The Pratfalls of Pain
By JON D. MILLS, PT
October 1, 2008
Treatment Options and a Case StudyGetting pain patients to take an active role in their care is highly beneficial. Performing relaxation techniques or using biofeedback can help reduce stress and anxiety. Exercise is important to help release endorphins, the body’s natural pain killers. Adjunctive modalities and hands-oncare provided during physical therapy are also effective procedures.
Electrical stimulation has been used for years to treat pain by interrupting the pain stimulus to the CNS. A newer form of electrical stimulation — interactive electrical stimulation — has allowed physical therapists to progress pain patients into more functional activities faster, with longer relief and less dependency on pain medicines. One such device is the Interx, a product of the Neuro Resource Group, which is a handheld unit with electrodes built in that allows the therapist to scan the body and identify optimal treatment points.The treatment is specific and customized to the individual and activates numerous pain-relieving mechanisms, increasing effectiveness of the overall treatment.
The interactive unit communicates with the body through the skin and gives the therapist feedback in the form of skin friction, with high drag points being areas of concern.The unit allows the therapist to achieve dynamic treatment with a set of flexible array pads that are attached to the body part, and then active exercise, strengthening and PROM can be done while the unit gives feedback using a frequency cycle controlling pain.
Use of the Interx unit has been highly beneficial in getting a return of functional status and decreasing pain.Treatment for fibromyalgia, reflex sympathetic dystrophy, orthopedic conditions, cervical and lower-back pain syndromes, plantar fasciitis, neuromas and neuropathy pain have been successful.The unit has been used dynamically to return full shoulder ROM postoperatively on the first day of treatment with pain levels dropping from eight out of 10 to one out of 10 during a 15-minute usage.
One such case found the use of the flexible array pads to be beneficial in removing pain from a total knee patient while doing stairs, her only deficit after three months of therapy elsewhere, in one session lasting 10 minutes. The array pads are used frequently on lowerback pain patients during strengthening and stabilization exercises, allowing them to get through a 30- to 60-minute program with better tolerance and then sticking with the therapy program versus complaining that the exercises hurt too much and then either self discharging or having chronic scheduling issues.
Being aware of how a patient responds to pain management is critical for success. It is important that the team approach with doctors, case managers and therapists is used and that open lines of communication are maintained.