Supplementing Peripheral Neuropathy Treatments With Interferential Electical Stimulation - A Case Report
Several of the major problems with patients having peripheral neuropathy are:
1. Loss of sensation in the feet, calves progressing to legs,
2. Pain as the neuropathy advances,
3. Falling and injury due to the loss of sensation in the feet so no proprioceptive feedback to the brain to adjust balance.
The above 3 are major issues for anyone suffering from peripheral neuropathy. This is information addressing a new method of slowing down the progression, reversing the progression and restoring sensation while eliminating pain for the NP patient. The method is to use interferential stimulation, twice daily for 20 - 45 minutes, in conjunction with or without medications. When used with meds we refer to that as "complementary" therapy simply meaning the use of interferential therapy with meds such as Lyrica or other prescriptions may enhance the patient outcomes by lowering the dosage thus reducing the side effects, or actually enhancing the absorption of the medicinal molecules by isolating the receptors in the neuropathy diseased areas.
Below was done in November, 2014 to associate the use of interferential stimulation, without the use of medications, to determine the physical effects of interferential stimulation to determine surface calf temperatures during treatments.
The patient is an 83 y.o. caucasian woman in good health but for the effects of peripheral neuropathy with the most serious being loss of balance. Little pain is present, full range of motion without any discomfort, but lack of sensory input while trying to ambulate which results in greater potential of falling and injury. The patient has fallen in the past.
The patient extended the right and left legs horizontally, absent any weight bearing to minimize any motor involvement or other conditions that may influence blood circulation.
Protocol used was to measure surface temperatures with a LaserGrip 800 Non-Contact Infrared Thermometer. The interferential machine was the Infrex Plus using outputs of 4,000 - 4,125 cycles per second, premodulated for true interferential therapy, over a 20 minute time period. Surface temperatures were taken at specific spots on the calves at time intervals on both calves, treated and untreated. The temperature surface areas were identified by the use of a skin marketing device to insure all temperatures taken were specific to one area. The surface temperatures were taken at 4, 8, 12 and 20 minute intervals. The room ambient temperature remained constant during the pre, and post treatment.
Before treatment began:
Left calf temperature was 82.5 F and the Right calf 82.3 F. Points were identified by use of the marker for measurements again at specific time intervals. For comparison the surface temperature on a 66 y.o. male, not having PN was taken for comparison and the surface temperature left calf was 94.1 and right calf was 94.2 F.
Treatment began with the Infrex Plus stimulator with the electrodes being placed in the arch of the right foot and the other electrode on the back above the waist, right side. Size of electrodes were 2" Round. The Infrex Plus uses a biphasic balanced dual polarity with a net 0 DC effect.
4 Minutes 8 12 20
Right Calf ( Treated) Temperatures: 83.8 85.2 85.2 85.5
Left Calf 82.5 82.8 83 83.2
Immediately after the 20 minute interferential treatments the temperature was taken in the exact places at regular intervals to monitor if any decrease in temperatures post treatment. The results are below.
Right Calf ( Temp was 86 after Stim) 85.2 84.5 84.9 85.2
Discussion: It appears the use of Infrex pre-modulated interferential stimulation therapy will increase the temperature by increasing the blood flow when in a prone setting of the extremity for patients diagnosed with peripheral neuropathy of the calves and feet. It also appears the contra/opposite calf will experience increased temperature during treatment of the contra extremity. The theory probably being that of Imitation Synkinesis. There appears to be a prolonged temperature increase of minimally 20 minutes following treatments. The results are based upon one session of treatment and the purpose of the session was to see if the use of interferential biphasic pre-modulated stimulation would elevate the temperature of the treated area. It did so in this session.
Over the next 60 days the treatments have been for 45 minutes, twice daily and the patient reports regaining of sensory input, maintaining of ROM, and no pain. The patient started the pain med Lyrica after the initial treatments and is experiencing some adverse side effects. Going forward the patient will soon begin to use the Infrex FRM machine which is a higher frequency device and also a device in which positive and negative polarities can be used for treatments. The Infrex FRM is not a pre-modulated device.