Patients heal faster and hold their adjustments longer

The use of electrical modalities can be a controversial issue between the straight chiropractors and the mixed chiropractors. Laying the politics aside, this article will discuss the therapeutic and physiological benefits of using electrical modalities. Therapeutic modalities, such as electric muscle stimulation, ultrasound, deep heat, ice, traction, and others, are considered adjuncts to the care given to your patients. They are never to replace effective chiropractic adjustments. Without chiropractic adjustments, which eliminate nerve compression and interference, the body will never be able to fully heal itself—no matter how many modalities are used.

Types and Benefits of Electrical Modalities
Patients heal faster and hold their adjustments longer with the use of electrical modalities. Some of the benefits of the different modalities include the reduction of edema or fluid buildup, the reduction of pain, the contraction and relaxation of muscles, the increase of blood flow and nutrition to tissues and muscles, the increase in range of motion, the decrease of muscle spasms, the decrease of trigger points, and the increase in muscle tone and strength.

The most common modalities used in a chiropractor’s office are electric muscle stimulation and interferential therapy. The purpose of interferential therapy is to send very mild electrical current through the patient’s skin into the affected tissue of the injured area. The current acts as a “squeegee,” eliminating most of the edema and fluid buildup around the injured area. This edema, if left untreated, will accumulate and put pressure on the surrounding muscles and nerves, causing more pain. The interferential therapy also interferes with the transmission of pain messages at the cord level, giving the patient more pain relief. Because of its frequency, the current has no problem crossing the skin and entering the damaged tissue. The majority of patients in our clinic with acute injuries are initially treated with this electrical modality, as well as with the application of ice to the affected area.

We had a patient recently present with an acute onset of neck pain, rating 9 on a scale of 10. After 3 treatments of ice, interferential therapy, and chiropractic adjustments, her pain scale had reduced to a 2 on a scale of 10. This is a common result from the treatment given to the patient during the acute phase of injury.

Electric Muscle Stimulation
Electric muscle stimulation is primarily used to help prevent or reduce muscle atrophy and spasm. Atrophy is the weakening or loss of muscle tone that occurs after surgery or trauma. This type of stimulation uses low-volt current targeted to stimulate motor neurons, causing muscle contraction and relaxation, which pumps the toxins and lactic acid out of the muscle. This prevents the pooling of metabolites and lactic acid in the muscle. Once the muscle is exhausted, it relaxes, allowing the chiropractor to adjust more effectively. If these muscle spasms are left untreated, the muscle can constantly contract and subluxate the spine. Electric muscle stimulation also increases blood flow to deep muscles, increasing their range of motion and strength.

A patient presented herself in our office complaining of severe lower back pain. She had signs of muscle weakness in her left lower extremity, decreased sensation at L-4 and L-5, but normal lower-extremity reflexes. After a thorough evaluation of this patient’s injuries, it was determined that this patient suffered from lumbar subluxations, sciatica, and myofascitis. We treated the patient for 5 visits using interferential therapy for pain and edema reduction as well as the application of ice. Her pain level decreased significantly, but weakness in her lower left extremity persisted. We switched her to electric muscle stimulation, which helped stimulate the contraction and relaxation of the muscle to eliminate the toxins and lactic acid from the affected area. This treatment lasted for 5 visits, and we then started her on some stretching and other exercises. These stretches and exercises helped to re-educate the muscle and start the strengthening process. We also used Russian stimulation at the end of care, which significantly increased the muscle strength in her left lower extremity. This patient was released after 16 visits and 9 weeks of treatment. Her pain was nearly eliminated, her muscle strength was normal, and her sensation at L-4 and L-5 were normalized.

Microcurrent Stimulation
Another electric modality is microcurrent stimulation, which is used to expedite the healing process. Research shows that the harmless low-current impulses remarkably shorten the healing time by improving the blood flow to the affected area and generating ATP, a material that supplies energy to the cells. Our clinic treats many professional athletes from various teams. We had a player present with a pulled hamstring, and he could barely walk. We treated this patient for 2 weeks with microcurrent, ice, and manual trigger-point therapy. He was playing again with no side effects after this treatment.

Other modalities such as ultrasound and deep heat relax muscle spasms, help reduce swelling, and increase mobility of the affected tissue. The end result of these modalities is that they help the chiropractor to more effectively adjust the spine and alleviate pressure on the nerves. As we all know, once the subluxation has been eliminated, the body has the most optimal opportunity to fix itself.

Trigger-Point Therapy
Another common modality is the use of trigger-point therapy. Trigger points are disruptions in tissues or muscles that can cause extreme pain and spasms, and can potentially cause subluxations of the spine. Many mechanisms are available to treat trigger points. High volt is the electrical modality of choice to release the trigger points. This modality sends a high-volt pulsed current into the affected muscle or tissue, helping to prevent or retard the muscle spasm. Once the spasm has been reduced, this modality can be used to help re-educate, maintain, and increase the range of motion of the affected area.

Another patient at our clinic was a professional athlete who completely tore his quadriceps muscle. We used a combination of interferential and trigger-point therapy to help relieve the pain. We also used high volt to help keep his muscle toned during his recovery and to re-educate and strengthen his muscle before he was released to compete again. The combination of these 2 modalities helped get this player back on the field in 3 weeks, compared to what would normally be a 6-week recovery time. Another trigger-point therapy treatment is the use of a T-Bar. This device is used to put manual pressure on and eliminate the trigger point. Another is the use of a G-5 or a vibration massage unit, which helps to relax the trigger point and alleviate the spasm.

After the patient has seen great improvement and a substantial decrease in pain, other modalities such as intersegmental mobilization or traction, as well as Russian electrical stimulation, are used to help mobilize the spine and increase muscle strength. The chiropractic adjustment and intersegmental mobilization or traction helps to maximize mobilization of each segment of the patient’s spine. Russian electric stimulation uses a high frequency that allows for deep penetration of muscles and a more complete and stronger contraction of the muscle fibers. This modality was originally developed by the Russian Olympic team to increase the athletes’ muscle size. Today, this modality is used for reducing muscle spasms and edema, as well as for increasing muscle strength.

Modalities are an effective tool that a chiropractor can use to optimize the results for his patients. They are not to replace chiropractic adjustments, but they are to be used to help innately heal the body. CP

Bart Wetherington, DC, Wetherington Chiropractic Clinic, Savannah, Ga, has been in practice for 4 years. He can be reached at drwetherington@bellsouth.net.