased or conversely if the conductance has decreased.

The basic theory behind the device is there tends to be a correlation between points of high conductance and pain. Following injury, or in the case of chronic pain patients, these devices identify points in the pain area by measuring the resistance/conductance and the patient has many more conductive points in the immediate area of pain which are treated. Upon completion of the treatments the patient's pain level has been reduced.

The therapist generally does palpation over the painful area prior to and after treatment to verify the specific painful areas sensitivity has been reduced post treatment.

The actual points are often referred to as "trigger" points rather than "acupuncture" points. Acupuncture points refer to specific anatomical distances and trigger points refer to electrical characteristics of specific areas at a specific time.

Tens Electrode Care

One of the continuing costs of use of a tens unit is the electrodes that are necessary for the operation of the unit. If your insurance company has purchased the unit for you then the continuing costs are covered, if not then it is out of pocket which is why we recommend using your insurance for the purchase so these costs
are covered. Here are some helpful tips to prolong the use of the electrodes.

Read the Instructions of the package the electrodes arrive in.

Be certain to follow the instructions for use and care, removal and storage of the electrodes before using them. Improper care may damage or destroy the electrodes.

Choose the Correct Electrode

Use the proper electrode style for the treatment site and type of stimulation. MedFaxx offers a variety of electrodes to meet the needs of each individual patient. If you have any questions about choosing the correct electrode, call our customer service department at 1-800-937-3993.

Prepare the Skin

Clean skin is the best preventative against skin irritation so always wash skin at the application site with soap and water and pat dry with a towel. Never use alcohol, lotions, oils, or creams on the skin prior to placing the electrodes. Trimming(not shaving) body hair from the area is often helpful. Additionally, pre- and post-treatment skin care products protect the skin and help to keep the treatment area healthy. Should any irritation occur, discontinue treatment until the skin heals.


Electrode Removal

Remove the electrodes from their liners by bending the liner slight at a corner. Loosen the gel from the liner by rubbing your thumb across the edge of the electrode in an upward motion. Once the gel has loosened from the liner, grasp the edge of the electrode and peel from the liner.

For those electrodes with pre-attached wires (or pigtails), PLEASE DO NOT PULL ON THE WIRE. Doing so will cause damage or destroy the electrode. The proper method of removal is to grasp the edge of the electrode and lift it from the liner or the skin.

Rotating Electrodes

To extend the life the electrodes, rotate their use. They should be rotated every 4 to 6 hours if being used in a hot or humid environment.

Over-Saturation

Over-saturation can occur if electrodes are worn too long without rotating. Over-saturation occurs when the solid gel electrode absorbs and retains moisture from perspiration, hot/humid environments, or excessive addition of water to re-hydrate the gel surface. Over-saturation results in an eventual lessening of the physical and adhesive properties of the gel. The electrodes should be removed from the skin and allowed to air dry in a cool and dry environment such as a refrigerator, with the gel exposed to the air for at least 24 hours.

Storing & Re-hydrating

Always check to electrode gel for tac prior to use. If the gel does not readily adhere to a gentle touch of your fingertip, rub a drop of water on the gel surface and repeat until the surface has been completely re-hydrated.

Return the electrodes to the release side of their liner and return to the storage bag. Store in a cool, dry place, avoiding exposure of the gel to heat and humidity.

How to Evaluate TENS units.

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Responding to the "Truth" Behind Electric Waves

The below post was made on Dec. 31, 2007 in response to article, "The Truth Behind Electric Waves For Pain Relief".

Response:

The author makes some interesting points here but the generalizations being made are without foundation or merit.

The title insertion of "electric waves" is illustrative of the misunderstanding of the subject matter. I'm not criticizing the author but pointing out the absurdity of many arguments that are made without knowledge of the subject being discussed.

The historic context of "electric waves" is one of the use of direct current, ie. the early Biblical references of "eels" and putting one's body part in the water for the shock effect which for some caused short/midterm pain relief. DC ( direct current ) is the form of electric waves upon which the historical context is discussed. Galvani used DC to stimulate frog legs to "jump",even after death, is one of the classics of "electric waves".


There is a plethora of research articles, most not double blind due to the sensory effect of electrical stimulation being felt, that have supported the use of E-stim for pain relief, be it chronic or acute. HCFA - Medicare, most major insurance companies, state funded health care ( Medicaid , Worker's comp programs- local and national, all relied upon the research to make their decisions to cover the cost of tens and it's associated supplies as an effective, cost efficient method of pain control for chronic pain and in some cases for acute pain if used for post surgical applications.

One of the most effective forms of electrotherapy , note I say electrotherapy, not electric waves, is the use of interferential therapy both clinically and now as an outpatient therapy. Electricity, interferential, is merely agents of the electromagnetic spectrum of which there are literally billions of combinations. Interferential is the use of 8,000+ pulses of electricity ( AC- alternatng current the difference in discussing electrotherapy now and in the past ) administered transcutaneously per second. This compares to "tens" which is generally 150 pulses per second.

Interferential ( IF) gives immediate results and also tends to have long term carryover relief for the patient. Carryover is the time one has significant pain relief prior to needing another treatment. Now having said that Interferential is still regarded, 60 years later, as "experimental" but is the most used form of electrotherapy for pain relief. TENS is not in any manner regarded as experimental nor is the efficicacy of the modality in question.

I find the article similar to describing Edison using electricity to create a light and one now saying comparing that ancient use to the microchips that used to promote our everyday lives lacks scientific evidence. There's really no comparison and the earlier results of Edison paved the way to greater understanding to create the complex chips we have today which benefit us all.

This type article fails to inform and is based upon archaic knowledge, or lack thereof, of the field.