Iontophoresis – Wellness

Introduction – Iontophoresis

Iontophoresis is a method of delivering a medication through the skin using an electrical current. This is an in-office procedure which can deliver anti-inflammatory medications to a site that is inflamed. This allows for the inflammation to be reduced along with the pain and swelling.

Anti-Inflammatory Benefits:

Dexamethasone is a corticosteroid medication that has anti-inflammatory properties. Therefore, it is used primarily in iontophoresis. In rehabilitation settings, it is used most often for the treatment of soft tissue and other types of musculoskeletal inflammation.

Conditions which can be treated with Iontophoresis include:

  • Tennis elbow
  • Golfers elbow
  • Rheumatoid arthritis of the knee
  • Plantar fasciitis
  • Achilles tendonitis
  • TMJ disorder

Treatment procedures:

Iontophoresis uses electrical current to administer a medication through the skin into the site of inflammation. This is performed by using a patch that has a positive and a negative charge. The medication and a solvent of a different charge are placed on different ends of the pad. This pad is then placed on the site to be treated. After this, a small power source is connected to the pad and set at a certain frequency to deliver the medication into the inflamed area. The patient is instructed to wear the pad for a specific duration of time before it can be removed.

Mechanism of absorption of drugs administered by iontophoresis is a bit different as compared to the administration of drugs via other methods.

Advantages of taking medication through transdermal iontophoresis relative to oral medications are:

  • Concentration in a specific painful area
  • The medication need not be absorbed within the GI tract
  • Safer than administering a drug through injection

Iontophoresis generators:

These devices produce continuous direct current and assure unidirectional flow of ions. Treatment duration ranges between 10-20 minutes with 15 minutes being an average period.

Positive ions that accumulate at the negative pole or cathode produce an alkaline reaction with the formation of sodium hydroxide.
The patient should be comfortable with no reported or visible signs of pain or burning. The skin should be checked every 3-5 minutes looking for the signs of skin irritation.

The intensity of current is decreased during treatment to avoid pain or burning.

Electrode preparation

To ensure maximum contact of electrodes, the skin is shaved and cleansed prior to attachment of the electrodes.

Do not excessively abrade the skin during cleaning since damaged skin has lowered impedance to current and a burn might occur more easily.

Selection of appropriate ion:

Negative ions accumulate at the positive pole or anode and produce an acidic reaction through the formation of hydrochloric acid. They produce softening of the tissues by decreasing the protein density. This is useful in treating scars or adhesions. Some negative ions even have an analgesic effect (salicylates)

Positive ions that accumulate at the negative pole or cathode produce an alkaline reaction with the formation of sodium hydroxide. They produce hardening of the tissues by increasing the protein density.      

The ions used for treatment include:

For inflammation

  1. Dexamethasone (-)
  2. Hydrocortisone (-)
  3. Salicylate (-)

Spasm

  1. Calcium (+)
  2. Magnesium(+)

Analgesia

  1. Lidocaine (+)
  2. Magnesium (+)

Edema

  1. Hyaluronidase(+)
  2. Salicylate (-)

Open Skin Lesions

Zinc(+)

Scar Tissue

  1. Chlorine(-)
  2. Iodine(-)
  3. Salicylate(-)

Chemical burns due to treatment

  • Most common problem with iontophoresis is a chemical burn which occurs as a result of direct current itself and not because of the ions used.
  • Continuous direct current creates migration of ions which changes the normal pH of the skin. Chemical burns usually result from accumulation of sodium hydroxide ions at cathode. Alkaline reaction causes sclerosis of local tissues. Decreasing current density by increasing size of cathode can help to minimize potential for chemical burns.

Thermal burns:

Thermal burns may occur due to high impedance to current flow which is created by poor contact of the electrodes with the skin. Thermal burns can occur due to various factors such as:

  1. Electrodes are not moist enough
  2. Wrinkles in the gauze or paper towels impregnated with the ionic solution
  3. Space between the skin and electrode around the perimeter of the electrode
  4. Body weight resting on top of electrode

- Links of interest: Twitter Wellness

This article is not medical advice nor a substitute to professional health advice. Always consult a doctor.


 

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