This modality is the application of ultrasound in conjunction with a topical drug preparation as the ultrasound conduction medium. This type of ultrasound is intended to enhance delivery of the drug through the skin, thereby delivering the drug for a local or systemic effect. This type of medication delivery has advantages over oral drug administration such as providing a higher initial drug concentration at the delivery site. It also avoids the pain, trauma, and infection risk associated with injection and allows delivery to a larger area than is readily achieved by injection.
This modality is a transdermal drug delivery that uses low voltage DC current to move charged ions across the dermal layer. This modality is a non-invasive method for delivering medications through the skin. An external energy source in the form of an applied direct electrical current will increase the rate of penetration by assisting the movement of ions, driving the drug across the skin. Like charges repel each other and opposite charges attract. Thus, positive ions in a water-soluble medication are repelled from a positively charged electrode positioned over the tissue into which the medication ions are to be delivered, and negative drug ions are repelled from a negatively charged electrode. The direct current moves the ions from the drug electrode through the patient’s skin. This modality avoids the pain, trauma, and infection risk associated with injection and allows delivery to a larger area than is readily achieved by injection.
is a general term for a therapeutic treatment procedure that involves multiple advances of a filament needle into the muscle in the area of the body which produces pain and typically contains a trigger point. There is no injectable solution and typically the needle that is used is very thin. Most patients will not even feel the needle penetrate the skin, but once it advances into the muscle, the discomfort can vary from patient to patient. Usually a healthy muscle feels very little discomfort upon insertion of the needle; however, if the muscle is sensitive and shortened or contains active trigger points, the subject may feel a sensation much like a muscle cramp, often referred to as a ‘twitch response”.
The twitch response also has a biochemical characteristic to it which likely affects the reaction of the muscle, symptoms and response of the tissue. Along with the health of the tissue, the expertise of the practitioner can also attribute to the variation of discomfort and outcome. The patient may only feel the cramping sensation locally or they may feel a referral of pain or similar symptoms for which they are seeking treatment. A reproduction of their pain can be a helpful diagnostic indicator of the cause of the symptoms. Patients soon learn to recognize and even welcome this sensation, as it results in deactivating the trigger point, reducing pain and restoring normal length and function of the involved muscle. Typically, positive results are apparent within 2-4 treatment sessions but can vary depending on the cause and duration of the symptoms, overall health of the patient, and experience level of the practitioner.
Dry needling is an effective treatment for acute and chronic pain, rehabilitation from injury, and even pain and injury prevention, with very few side effects. This technique is unequaled in finding and eliminating neuromuscular dysfunction that leads to pain and functional deficits.
Cold Laser Therapy or Low Level Laser Therapy (LLLT) is a treatment that utilizes specific wavelengths of light to interact with tissue and is thought to help accelerate the healing process. It can be used on patients who suffer from a variety of acute and chronic conditions in order to help eliminate pain, swelling, reduce spasms and increase functionality.