One student athlete found relief through interferential therapy with diversified adjustments

The choices of passive and active therapies, available to today’s DC as an adjunct to the chiropractic adjustment, are as many as they are varied.

Passive and active modalities are generally instituted and used in accordance with the three phases of healing. You probably remember them, but in case you forgot, they are reaction, regeneration, and remodeling.

For the purposes of this article, though, we will refer to the use of interferential primarily as a passive modality used during the reaction and repair phases of care.

User-Friendliness a Top Consideration
Interferential therapy has been a favorite choice and mainstay in our office. We chose interferential as our first choice of unattended therapy because of its user-friendliness, flexibility, and effectiveness of care. We use eight interferential units in our office to complement our eight adjusting rooms. We use interferential therapy more than other passive therapies, mainly because of the variability of frequency choices.

We chose the interferential units we currently employ based on appearance; durability; manufacturing support; and, of course, cost.

After trying out five or six different units, we finally settled on one particular manufacturer for our interferential needs. Using the same units allows us to ensure familiarity and consistency of application among our chiropractic assistants.

We made outright purchases of our units as our practice and budget grew throughout the years. This helped us spread out our tax incentives and deductions at the same time.

The cost of each unit varied based on the features of the units. Specifically, the option of four-channel units versus eight-channel units ultimately helped determine the range of cost difference.

Admittedly, the year that we bought the interferential units determined the cost, too, not to mention retailer promotions and incentives at the time. All in all, we spent between $1,000 and $2,000 for each unit. Today, the same units are selling for closer to $2,000 and above.

As I mentioned previously, user-friendliness figured in our selection process. For us, that meant the choice of touch-pad or keypad models over more cumbersome knob models. Speed of setting up the therapy, which includes the option of preprogrammed parameters, was also a consideration. These points, along with the durability of the equipment and manufacturing support, led us to the current models that we have and use now.

Our interferential units have a pleasing and professional appearance, too. I know it sounds a little picky, but the appearance of the units seem to make a big difference for our patients as they enter the treatment rooms. I feel that this professional appearance boosts the trust and confidence the patient has in our ability to help them heal.

When all ranges of interferential frequency are considered, this therapy can actually be incorporated into all three phases of healing. This even includes the early remodeling phase in cases of chronic edema.

Low-range interferential is great for joint effusions. For example, in the 0–5 Hz range, interferential is great for reducing acute edema, while the 5–15 Hz range is better for reducing chronic edema.

Static medium-range interferential, which is used perhaps less than the other two ranges, is used for muscle atrophy.

High-range interferential includes the 80–150 Hz range, which is useful for endorphin and enkephalin chemotaxis—which is, of course, for pain reduction.

Sweeping full-range interferential is generally considered to be from 0–150 Hz, and it encompasses all of the above-listed benefits transitionally.

As you can see, interferential current is a very flexible form of therapy with a lot of choices available to the DC. That’s why it’s our favorite.

Case Study
A 16-year-old high school student athlete was recently referred to me by his baseball coach.

This was the patient’s first exposure to chiropractic, so after that recommendation, he was expecting nothing short of a miracle to take place in a very brief period of time.

On presentation, the patient complained of right-sided thoracolumbar pain rated as a 5 on a modified visual analog scale (VAS). He described a past history of headaches, knee pain, lower-leg pain, and seasonal allergies, none of which was currently active.

The current history and onset of his back pain began 5 weeks prior as the result of “lifting a lot of weight” during off-season strength training. His frequent, sharp pain had not changed in the 5 weeks leading to his presentation to my office.

The patient indicated that the pain interfered with his schoolwork “quite a bit” and his social activities “most of the time,” despite the fact that he rated his overall health as excellent.

This young man was taken by his mother to the family medical doctor shortly after he began to experience pain from his weight training. The general practitioner diagnosed a muscle strain and prescribed ibuprofen along with rest.

Four weeks went by without any improvement in his pain, with the exception of temporary relief of about 6 hours’ duration whenever he took the prescription-strength ibuprofen.

My examination revealed inspectional and palpatory muscle spasms with edema of the right thoracolumbar spine. Active lumbar range of motion was within normal limits with the exception of mild reduction on forward flexion, which also elicited additional pain.

Orthopedic examination was also within normal limits, with the exception of Valsalva Maneuver, which produced extra discomfort upon performance. There was a physiological short leg of 1 inch on the contralateral side of the pain.

Initial diagnostic impressions included thoracolumbosacral subluxation, concurrent with myospasms and edema, complicated by apparent physiological short-leg syndrome.

The patient’s mother, who was observing the examination procedures, was quite surprised when she saw the leg- length discrepancy. I used the opportunity to explain neuromusculoskeletal mechanics further to the patient and the parent. They quickly began to understand why ibuprofen was ineffective for correcting the problem.

The student athlete was treated on the first visit with diversified adjustments to the thoracolumbosacral spine. Interferential therapy was performed for 15 minutes to the swollen and spastic area.

On postadjustment reassessment, the leg lengths were equal on prone visualization. I chose to use low- and high-frequency interferential on the patient to assist with the reduction of edema and to tap into the endorphins and enkephalin response to the affected areas, respectively.

Upon the second visit to my office, the patient described a 4 on the VAS. Inspectional and palpatory edema was gone. There was a 50-percent reduction in muscle spasms overall. The leg lengths were level with one another on preadjustment.

Diversified and interferential therapy were once again performed, and the patient was instructed to follow up.

During the third visit, the patient described his pain as a 3, with further reduction of muscle spasm noted. No leg-length deficiencies were observed. Since the treatment plan subjectively and objectively appeared to be working, we continued with the same.

On the fourth visit, a VAS of 2 was reported, while only very mild muscle guarding was found. Leg lengths were again bilaterally equal.

On the fifth visit, the patient reported a VAS of 1. No palpable muscle spasms were detected. Apparent leg lengths remained to be level prior to diversified adjusting and interferential.

The patient has since been released from active care.

I guess the following question could be raised at this point: What helped the patient: chiropractic adjusting or interferential therapy?

The answer to that question is another question: Why can’t it be both?

Speed of recovery can be enhanced with the help of properly applied interferential, but at the same time, you should understand that nothing replaces the chiropractic adjustment. The star player is the adjustment. Interferential is the teammate supplying the assist. CP

Robert Mariner, DC, has been in private practice for 16 years in Frankfort, KY. Contact him through his Web site at www.MarinerChiropractic.com or by email at DrMariner@prodigy.net.