Taking the shock out of electrotherapy: Advice on how to add a new form of treatment to your practice

Larry Beardall

The field of electrotherapy is expanding as medical science continues to reinforce connections between electrical stimulation and pain therapy. And as research grows, modalities for treatment also increase. For chiropractors, particularly those new to the field of electrotherapy, wading through the range of options in treatment and apparatus can be a challenge.

Mark Reiter

For those chiropractors who are looking to adopt electrotherapy into their practice, this article is a good place to start the research. Chiropractic Products invited two experts in electrotherapy products to discuss the latest innovations and trends, the costs of incorporating the treatment into one’s practice, and the best ways to make the program a success.

Larry Beardall has served as executive vice president for Dynatronics Corporation for the past 19 years. Dynatronics, headquartered in Salt Lake City, specializes in the design and manufacture of innovative, high-tech therapeutic equipment, including electrotherapy, ultrasound, and light therapy.

Mark Reiter is the senior vice president of LSI International Inc, a wholesale distributor of chiropractic, physical therapy, and massage therapy equipment based in Overland Park, Kan. He is a regular guest lecturer at Cleveland Chiropractic College and has more than 10 years of experience in the chiropractic field.

What type of electrotherapy equipment do you recommend for most DC offices? For DCs just starting? For those expanding their current services?

Beardall: Each practitioner needs a complete toolbox of modalities providing as many options as possible. Interferential therapy (IFC) has been the stim of choice for most chiropractors, but muscle stim and ultrasound are also used by many. Light therapy is making great strides at becoming a standard modality for most DCs. For chiropractors who are just starting, a device containing IFC, ultrasound, and light therapy would be my recommendation.

While still relatively new to the United States market, light therapy is quickly gaining a reputation for being fast, easy to administer, and effective for treating a broad range of conditions.

Reiter: Interferential therapy is probably the most widely accepted and versatile form of electrotherapy available. Its ability to treat acute, chronic, and subacute conditions and, in most cases, do Russian stimulation for rehabilitation, make it a real value. For chiropractors who are just getting started, there are often bargains on good used equipment. Our company offers new doctors special discounts on new equipment to help them get started while saving money. For doctors who have been in practice for a while and are looking for something new and exciting, the cold laser is the hottest thing (pun intended) on the market. Its effectiveness and uniqueness make laser an exciting new addition to an established practice.

What are the average costs that chiropractors can expect to spend on electrotherapy devices, office space, and staff?
Beardall: The saying, “You get what you pay for,” definitely applies to electrotherapy equipment. There is often a temptation to save a few dollars by buying through a catalog, but the value of service and free loaner equipment must be considered in the equation. A DC can’t afford to have equipment down and should always buy from a full-service dealer who will ensure that all their needs are met. For a basic package that includes stim, ultrasound, and light therapy, the price will range from $5,000 to $6,000.

Reiter: The cost of electrotherapy devices is as varied as the devices themselves. In general, you could expect to pay between $1,000 and $2,000 for a new interferential unit. Ultrasound machines are around $900 to $1,000. You should be able to get a used piece for about half of its original value, depending on age. Most of this equipment doesn’t take up a lot of office space, so in that sense it’s relatively economical to own. In terms of staff, you should consider whether a therapy is attended or unattended. If you’re going to use ultrasound, you need someone to operate the machine continually while it is in use. With other electrotherapies, you can set the patient up and go do something else.

What type of equipment is utilized most in DC practices? Why?
Beardall: For nearly 20 years, IFC has been the workhorse of all modalities. It is easy to apply, comfortable to the patient, and effective.

Reiter: At this point in time, I think the most common equipment in use would be an interferential unit and an ultrasound. If sales of the cold laser continue to grow like they are now, it won’t be long before a laser device becomes as common as ultrasound.

What marketing tools do you recommend when promoting electrotherapy adjunct services?
Beardall: The FDA has cleared light therapy for the treatment of arthritis. To help chiropractors with promotion, Dynatronics provides a complete marketing kit to Dynatron Solaris owners, including patient brochures and newspaper ads.

Reiter: Patients are smarter and more aware of the services offered by chiropractors than ever before. They frequently will pick and choose who they want to see by what adjuncts are offered. I think this is relatively new and might be a result of DCs doing more patient education and patients discovering the different chiropractic techniques that work best for them. For example, I recently had two doctors coincidentally call the same day and purchase an ultrasound because they had patients basically “demanding” that ultrasound be done on them. These were established doctors who had been treating patients for years and never used ultrasound; but because of patient demand, they had to add it to their regimen. Because of this increase in patient awareness, I think doctors should promote their adjuncts in all of their advertising.

What patient-education materials do you recommend for patient retention and referrals?
Reiter: The most important patient-education material for electrotherapy modalities is explaining exactly what the therapy is, how it works, and how the patient can expect to feel during and after the treatment. If it’s ultrasound, they might want to explain why the patient won’t feel anything and how it can still be an effective treatment. If a patient has never had electrical stimulation, they need to be told what it would feel like and how it works to reduce their pain or rehabilitate their muscles.

Tell us a success story about one of your clients.
Reiter: Here is one of my favorites. I was attending the Florida Chiropractic Association meeting in Orlando about 12 years ago; I was approached by Florida’s 1992 female bodybuilding champion, who was working in another vendor’s booth. She heard I had a machine that could help relieve some horrible muscle spasms she’d had in her upper traps. They were causing tension headaches as well as local and referred pain. Needless to say, she had incredible muscle mass and definition in the area of the spasm. So we hooked her up and did Russian stimulation on the area to fatigue the spasm. After 20 minutes, the spasm was completely gone, and the muscles were totally relaxed. While I was unhooking the electrodes, I noticed she was crying. I asked her if everything was all right. She told me that she had been living with the pain for weeks and that it was growing intolerable. Now that it was completely gone, she was overcome with relief. It was a very neat moment, and it taught me the power a modality like this can have in helping people get better, faster.

What are the latest technological advances in this field?
Beardall: Backed by more than 3,500 published articles, light therapy is the latest innovation in therapeutic modalities. Chiropractors across the country are discovering the amazing benefits of treating a wide variety of soft-tissue injuries with light to promote tissue healing.

Reiter: Laser is the newest, most exciting thing to happen to electrotherapy. It’s easy to use, noninvasive, and extremely effective.

Any last words of advice?
Beardall: A clinician should do their homework before buying any equipment. They should buy only from reputable companies who have a long history of standing behind their products and providing excellent customer service.

Reiter: I was told once that it’s not the therapy device that treats the patient, it’s the doctor. I agree with that statement 100 percent. The doctor should know what devices to use and how to use them to get positive outcomes. Like doctors treating patients, carpenters build houses; but they don’t do it with their bare hands. Good-quality tools in the hands of a skilled user will yield the best results. CP

Julie Z. Lee is a contributing writer for Chiropractic Products.