Electrotherapy

Synonyms: electrical treatment, electromedicine, electrical stimulation therapy

definition

The Electrotreatment works with different electrical currents, which develop different biological effects in the body. It is used for therapeutic applications in medicine and physical therapy.

effect

What all the methods have in common is that they are in use Equal- or Alternating currents flow through the body or body parts. The corresponding voltages are either over Electrodesthat are attached to the skin surface or supplied via electrodes in one water bath.
In special applications are Implants to functional electrical stimulation implanted in the tissue.

The different types and frequencies of the current have different effects on the body. For one thing, the Ions increasingly transported in the body. With direct current there is a directed transport of the ions, alternating current leads to pendulum movements. In addition, the current depolarizes the cell membrane and thereby dissolves it Action potential out. This leads to contraction one Muscle cell or a conduction of excitation at the Nerve cell. Another electricity effect is the generation of warmth in the tissue. This occurs due to friction between the charge carriers and the treated tissue.

DC treatment

Direct current and alternating current are used in electrotherapy.

Direct current treatment is mainly used in the form of hydroelectric baths. The directed current can be conducted through the entire body during a full bath (Stanger bath). The bathtubs for the Stangerbad have metal plates at the foot and sides. These plates serve as the positive pole (anode) and negative pole (cathode) and have different effects on the body. Some bathrooms also have metal plates at the bottom of the tub and at the head end. However, these must be provided with perforated plastic covers in order to comply with the safety regulations.
The water temperature and the current strength are adapted to the patient's comfort. In the case of muscle tension and pain, the temperature is usually set at 34 ° C and more, in the case of flaccid muscles or paralysis it is set below 34 ° C. The current should tingle slightly on the skin, but not cause pain or discomfort. As a rule, currents between 200 and 600 mA are used.
In so-called cell baths, the directed current is only directed to certain areas of the body, for example the arm or leg. The addition of ionizing substances can lead to the absorption of pharmaceuticals through the skin (percutaneous) can be achieved. For example, in iontophoresis, analgesic, anti-inflammatory or blood circulation-promoting agents can be taken up locally in the diseased body regions. Due to the strict laws and precautions when combining water and electricity, the regulations are very strict. A Stangerbad must comply with the Medical Devices Act and the Medical Device Operator Ordinance, as well as meet the DIN standards.

Stimulation current therapy

The stimulation current therapy takes place with low frequency Currents intended to stimulate the muscles. So can the occurring Muscle breakdown (Muscular atrophy) can be counteracted after injuries or a long illness.
The electrodes are used in electrical stimulation therapy directly attached to the skin. The contact resistance between skin and electrode is usually reduced by a gel. The current impulses lead to typical measurable changes in the muscles and stimulate them selectively. Usually can Strength and Duration set the pulses individually so that the current is not perceived as unpleasant. Since sudden strong impulses are often perceived as annoying, the electrical stimulation devices work with several average impulses per second.
With specially set training programs, the devices can be used for the Strength training and to increase the Strength endurance can be used. The effectiveness of the procedure for the Muscle building however, it is controversial. The study situation has not yet provided any convincing results on training the muscles.
Still, it seems beyond dispute that the Stimulation current therapy can effectively stop or slow down muscle breakdown due to injuries or prolonged immobility. Stimulation current therapy is contraindicated in all patients Heart problems or one Pacemaker, since the current has dangerous interactions with the Pacemaker can trigger.

Diadynamic currents

The diadynamic currents consist of two different ones Power components: A lower frequency Share and one DC component. The diadynamic currents are very strong pain reliever (analgesic) Effect, which increases with the direct current component. For this reason the diadynamic currents are common in all painful diseases Support and locomotor organs indexed.

Transcutaneous electrical nerve stimulation

With the help of transcutaneous nerve stimulation, the Spinal cord pulling annoy and the ones running here Pain afferents blocked. Therapy takes place with mono- or biphasic square-wave pulses (Alternating current) lower frequency (2-4 Hz) or high frequency (80-100 Hz). The current sequences can be in both form more constant or interrupted Pulse trains are applied.

The electrical impulses are transmitted to the skin surface via various electrodes. The electrodes are placed near the painful area appropriate. The stimulus itself shouldn't cause pain, just a slight pain tingle left on the skin. The high frequency irritation will be directly above the painful one Dermatome applied, while the low frequencies are only applied when the aftereffect of the high frequencies does not last long enough. The treatment is said to be pain relieving sensitive nerve tracts affect to thereby the Transmission of pain to the brain to reduce or prevent.
The theory behind the TENS states that for one the body's own inhibition mechanisms activated when the pain fibers in the spinal cord are stimulated.
On the other hand, other fibers descending to the spinal cord should be stimulated and the Endorphin release can be increased in the brain. Both mechanisms lead to a lower sensation of pain.

The TENS is mainly used at chronic pain conditions applied of any kind. However, the treatment is contraindicated for Pacemaker wearers, psychogenic or central syndromes. Although there are some studies that do not confirm the effectiveness of TENS, the effectiveness is assumed in Germany and some treatments are accepted by the Health insurance paid.

Medium frequency currents

Since the frequency is too high for medium-frequency currents, the Muscle cell no longer react to each individual impulse. This creates a reactive depolarization the muscle cell and an accompanying local Muscle contraction without a sensitive nuisance.

Since the medium-frequency currents can effectively train the muscle contraction, they are happy to help Muscular atrophies (Muscle breakdown) used after severe injuries or long immobilization.

Radiofrequency therapy

In contrast to classical electrotherapy become electrical in high frequency therapy Alternating fields in the frequency range between 4 to 30 kHz used. The high frequency therapy generates electrical or. magnetic (Shortwave) or electromagnetic (Decimeter wave, microwave) waves. Their energy is generated warmth in the body and thereby relaxes the treated muscles.
With increasing Frequency takes the Penetration depth of the streams. For this reason, the short wave has the best penetration depth. In contrast, the penetration depth of the microwaves is only a few centimeters. Although the method has been contested and the effectiveness has not yet been proven by studies, high-frequency therapy is offered by numerous medical professionals in Germany.

Due to the study situation, however, the costs of the treatment are not covered by the health insurance. Proponents of the therapy state that the treatment is permanent 3 times should be applied for 30 minutes a week. Only then is there a possibility of permanent pain relief. The indication of high-frequency therapy is very broad and is mainly used in Back pain, degenerative joint diseases, diabetic polyneuropathy, migraine and a headache their application.

Summary

The Electrotherapy includes various forms of therapeutic Power application to treat Pain and Muscle breakdown. The different forms of electrotherapy can have different effects on the body directly or by water are transmitted to the body and have different Penetration depths.
Electrotherapy thus covers a broad spectrum of physical therapy and is an integral part of therapy for some diseases. However, there are methods such as the Radiofrequency therapywhose effectiveness is still controversial today and whose payment is not covered by health insurance companies. The effectiveness of the transcutaneous electrical nerve stimulation (TENS), however, has been proven by studies and is therefore widely used in the Pain therapy.
In general, however, each form of electrotherapy is perceived by patients to be differently effective and pleasant and for this reason each patient should decide individually about the effectiveness of the individual methods.

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Who am I?
My name is dr. Nicolas Gumpert. I am a specialist in orthopedics and the founder of .
Various television programs and print media report regularly about my work. On HR television you can see me every 6 weeks live on "Hallo Hessen".
But now enough is indicated ;-)

In order to be able to treat successfully in orthopedics, a thorough examination, diagnosis and a medical history are required.
In our very economic world in particular, there is too little time to thoroughly grasp the complex diseases of orthopedics and thus initiate targeted treatment.
I don't want to join the ranks of "quick knife pullers".
The aim of any treatment is treatment without surgery.

Which therapy achieves the best results in the long term can only be determined after looking at all of the information (Examination, X-ray, ultrasound, MRI, etc.) be assessed.

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