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MET Treatment Protocols

Part two of this series covers basic methodologies of Microcurrent Electrical Therapy.
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It is important to take or review a comprehensive history and do a brief analysis of the patient's current condition before beginning each session of MET as a diagnosis is not enough. One should determine when the pain first presented, its frequency, duration, intensity, limitations-of-motion, positions that exacerbate the pain, and any precipitating factors. Ask patients about the specifics of previous treatments and details of all surgical scars and traumatic injuries. MET is a holistic procedure whereby it may be necessary to clear the body of any and all electrical "blocks" in order to achieve the best results. Even brief 10 to 20 second treatments of other problems and/or old injuries may reverse a refractory case.

Immediately before each treatment determine the patient's present pain level, and positions that exacerbate the pain. Ask the patient to rate his or her present pain on a scale of 0 (no pain) to 10, with 10 being excruciating, debilitating pain. Tell the patient to consider 10 as "the worst this condition has been." Also note any immediate limitations-of-motion, positive orthopedic and neurologic test findings, and objective signs of psychological distress. Because the results of MET can be seen after only a minute or so of treatment in most people, these indicators are necessary reference parameters to determine effectiveness throughout a single treatment session.

Adjusting the Settings

Use a low frequency, typically .5 Hz most of the time. Faster results are sometimes seen with initial use of 100 Hz when treating inflammatory articular problems (e.g., arthritis, bursitis, tendonitis, etc.). However, 100 Hz does not contribute much to long term results so treatment should always be completed using .5 Hz. Set the current intensity level at the highest comfortable position which is usually 500 to 600 µA for probes, although sometimes less for the silver electrodes used with MET. Do not use standard TENS electrodes except in the initial treatment of hypersensitive patients as only silver electrodes will work effectively with MET devices. Carbon TENS electrodes have a resistance of about 200 ohms, while silver electrodes have a resistance of about 20 ohms.

When using probes, first affix new felt electrodes and saturate them with an appropriate electromedical conducting solution. Then apply firm pressure, but less than that which would cause more pain. Saline solution may be used if a conducting solution is not available.

Basic Treatment Strategy

When treating patients with MET, there are a few important principles to remember. The patient should be in a relaxed position to receive maximum beneficial effects. For example, when treating a patient's hands, do not allow the patient to hold up his or her arms, as this causes the arm muscles to tense. In this case, it is better to place both hands on a table.

The most important variable is the position of the probes, or silver electrode pads. Place the probes, or pads, in such a way that if a line is drawn between them, it will travel through the problem area. Keep in mind that the body is three-dimensional. Therefore, there will be many possible lines that can be drawn through the problem area. Some lines will work much better than others, but the correct electrode location is the one that works. The one that works may be transient, working well one day, but ineffective another day. As the problem begins to resolve, the electrode locations may require frequent adjustments.

The most important variable is the position of the probes, or silver electrode pads. Place the probes, or pads, in such a way that if a line is drawn between them, it will travel through the problem area. Keep in mind that the body is three-dimensional. Therefore, there will be many possible lines that can be drawn through the problem area. Some lines will work much better than others, but the correct electrode location is the one that works. The one that works may be transient, working well one day, but ineffective another day. As the problem begins to resolve, the electrode locations may require frequent adjustments.

A common mistake made by clinicians familiar with traditional TENS is placing the electrodes on each side of the spine for back pain. This is a two dimensional approach. With such a placement microcurrent will travel just under the skin between the electrodes and never reach the spine. Nor can the electrodes be effectively placed "between the pain and the brain." A better way is to place one electrode next to the spine at the problem level and the other on the contralateral side, anteriolaterally (front and opposite side). A line drawn between will go right through the spinal nerves. Next, reverse the sides. Then follow-up by doing another set of contralateral placements one spinal level above, and one below the problem to accommodate overlap in the dorsolateral fasciculus.

Always treat bilaterally. Bilateral treatment includes the spinal cord thereby involving dermatomes, myotomes, and sclerotomes. Also if the problem is within the axial skeleton and the contralateral side is ignored, there is a good chance that the primary location of a pain problem will be missed. Pain often presents itself on the tense side that may be compensating for muscular weakness on the other side.

Quick Probe Treatments

When using probes, set the timer on a probe setting, or if one is not available, treat about 10 seconds per site. Consider one treatment "set" to be 12 to 20 of these 10-second stimulations, each at a different angle of approach. The first set should take approximately two minutes, but additional treatment may be performed at one-minute intervals. The patient should be reevaluated between each set.

The protocol involves four steps:

  1. First treat in a large "X" manner over a wide area holding the probes so that the current is directed through the problem area. An example of this strategy for knee pain would be to first make the large X by treating from the medial, superior thigh to the lateral foot, then lateral at the hip to the medial foot.
  2. Treat with smaller X's, or a "star" (*) closer in directly around the involved knee (e.g., two obliques, one or two medial-lateral, one or two anterior-posterior, etc.).
  3. Treat the opposite knee for at least 20 seconds (one X), even if it is asymptomatic.
  4. Connect the two knees by placing a probe on each knee at least four times.

This procedure takes two minutes. Placing a big X beyond the area (20 seconds) and a star through the chief complaint (40 seconds), then treat the opposite side with one small X (20 seconds) and connect the two sides (40 seconds). Then reevaluate the pain based on the original criteria.

If the pain is gone, stop for the day. If it is reduced, ask the patient to point to where it hurts with one finger and treat for another minute or so directly through the area of pain, which may have moved after the original two minute treatment.

Think in terms of symmetry. Look, palpate, and otherwise examine areas above, below, and to the left and right of the primary area undergoing treatment. Always treat the opposite side and connect both sides.

Last updated on: May 16, 2011
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