New Technique Combines Electrical Currents and Local Anesthetic for Pain Management

Combined electrochemical nerve block reduced pain in 80% of patients with neuropathies and 50% of patients with intractable back pain.

Numerous types of electrical currents are offered in modern electromedicine. The plethora of currents is made possible by varying the frequency, amplitude (intensity), and direction of the current in time. Within these electric current parameters are distinct and varying physiologic and therapeutic effects for the human biosystem.

Typically, therapeutic electric currents are classified according to their frequencies-for example, low frequency (LF; <2,000 Hz), medium frequency (MF; 2,000-100,000 Hz), or high frequency (HF; &mt;100,000 Hz). This therapeutic classification system appears to originate from numerous physiologic investigations made in the last century.1-5 In the human biosystem, LF and MF currents are used for therapeutic stimulation of excitable cells (receptors, nerves, and muscles). Depending on the stimulating frequency delivered, physiologic and therapeutic actions may occur that may include vasodilatation, vasoconstriction, analgesia, activation of regeneration, and facilitation of metabolism.

This article describes a new electromagnetic device and its use in combination with local anesthetic therapy to treat pain problems.

New Advanced Technology

The vast majority of electromedical devices available in the United States employ LF stimulation (eg, transcutaneous electrical nerve stimulation [TENS]). Balanced MF currents have been developed that produce twice the electrical current with no electrical charge. A new type of electrical current technology has been developed to enhance the stimulating lower frequencies and nonstimulating middle frequencies for increased efficacy in clinical practice. The device also combines, and simultaneously delivers, frequency-modulated (FM) and amplitude-modulated (AM) electric cell currents in the MF range. We refer to this electromedical approach as electronic signal treatment (EST).

This new technology may reach deeper into tissue structures with simultaneous modulation of amplitude and frequency between 2,500 Hz and 33,000 Hz. It is also capable of modulating its MF electric cell-signaling current down into the LF range at available frequency rates between 0.1 and 999 Hz.

In addition, we have combined the new EST with local anesthetic injections (bupivacaine 0.25%) with clinical success. This technique provides a combined (electrical and chemical) nerve block that enhances treatment of a neuropathy or a painful condition (see Tables 1 and 2, page 63). According to the Gould Medical Dictionary, a nerve block is defined as "[t]he interruption of the passage of impulses through a nerve, as by chemical, mechanical, or electrical means." Because nerve blocks occur at voltage-gated channels, all nerve blocks are essentially electrical. According to Szasz, "There is no such thing as a chemical block ... only an electrical block."6 We refer to this as combined electrochemical block (CEB).

Clinical Experiences

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