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13 Articles in Volume 11, Issue #3
Advances in Cranial Electrotherapy Stimulation
Chronic Migraine: An Interactive Case History, Part 3
Cost-effectiveness Of Treatments for Low Back Pain
Electrical Me
Lessons From The Father of Electromedicine — Dr. Luigi Galvani
Medications for Chronic Pain—Nonopioid Analgesics
Pulsed Radio Frequency Energy As an Effective Pain Treatment
The Role of Body Posture In Musculoskeletal Pain Syndromes
The Role of Body Posture In Musculoskeletal Pain Syndromes
Therapeutic Laser for the Treatment of Chronic Low Back Pain
Tolerance to Opioids
Understanding Electromagnetic Treatments
Update: Clinical Challenges in the Diagnosis And Management of Fibromyalgia

Understanding Electromagnetic Treatments

In addition to immediate pain relief, the administration of electricity or its derivatives may assist tissue healing and regeneration by cell stimulation, removal of edema and inflammatory mediators, and angiogenesis.
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These two mechanisms may be operative, but they are very likely not the sole answers. Administered electricity simply has too many biologic effects independent of the spinal cord. Galvani showed that frog legs, when separated from their spinal cord, would still contract when an electric current or metals touched the legs4. Electricity administered though acupuncture needles placed in the body’s meridians relieve pain, and the meridians are not connected to the spinal cord.1,9

It is this writer’s conviction that an electric current and its derivatives disperse pooled electricity and/or change the polarity of pooled electricity to reduce pain. Painful, pooled electricity can be either dispersed into the surrounding tissue or channeled into intact nerves. The dispersion theory is enhanced by the clinical observation that pain may be relieved for hours or days after a single administration of electricity, but the pain will recur. The pain returns when electricity emitted from the damaged nerves again recollects and pools. In summary, we must labor with an incomplete understanding of the precise mechanisms by which an electric current or one of its derivatives produces short-term pain relief.

Figure 3: The Electromagnetic Spectrum

Derivatives of Electric Currents

An electric current that passes through a wire will produce electromagnetic energy around the wire. The unit of measurement is the photon.2,3 All of us have seen and heard the displacement of air caused by the emission of these energy waves when we look up at a high transmission wire carrying an electric current of high amperage. The fields emitted around the wire are about 50% electric and 50% magnetic in nature. The energy waves generated by an electric current are collectively known as the “electromagnetic spectrum” (Figure 3). The smallest waves are invisible and consist of ionizing gamma and x-rays.

Of the waves in the electromagnetic spectrum, laser, infrared, and radio are currently used in pain treatment. Radio waves are very long—about the size of a building—and laser waves are about the size of a protozoan. The different wavelengths and frequencies of these energy waves are believed to give each wave varied clinical usages and potentials, but this hope has not yet materialized enough to permit specific clinical recommendations. The electromagnetic devices that administer the energy waves are of a low, safe frequency and are to be clearly contrasted with the high-frequency lasers and radiofrequency devices used solely for tissue ablation.

In addition to electromagnetic energy waves, scientists found a way to make an acoustic or sound wave from an electric current. Ultrasound, the first innovation, has been a mainstay of electomedicine for more than 5 decades.12,13 It has found great use in acute injuries to soft tissue structure such as muscle and fascia. It can also diffuse medications through the skin (eg, phonophoresis).

Inexpensive ultrasound devices are now available for at-home use by patients. More potent acoustic wave devices have been developed that effectively disintegrate kidney stones—lithothripsy. A related technology now available for pain treatment is called extracorporeal shockwave therapy (ESWT). ESWT is a high-pressure acoustic wave derived by passing an electric current through a crystal. Clinical investigations have found that some recalcitrant problems such as plantar fascitis and chronic epicondylitis respond to this new derivative of an electric current.14,15

Regeneration of Tissue

An exciting area of current research has been the use of electrical currents to regenerate tissue—and even “cure” a pain site.16-19 Just as Sinyukhin regenerated his tomato plants and Becker his salamanders, clinicians everywhere are progressively observing regeneration of tissue with these devices. Acute injuries and wounds such as the common low back problem or diabetic ulcers heal much more quickly with these devices.16-19 The regenerative effects on tissue are well documented and are summarized in Table 2. They include growth of cells, angiogenesis, reduction of edema, and clearing of inflammatory mediators.

At this time, there is considerable clinical study by practitioners as to which device may provide maximum regeneration and healing of some difficult pain problems. For example, microcurrents (Alpha-Stim) are being used for cranial stimulation, and radiofrequency (Provant) is being used for plantar fascitis.10,19

Use With Other Therapies

All of the electromagnetic measures mentioned here can be used in combination with the standard pharmacotherapy agents, including anti-inflammatory agents, antidepressants, neuropathic drugs, opioids, and topical medications. The simultaneous use of drugs and electromagnetic measures is highly complementary and enhancing.

Some pain treatment drugs directly or indirectly act to control electrical activity. Opioids suppress electrical activity.4 The antidepressants and neuropathic agents attempt to curtail electrical transmission at synapses. Anesthetics and some oral agents aim to retard the transmission of electronic signals by blocking sodium or calcium channels in nerve membranes. Topical treatment agents, including opioids, anti-inflammatory agents, and homeopathic solutions, can be used simultaneously with or even diffused through the skin into a pain site by many of the electromagnetic devices that administer an electric current or an electromagnetic energy wave.

Along with pharmaceutical agents, there is now a growing number of reports that prolotherapy, homeopathy, and hormone treatments also may be curative at some pain sites. Concomitant use of these modalities with electromagnetic measures may also be helpful.

Side Effects

Electromagnetic measures can produce side effects. Even a simple magnet or piece of copper may cause pain in some patients as it mobilizes the body’s electricity. Electric currents and electromagnetic energy waves are actual matter. When administered into pain sites, they may cause rather than relieve pain. This author has particularly observed this in patients with intractable pain who have very old, scarred, and contracted pain sites. All the electromagnetic devices on the commercial market meet FDA safety requirements, so one can have a high degree of confidence in their safety. Be on the lookout, however, for pain generation rather than pain relief. If it occurs, simply stop or modify the treatment, as the side effects are transient.

Last updated on: November 30, 2011