Thursday, 8 December 2011

Microcurrent Therapy – Evidenced practice or another way to rip offpatients?

Electrotherapy – the use of electrical currents to treat medical problems and diseases – has a long history in the medical and therapy based professions. By way of illustration, it is often cited that the Romans used electric eels as a means to bring about pain relief. Just because the Romans did it does not necessarily mean that it was a good, nor necessarily an effective way of dealing with a medical problem! In more recent times – say the last 100 years – there have been a plethora of ‘treatments’ using a wide range of electrical, electromagnetic and associated energies as a means to treat a wide range of clinical problems, ranging from obesity through depression to arthritis and sporting injuries. Some of these therapies have a substantial research base whilst others are rather more weakly supported.

There is a trend at the moment for ‘home based’ therapy devices : patients purchase their own machine and carry out their own treatments at home – reducing the need to attend therapy clinics or hospitals in order to be ‘treated’. This can indeed be a very effective way to get an effective treatment at low cost and with minimal disruption to work, sporting or social activities and the reduce the burden on an overstretched Health Service. TENS (Transcutaneous Electrical Nerve Stimulation) has become a popular application for DIY pain relief. Machines can be easily purchased in high street pharmacies or from web based retailers. There is a good evidence base for its efficacy and is used by therapists and pain specialists the world over on this basis.

Microcurrent therapy is a ‘modern’ version of an electrical stimulation application. It employs a very small electric current (less than one thousandth of an amp) delivered through electrodes placed on the skin. The current is so small, the patient does not actually feel anything. In principle, this small current is designed to stimulate, or enhance, the small, naturally occurring currents in the body which appear to be disrupted on injury, and furthermore, appear to be part of the tissue healing process.

If these small natural electric currents are as important as some of the research suggests that they are, it is logical to use an external device to support their effects, especially when healing is disrupted or stalled as we see in many patients coming to therapy.

There are many types of microcurrent machine. They are relatively inexpensive (from less than a hundred pounds), they are usually small, portable, battery powered and easy to use. This makes them very attractive as a home based therapy device, and the commercial world has recognised this, and the market is getting flooded with machines which are claimed to treat just about everything from pain relief in arthritis through to treating depression and just about everything in between.

There is good research evidence to support their use for various wounds (leg ulcers for example) and for bone fractures which are not healing well. We have been researching the use of microcurrent therapy in other clinical problems such as Tennis Elbow, and some work about to start with low back pain. It would seem that there is an advantage to using these devices, and also support for their use as a home based therapy. That having been said, we did not find that the more expensive machines necessarily provided ‘better’ therapy, nor that the ‘complex’ and ‘patterned’ stimulation sequences gave better results. In fact, it is not actually known yet which is the best way to use these devices, nor do we know for sure, which parts of the microcurrent therapy systems are the most important – time, strength of the current or how it is delivered etc.

Our results to date, certainly with the Tennis Elbow study would suggest that using a small amount of current over a prolonged period of time (hours a day as opposed to minutes) seems to give the best results. This would be in line with the findings from other research groups around the world.

Buying an expensive machine does not necessarily provide value for money – in that more costly does not mean that you will necessarily get better faster. Machines which offer special features – all the bells and whistles – do not necessarily give better results. Some patients are certainly being asked to part with a lot of money for a machine that simply does not do what it says on the label. The treatment therefore gets a ‘bad press’ and is labelled as ‘mumbo jumbo’. To some extent, that is fair enough in that there are claims made which are not supported by the research BUT that does not mean that the whole of microcurrent therapy is ineffective – just that you have to get it right – just like any drug based therapy or exercise or any other treatment.

We are seriously looking at what it is about microcurrent therapy that makes it effective, what it is most effective for and how it should be best used. If it works and is a research supported treatment, it makes sense to use it. If it is simply a way of getting patients in pain to part with their hard earned cash, then it should be dropped and people should not be ‘conned’ into buying the machines.

At the present time, it looks like it is effective for treating some medical problems. Once we know the most effective way of using the therapy, we can be more focussed. In the meantime, there will, inevitably, be retailers who will sell the machines to anybody willing to part with some money. Hopefully, we will be able to find out the real story before another type of electrical treatment gets wrongly labelled as being all ‘smoke and mirrors’ and before patients are tricked into spending money on a treatment that is not really effective.

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