Electrical stimulation for the Treatment of Pain

Question 1

iontophoresis

Answer 1

• use of mild direct current to drive negatively charged ions of drug solution into patients skin and tissues
• benefits: delivers medication without needle sticks
• used for acute epicondylitis

Question 2

iontophoresis - set up

Answer 2

• monopolar electrode arrangement (1 active electrode has medication and other is dispersive electrode)
• the dose is the amount of charge that is delivered
• dose = mA/min

Question 3

dexamethasone

Answer 3

• most widely used drug (anti-inflammatory)
• has a negative ion where solution goes
• half life: 36-48 hours
• must have physicians prescription
• inflammation and pain control

Question 4

empi phoresor

Answer 4

• front panel displays: time, dose, current
• top controls: S1- channel 1, p-pause, r-run
• active pad gets drug, dispersive pad gets a non charge saline solution

Question 5

TENS types

Answer 5

1. sensory (high)
2. motor (low)
3. brief-intense (noxious)

Question 6

sensory (high) TENS

Answer 6

• small, portable, battery operated unit
• primarily used for pain control
• decreases the perception of pain by decreasing signals from A delta and C fibers
• asymmetrical balansed biphasic current
• maximum tolerable sensation, no contraction
• frequency/pulse: 60-100
• duration: as needed
• onset of relief: <10 minutes
• lasting relief: minutes to hours
• gate control mechanism

Question 7

motor (low) TENS

Answer 7

• asymmetrical balanced biphasic current
• muscle twitch (want strong contraction, no pain)
• frequency: 2-4 pps
• pulse width: 150-250 usec
• duration: 30 min
• onset of relief: 20-40 min
• lasting relief: hours
• gate control + descending pathways
• best for chronic pain, may increase acute inflammation

Question 8

brief- intense (noxious) TENS

Answer 8

• asymmetrical balanced biphasic current
• painful + muscle contraction (uncomfortable)
• frequency: >100 pps
• pulse width: 300-1000 usec
• duration: 15-30 min
• onset of relief: <30 min
• endogenous opiate mechanism

Question 9

interferential current (IFC)

Answer 9

• crossing two slightly medium frequency alternating currents within a tissue
• a 3rd frequency of current greater intensity is created in deeper tissues
• higher frequency the lower the resistance
• channel 1: high frequency
• channel 2: variable frequency sine wave
• duration: 15-30 min
• intensity: tolerable sensory or muscle twitch

Question 10

why IFC?

Answer 10

• the high carrier frequency passes through skin and other tissues with ease = comfortable
• electrodes are set up in quadripolar arrangement to create interference

Question 11

premodulated current

Answer 11

• a single alternating current that is mixed within the generator to provide a sine wave of varying amplitude
• feels similar to IFC for sensory level control, but you use two independent channels for stimulation
• used in smaller areas

Question 12

MENS (micro current electrical nerve stimulation)

Answer 12

• closer to the bodes own natural healing
• will work at the cellular level to assist healing and pain reduction
• current: monophasic, biphasic, direct, or alternating
• current flow: 1-999
  frequency: 0.1-1000 hz
• pulse duration: 0.5-5000
• intensity: subsensory
• duration: 30 min to 2 hours
• used for acute & chronic pain, wound healing, scar tissue