Electrotherapy and Osteoarthritis Essay

Osteoarthritis has been described and defined as a condition involving the human bones that is caused by the breakdown of the joints, leading to the loss of cartilage, or what is known as the ‘cushion’ between the bone and the joint, in the affected joint or joints. Osteoarthritis is known to affect more than twenty million people every year in the United States of America alone. This degenerative disease affects persons aged above forty five, and it is found in both sexes, and it does not distinguish between races and colors and ethnicities. The hands, the feet, the spine and the large joints of the body fall prey to this debilitating disease, and until today, research has not been able to reveal the specific cause of osteoarthritis, although it is true that it can be directly attributed to the impact of ageing. Injuries in a joint, ageing and being overweight can also lead to the onset of osteoarthritis. The pain in osteoarthritis is caused due to the rubbing of the bones together after the cartilage that cushions them has been worn out. Some of the prescribed therapies to deal with the disease are exercise, stringent weight control, resting of the painful joints, pain relief medication, electrotherapy, and alternative therapies, and if the pain is excruciating, surgery. Electrotherapy is today one of the most accepted and used skills of physiotherapists, although it is by no means new. The use of heat, cold and electrical stimulation have been in use for a long time now, but the inherent problem is that the benefits and the advantages or disadvantages if any have not been analyzed or accounted for, and this means that the method is not as widely used as it can be. However, it remains a fact that electricity has been used by medical practitioners for hundreds of years now, and it is now one of the most common treatment approaches, giving new hope to millions of sufferers across the globe. (Kitchen, Sheila 2002) Take for example this table demonstrating the improvement in the management of pain in osteoarthritis using electrotherapy. Recent research has been able to prove that electricity would be able to bring immediate relief for both acute as well as chronic pain, and it must be remembered that in the case of osteoarthritis, the pain can be both acute and chronic. Nevertheless, the exact mechanism of electrotherapy is not known yet, although it is true that the method can block the transmission of pain signals across the nerves, and can also cause the release of endorphins, or the natural painkillers that are created by the body to combat pain. There can be several different types of electrotherapy methods, and some of them are: TENS, or ‘transcutaneous electrical nerve stimulation’, inferential current, and galvanic stimulation. One must note that all the three methods use electrotherapy to stimulate nerves and muscles, through the adhesive pads that are applied on the skin. Electrotherapy must never be used over malignancies, open infections, over pacemaker leads, and over the throat, because it may cause lowered blood pressure, and over a pregnant uterus, as it may affect the fetus. In the year 2004, a randomized double blind pilot study on the impact of electrotherapy on about sixty four osteoarthritis patients suffering from moderate to severe pain in their various joints was conducted. The aim was to study whether the therapy would be useful in alleviating the pain for these patients, and it was found that it would definitely be able to provide temporary relief from severe and intolerable pain. At the present time, stated the researchers who were involved in the experiment, pain relief for osteoarthritis is predominantly medication, and this approach could bring better relief. In the study, the approach was to apply micro to milliamp current to certain specific areas of the patient’s head. This would result in the release of endogenous opioids from the various pain management areas located within the human brain. For a period of two weeks prior to and tow weeks after the study, the subject pain was self assessed using the ‘value scale’, and none of the physicians, patients and the device operators were let in on which device was real and which, false, and the data thus collected revealed the interesting fact that electrotherapy was indeed beneficial in bringing down the pain of the patients of osteoarthritis. According to the Australian Physiotherapy Association, there is sufficient evidence available to prove that physiotherapy management of the knee joints is a very good idea, and that there is a lack of evidence to prove that electrotherapy, specifically shortwave diathermy, including ultrasound, microwave and shortwave may be useful in managing the pain. It may however be true that a recent Cochrane review was able to prove conclusively that TENS or transcutaneous electrical nerve stimulation may be quite effective in controlling pain in these patients. However, better designed studies have to be made before it can be stated that TENS can be used to treat pain for osteoarthritis sufferers. (Bennell K, Hinman R, Crossley K 2001) It is important that the treatment plan must be made with the complete cooperation and consultation with the patient. The treatment goals would depend on the timescale of the treatment that he or she is undergoing for his osteoarthritis, the patient profile, and the affected joints. This would ensure that the patient achieves the maximum benefits of the treatment, so that he may be able to continue living a healthy and active life. Although research has shown that electrotherapy methods like laser therapy and ultrasound do not bring in any significant levels of improvement in the long term for the pain, they do bring in immediate relief from the pain. (EMHM Vogels, HJM Hendrick et al 2003) This cannot be taken to mean that electrotherapy does not bring relief for patients of osteoarthritis; it has been found that low power laser therapy has brought great relief for the pain of sufferers of osteoarthritis in Russia and in Eastern Europe. A study showed that electrotherapy brought relief for pain, mobility, tenderness and functioning in these patients, with relatively little adverse effects. In all probability, the mechanisms treated successfully using laser electrotherapy included peripheral nerve stimulation, resolution of inflammation, enhanced chondrocyte proliferation and increased matrix synthesis. (Ghassemi, M, Marks R 1999) There can be no doubt that the studies conducted so far are by no means conclusive, and the issue of handling the joint pains of those suffering from osteoarthritis with electrotherapy must be analyzed and studies further to bring in real statistics and real results. Perhaps, very soon, there may be available some sort of revolutionary treatment for the management of pain, which these patients would be able to use without fear of side effects or other complications, so that they may be able to continue to live an active and healthy lifestyle.