14 August, 2017
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Physical Therapy: Battery Powered Cortisone Patch for Tennis Elbow
Tennis elbow, the medical term for which is lateral epicondylitis, is an overuse injury that causes pain and inflammation on the outside of the elbow. The usual treatment recommended by doctors is rest, avoidance of the injury-causing activity, ice packs and medications. Tennis elbow injuries that do not improve in two to three weeks often require additional treatment, such as physical therapy. Treatment might include cortisone, which is an anti-inflammation steroid. A treatment called iontophoresis uses a battery-powered medication delivery system that uses cortisone patches or other medications.
Tennis elbow affects tennis players and others -- such as painters, plumbers, carpenters, cooks and computer users -- who engage in activities that require repeated contractions of the forearm muscles that move the lower arm, wrist and hand. The repeated contractions can cause inflammation or small tears in the tendons that connect the muscles to the bones of the elbow. The symptoms include worsening pain and weakened grasp. Grasping or twisting motions cause the pain to radiate from the outside of the elbow and down the forearm to the back of the hand.
While nonsteroid anti-inflammation medications such as aspirin and ibuprofen reduce pain and inflammation caused by tennis elbow, doctors sometimes prescribe cortisone injections or patches for more severe cases. Cortisone blocks your body from releasing inflammation-causing substances. The cortisone patch, which is actually an adhesive membrane use in Iontophoresis, is used to deliver the medication through the skin at the injury site.
Iontophoresis uses an adhesive membrane, or cortisone patch, to which the cortisone dose is applied. Electrodes made of silver chloride and zinc are embedded in the membrane. The patch is affixed securely and uniformly to the skin and a small current generator machine is attached to the electrodes. The current generator unit is not required for the portable self-contained patch electrodes, which use a dual-chamber electrode system. The portable systems, which are activated when contact occurs between the saline and treatment solutions bathing the electrodes, are available in 12-hour and 24-hour systems.
During iontophoresis treatment, electrical currents travel through the patch and into the skin. Electrical currents force charged molecules into the skin and through the subcutaneous tissues. The amount of electrical current used is based on the size of the semi-permeable membrane’s surface area. The treatment also increases blood flow in the treatment area for up to one hour and can cause mild rash and redness of the skin following treatment. Although two to three iontophoresis treatments might be required before pain relief occurs, most patients report same-day relief, according to the online journal, “Rehab Management.”
The effectiveness of iontophoresis depends on proper preparation of the treatment site and correct application of the membrane patch. Skin burns and irritation are the most commonly reported problems. The amperage used in treatment should be reduced if the patient experiences feelings that exceed mild tingling at the treatment site. Iontophoresis is effective as an early treatment to control pain from overuse injuries, avoids the side-effects experienced with oral medications and helps patients engage in more aggressive physical therapy. Patients who use the systems report few side effects.
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