The video is in Italian with the possibility of selecting English subtitles

Back pain is one of the world’s most common pain conditions. About 15 million people suffer from back pain in Italy alone, and more than half of the Italian population has at least one episode of back pain per year.

Physiotherapists treat several types of back pain. The most common ones include disc herniation, discal protrusion, facet syndrome, reduced stability problems (e.g. anterolisthesis) and myofascial conditions (e.g. trigger points).
It’s up to the physiotherapist to accurately assess the patient to identify the dysfunction that needs to be treated.

Integrated treatment of trigger points

Trigger points are spots in the myofascial tissue with the following characteristics:

  • Stiffness
  • Reduced muscle function
  • Pain on palpation
  • Referred pain
  • Taut bands
  • Twitch response
  • Altered motor pattern

Trigger points can be treated with various tools and techniques, which have the following elements in common:

  • Local compression
    Local stretching
    Local fascial release
    Intermuscular mobilisation

Today, physiotherapists treat myofascial problems with IASTM (Instrument-Assisted Soft Tissue Mobilisation) to ensure effective results while minimising stress on their hands.

Not so long ago, physiotherapists who wanted to combine IASTM and tecar therapy had to divide the treatment into two parts: first tecar therapy and then the mechanical treatment or vice-versa.

Now, Fisiowarm 7.0 allows you to combine and enhance the benefits of these two approaches, using a multifunction instrument – Fascial Full –as an electrode from the Fisiowarm range. This way, physiotherapists can use this energy-delivering instrument to mobilise the tissue using different techniques while the radiofrequency stimulates it.
As we teach in our courses, these treatments require a frequency ranging from 500 kHz (for the deeper myofascial areas) to 900 kHz (for superficial areas).

Tecarterapia e Trigger Point

In the past, when only unipolar tecar therapy units were available (with electrode and plate), treatments were mainly passive. That was because of the risk of the plate losing contact if the patient moved. For example, when you treat the lumbar spine positioning the plate under the tummy of a patient in the prone position, it’s impossible to integrate McKenzie exercises.

But with Fisiowarm 7.0, combining tecar therapy with manual therapy and mobilisation techniques is not a problem, thanks to its innovative accessories, such as the bipolar electrode.

What is the bipolar electrode?

It’s an electrode that’s free of the plate because it includes it.
As we explain during our courses at the Italian Tecar Therapy Academy, shape and size are the only differences between the plate and the electrode. When they have the same shape and size – as in the resistive bipolar electrode – the charge concentration is the same.

However, with the capacitive bipolar electrode, plate and electrode are on the same surface.
The Profile resistive bipolar electrode is one of the most widely used Fisiowarm accessories for integrated treatments of discal and joint problems. The recommended frequency is 300 kHz, as they are deeper tissues. This way, the energy goes through the target tissue without getting dispersed in other districts not involved.

Moreover, this electrode is easy to hold and apply, so you can easily integrate posteroanterior mobilisation, mobilisation with movement, and specific exercises into the tecar treatment.

Artropatie Cervicali

The image below shows how we treat facet joint pain. The bipolar electrode is applied parallel to the spine, so the target tissue is at the centre.

elettrodo bipolare trattamento faccetta articolare

This image shows how to use the electrode to treat discal problems.

trattamento bipolare discale

Treating cervicobrachialgia caused by disc herniation

Tecarterapia e Trigger Point
The traditional unipolar system (with plate and electrode) is extremely effective for specific conditions, such as cervicobrachialgia. Whenever possible, we recommend treating the patient in the seated position.
To enhance the treatment’s effectiveness, we recommend placing the resistive electrode in the contralateral area above the target area, as shown below.
unipolare con piastra ed elettrodo

Neurodynamic mobilisation helps restore and improve peripheral nervous system mobility. These techniques can be integrated into a tecar treatment, using the Neutro Dinamico® system.
The image below shows how holding the electrode (protected in the top part) between your fingers, allows you to correct the execution of a slump stretch. The system transfers resistive energy, and the recommended frequency is 300 kHz. For chronic pain conditions, we recommend the continuous mode. For specific acute conditions that require a lower thermal effect, it’s better to use the superpulsed mode.

Tecarterapia Fisiowarm e Slump

The image above shows how you can integrate neurodynamics into a tecar treatment for sciatica. This technique can also be used for peripheral nerves, such as the median nerve for the upper limbs.

We have created a training programme that teaches physiotherapists how to integrate various other approaches into a tecar treatment and achieve the best possible results.

Andrea Pettirossi 
Physiotherapist, Expert in Orthopaedic Manual Therapy. Specialised in Chiropractic Techniques.

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