Because the body’s nerves are electrical conductors, medical professionals have long held that stimulating nerve endings with small electrical current can produce beneficial results.
The theory behind electrotherapy as part of chiropractic care is that such stimulation to affected nerves and muscles encourages the body to release pain-killing chemicals, such as opiates and endorphins, and blocks pain signals from being transmitted to the brain.
Electrotherapy is a pain management technique, and as such, is part of an overall chiropractic treatment regimen. Electrotherapy is usually involved in the early treatment stages, especially right after an injury. Ice and heat therapy may be combined with electrotherapy to boost its pain-kill ing powers.
Electrotherapy normally involves placing small adhesive pads on the skin at various points on the body. Electrotherapy is generally not painful. The adhesive pads may cause a minor skin irritation after being removed, and in some instances, patients may feel a mild stinging after therapy.
Common types of electrotherapy include:
- Galvanic stimulation (GS) – High voltage pulsed galvanic stimulation has been used in acute low back pain to reduce muscle spasm and soft tissue edema (swelling). It is commonly used despite the lack of hard scientific evidence for its efficacy. Its effect on muscle spasm and pain is felt to occur by its counter-irritant effect, effect on nerve conduction, and a reduction in muscle contractility.
- Radiofrequency rhizotomy – Normally used for chronic cases of facet joint syndrome, a degenerative condition in which joint cartilage wears thin, causing stiffness, inflammation, muscle spasms, and later osteoarthritis. This procedure applies heated radio-frequency waves to the joint’s nerves that carry painful impulses.
- Transcutaneous Electrical Nerve Stimulation (TENS) – This is the most common type of electrical stimulation used today. TENS therapy is normally used to treat chronic, or long-term pain in the lower back. Small electrodes are placed inside an elastic-type belt worn around the lumbar region. Percutaneous electrical nerve stimulation (PENS), an enhanced and newer type of pain management therapy, makes use of very thin needles (much like those in acupuncture), which are inserted in the lower back by the chiropractor. Small, battery-powered TENS units also are available for use at home, work, or other activities. The patient is able to control the level and frequency of stimulation, and self-administer impulses during episodes of pain.
- Interferential current (IFC) – This is a kind of TENS therapy in which high-frequency electrical impulses are introduced deep into the tissues near the center of the pain.
Exercise therapy is a form of chiropractic treatment used to help manage pain, rehabilitate damaged soft tissues such as muscles, ligament and tendons, and restore normal range of motion and function.
Such therapy has been shown to alleviate pain, improve overall muscle strength and range of motion, improve balance, as well avoid further deterioration of muscle tissues. The overall goal of an exercise therapy program is to promote healing and prevent further damage and injury to your body’s musculoskeletal system. Exercises programs also help in minimizing scar tissue formation following an injury or surgery.
Most exercise programs are designed to improve cardiovascular conditioning and bolster your strength. Many exercises involve flexing and extending specific parts of the body.
As a patient, you play a pivotal role in the outcome of any therapeutic exercise program. Your dedication to following the steps outlined in the program will go a long way in ensuring its success.
While ice therapy is used to reduce swelling, heat therapy can be used to relax the muscles and increase circulation.
Heat therapy is often used in patients who have chronic, or long-lasting pain. Heat therapy can involve many kinds of methods, from simple heating pads, wraps, and warm gel packs, to sophisticated techniques, such as therapeutic ultrasound.
Back injuries can create tension and stiffness in the muscles and soft tissues of the lumbar region, or lower back. In many cases, your circulation may be impeded. The tension in the muscles can sometimes escalate to spasms.
- Dilates the blood vessels of the affected muscles, allowing them to relax and begin healing
- Helps lower discomfort by reducing the amount of pain signals going to the brain
- Increases the ability of your muscles to easily flex and stretch, thereby decreasing stiffness
Heat therapy, as well as ice therapy, are normally a part of an overall chiropractic treatment plan and rarely accomplish maximum results without it.
Heat therapy is not used on swollen or bruised tissues, or in patients who have dermatitis, deep vein thrombosis, diabetes, peripheral vascular disease, open wounds, cardiovascular conditions such as hypertension.
When the muscles supporting the lower spine need to be strengthened, lumbar stabilization may be used in your chiropractic treatment as a form of therapy. Lumbar stabilization helps you develop strength, flexibility, and endurance and also has been shown effective in alleviating lower back pain.
The key to lumbar stabilization is achieving a “neutral spine” position. The neutral spine position is that which is the least painful but most sound posture for your lower back.
When your spine is in a neutral position:
- The discs and vertebrae are able to absorb shocks and other forces acting on the spine in an optimal way.
- There is less tension on the ligaments and joints of your spine.
- Your posture is centered.
Once your learn how to go to your neutral spine position, lumbar stabilization teaches you how to maintain that position through a technique called “proprioception.” Proprioception teaches you how to know where your joints are at any given time.
Lumbar stabilization helps you:
- Better control the movements affecting your spine
- Heal muscle strains, sprains, and damaged ligaments
- Know how to avoid future injuries
- Reduce pain in your lower back
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These types of therapies uses a hands-on approach rather than relying on muscle manipulation through mechanical means. In addition to restoring lost function, manual muscle therapy also addresses pain caused by muscle strain, tension or spasm and related musculoskeletal issues, such as joint dysfunction.
Impaired mobility and loss of range of motion can be addressed with sof tissue mobilization, or STM, which targets scar tissue, trigger points and other adhesions that interfere with muscle function. The strain-counterstrain technique uses gentle stretching to encourage muscles to “reset” to a normal position. Joint mobilization counters muscle strain as the result of joint stiffness.
By addressing, not only the vertebrea, but the surrounding soft tissue, healing can occur MUCH faster and more thoroughly. Improving range of motion and decreasing pain, allows you to return to your normal daily activities faster.