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 A
Practical Protocol for Electromedical
Treatment of Pain
Chapter 61 in Pain Management: A Practical Guide for Clinicians
Daniel L. Kirsch, Ph.D., D.A.A.P.M., F.A.I.S.
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we not try the most inexpensive and conservative treatments first,
instead of last? When that treatment is based on sound electromagnetic
principles, most physicians are surprised to discover that, while not
a drug, the results are often more immediate and spectacular than one
can imagine. Also, unlike drugs, the results are usually long lasting
and cumulative.
While electromedicine has been practiced in some form for thousands of
years, research and clinical usage in electromedicine are expanding as
never before in history. Perhaps even more than any other therapeutic
option, electromedicine is now used routinely by a growing number of
practitioners from all of the healthcare professions, as well as by
patients themselves at home. Only the United States Food and Drug
Administration (FDA) restricts the sale of electromedical devices for
use by or on the order of licensed healthcare practitioners. All other
countries allow people to purchase therapeutic electromedical devices
over the counter for their own personal use. Electromedical modalities
are easy to use, relatively safe, and the newer technologies, such as
microcurrent electrical therapy and cranial electrotherapy
stimulation, have proven efficacy unprecedented by any prior form of
medical intervention.
One word of caution, though: Medicine is still a science. Modern
electromagnetic therapies have attracted many charlatans. Simply said,
not everything is equally safe and effective. Rely only on
evidence-based technologies.
MICROCURRENT ELECTRICAL THERAPY
Joseph M. Mercola and Daniel L. Kirsch (1995) coined the term
"microcurrent electrical therapy" (MET) to define a new form of
electromedical intervention using biocompatible waveforms.
Patrick DeBock (2000), a physiotherapist at the University of Antwerp
in Belgium, recently compared MET with TENS based on the Eight
Parameter Law which covers every possible influence in electrotherapy.
In his conclusion, DeBock states, "MET has a completely different
mechanism, which at this time is not fully under-stood, but works on a
cellular level ... It looks as if TENS is going to lose this
competition ... MET will, in most cases, be much more satisfying than
TENS because of the longer lasting and more intense effects."
A growing body of research shows the effectiveness of MET to do more
than control pain. It can actually accelerate and even induce healing.
When a wound is dry, its bioelectric current flow is shut off.
Eaglstein and Mertz (1978) have shown moist wounds to resurface up to
40% faster than air-exposed wounds. Falanga (1988) found that certain
types of occlusive dressings, like Duoderm, accelerate the healing of
wounds. It is probable that these dressings achieve their effects by
promoting a moist environment (Kulig, Jarski, Drewek, et al., 1991).
The moisture may allow endogenously produced current to flow more
readily through the injury, and thus promote wound healing. Electrical
stimulation of the wound has a similar effect, and also tends to
increase the amount of growth factor receptors, which increases the
amount of collagen formation (Falanga, et al., 1987).
Electricity was first used to treat surface wounds over 300 years ago
when charged gold leaf was found to pre-vent smallpox scars (Robinson,
1925). There are several recent studies supporting the beneficial
effects of treating wounds with an artificial current (Goldin, et al.,
1981; Ieran, et al., 1990; Jeran, et al., 1987; Mulder, 1991).
Experimental animal wound models in the 1960s demonstrated that
electrical intervention results in accelerated healing with skin
wounds resurfacing faster, and with stronger scar tissue formation (Assimacopoulos,
1968; Carey & Lepley, 1962).
Assimacopoulos (1968a) published the first human study using direct
current for wound healing. He documented complete healing in three
patients with chronic leg ulcers due to venous stasis after six weeks
of electrical therapy. One year later Wolcott, Wheeler, and Hardwicke
(1969) published the most frequently cited work in the history of
electrical wound healing. They used direct cur-rents of 200 to 1000 RA
on 67 patients. Gault and Gatesn (1976) repeated the Wolcott and
Wheeler protocol on 76 additional patients with 106 ischemic skin
ulcers. Rowley, McKenna, Chase, and Wolcott (1974) studied a group of
patients having 250 ischemic ulcers of various types. These included
14 symmetrical control ulcers. The electrically stimulated ulcers had
a fourfold acceleration in healing response compared to the controls.
Carley and Wainapel (1985) performed one of the only studies on this
subject with equal and randomized active and control groups. All of
these studies documented significant accelerated healing from
electrical stimulation.
One additional consistent observation in these studies was a reversal
of contamination in the wounds. Wounds that were initially
contaminated with Pseudomonas andlor Proteus were usually sterile
after several days of MET. Other investigators also have noticed
similar improvements and encourage the use of this therapy as the
preferred treatment for indolent ulcers (Alvarez et al., 1983; Barron
& Jacobson, 1985; Kaada, Flatheim, & Woie, 1991; Lundeberg, Eriksson,
& Maim, 1992). Additionally, no significant adverse effects resulting
from electrotherapy on wounds have been documented (Weiss, et al.,
1990). A review of the literature by Dayton and Palladino (1989) shows
that MET is clearly an effective and safe supplement to the
nonsurgical management of recalcitrant leg ulcers.
Some of these studies used unipolar currents that were alternated
between negative and positive based on various criteria. Some
researchers initially used negative current
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<Previous Page
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Pain Management: A Practical Guide for Clinicians • Chapt. 61 • 2002 |
Used with permission of Electromedical Products
International, Inc.
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