Microcurrent Therapy: "Wave" of the
Future?
By Deborah L. Wieder, MS, PT, ATC
Microcurrent therapy is one of the most controversial. Confusing. Frustrating.
Amazing
and fascinating modalities available to the physical therapist. How can one
modality
create so many different emotions in one clinician? Each day therapists working
with
microcurrent became amazed with the clinical results in some cases and frustrated
with
the results in others, Probably the greatest frustrations encountered are the
dearth of
professional research and the difficulty in determining the ideal protocol of
use for a
specific patient.
Microcurrent is a much smaller current than was previously available for clinical
use.
Historically, the approach has been that if some electricity is good, perhaps
more is better
the microcurrent original thinkers and investigators have recently challenged
this
concept. Among them Dr. Robert Becker and Dr. Bjorn Nordenstrom. It has been
demonstrated that trauma will affect the electrical potential of cells is tile
damaged tissue.
Because electricity will always take the path of least resistance. Traditional
electrical
charges placed on the body will travel around the traumatized cells. A smaller
current -
one that can penetrate the cell and balance the cell electrically - can restore
a more
normal physiological state to the damaged cells. Small electrical charges may
be helpful
in initiating and perpetuating the numerous electrical chemical reactions in
the healing
process. Microcurrent Therapy: "Wave" of the Future?
Becker found a constant direct-current control system in his investigation of
animals. It
appears that repair occurs after an injury in response to signals that emanate
from this
electrical system. Becker refers to this as the current-of-injury, It has been
suggested that
the current of injury has become less efficient with evolution; therefore. Many
animals
have a greater capacity for self-healing than do humans. For example the starfish
who is
able to generate a new limb after injury. The
seemingly amazing results that we can obtain with microcurrent therapy may just
be a
matter of throwing an electrical switch that allows the heating to commence.
(I)
Nordenstrom also believes in the human electrical potential. He states that
the human
body has the equivalent of electrical circuits that play a very important role
in healing. (2)
Like transcutaneous electrical nerve stimulation (TENS). microcurrent is capable
of
decreasing or eliminating pain. In addition to the treatment of pain, microcurrent
also
appears to have a capacity for stimulating the healing process. Clinical observation
clearly shows that microcurrent therapy does more than just block pain, because
microcurrent is such a small current. Typically less than 600 microamps, there
is no
patient discomfort or even sensation during application. The various modes of
application
adjustable treatment variables, and relatively few contraindications make it
the modality
of choice for a large variety of clinical problems.
Nocioceptive fibers, the free nerve endings sensitive to tissue dysfunction
are found in
variety of tissues including skin, fibrous capsule periosteum intra-muscular
arteries,
blood vessel walls, and in abundance In the blood vessels of adipose tissue.
Deformation
of Nocioceptive fibers may cause stimulation and therefore reporting of' pain
to the brain
specifically. for example, if nocioceptive fibers are located in a joint capsule
and are
reporting pain, it is usually due to a joint effusion. In order for this pain
to be reduced,
one of three courses must be he taken;
I. Medications - block the brain's realization of the pain.
2. TENS - block the afferent input of the pain to the brain..
3. Reduction of the joint effusion get rid of the cause of the pain. It is speculated
that microcurrent works to decrease pain by reducing the cause of pain and
altering the electrical activity surrounding the injured area- Microcurrent
5 very
effective on areas of increased blood supply and therefore increased Nocioceptive
fibers.
Muscle tissue. Periosteum, and joint capsule are areas often easily affected
by
microcurrent therapy A study of Cheng found that microcurrent is able to increase
adenosine triphosphate (ATP) production three to five fold, augment membrane
transport, which increases nutrients into the area and boost protein synthesis.
This
was found in animal skin studies using 50-1000 microamps of electricity.
Interestingly ATP production actually decreases with 5000 microamps of
electricity. (3)
The most versatile units available allow for the most variability in choice
of frequency,
current, and ramp. The ideal units for clinical use allow the therapist to treat
with both
pads and probe applicators. for more specific techniques. One of the units displaying
this
versatility is the Intellect 600MP. The intellect 600MP offers the therapist
the desired
variability of functions as well as a feedback mode wherein the therapist is
able to search
diagnostically for high conductance points in the body. Once the area is located,
it may
he treated to help reduce pain and muscle spasm. According to clinical research
by Lynn
Wallace, Ph.D.. P.T. (4). there are two general modes of treatment which produce
maximum effectiveness. The pain mode is used to reduce pain in a patient. The
pain
mode consists of a short ramp of .01 seconds. a frequency of 30 Hz, and a current
of 80-
100 microamps. The pain mode is always followed by the ETR (Enhancement of Tissue
Repair) or healing mode. The ETR mode consists of a longer ramp of 2 seconds.
a
frequency of .3 Hz and a current of 20-40 microamps. An average treatment includes
10
minutes on the pain mode followed by 10-20 minutes on she ETR mode. Treatment
should be performed every other day, or daily for optimal results.
There are a variety of different methods and techniques to try when using microamp
current. Most importantly when treating a body part with microcurrent. the placement
of
pads must follow an electrical pathway within the body. Pads may he placed from
the
origin to the insertion of a muscle following muscular electrical flow, down
the pathway
of radiating nerve pain. through acupuncture or trigger points, or medial/lateral
through a
swollen joint.
Microcurrent works best in combination with mechanics and therapeutic exercise.
When
used with a stretching program microcurrent therapy can encourage relaxation
of the
musculature causing a mechanical deformation. Microamp in
conjunction with exercise can encourage muscle re-education.
The effectiveness of microcurrent therapy has recently been clinically documented
by
Wallace ins study of 1,531 patients with a large variety of diagnoses 94% of
the patients
experienced a reduction in pain during the first treatment. The average number
of
treatments to achieve a zero/one pain level (zero to ten scale) was 3.8. Ninety
percent of
the subjects studied achieved a zero/one pain level in less than ten treatments.
(4)
All the physiological rationale behind the clinical effects of this instrument
has not been
ascertained. It would appear to be more clinically effective than other form
of electrical
stimulation for the following reason
1. -The microcurrent unit is biologically more compatible.
2. -It is more effective in neutralizing the oscillating polarity of injured
cells.
3. -The current under 600 microamps has a positive effect on increasing
local availability of ATP.
4. Microcurrent has a positive effect on increasing cell permeability.
3. Microcurrent increases local protein synthesis Microcurrent therapy will
continue to he controversial until a substantial number of clinical research
studies are published. In order for confusion and controversy to rest.
supportive scientific research in this area must be encouraged.
References
1) Becker.RO: The Body Electric. New York
William Morrow and Co. Inc. 1983
2) Nordenstrom.B: Biologically Closed Electrical Circuits, Nordic Medical Publications.
Uppsala. 1983.
3) Cheng. N.. et al. The effect of electric current on ATP generation. protein
synthesis,
and membrane transport in rat skin.
Clin. Othop. 171:264-272 1582.
4) Wallace. LA. MENS Therapy: Clinical
Perspectives Vol. 1. Cleveland: privately
published. 1990. Distribution.
(back)