Interferential Current for pregnant

[ramywhite]

Hi everybody,

Is Interferential Current safe for treating a 7 months pregnant women even if it is applied over her left shoulder?

thanks

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[oscar]

Hey, just had a quick look in my electrotherapy book (Kitchen, 2002) and it says interferential is contraindicated in pregnant women over the abdomen only, so I'm guessing it's ok on the shoulder??

[wutti]

hi there is no problem with interferential over the shoulder. only abdomen and lumbar spine are contraindicated in pregnancy.

but just to be sure, why do you want to use the interferential? for decreasing muscle tone or pain relief?

cheers

[ramywhite]

Hello wutti,
Thank you for your kind replay. I use Interferential for pain relieve in that case. But let me ask a question. What is the evidence that Interferential is save for fetus if it is away from pelvic and abdomen? There are some postulates in physical therapy we say them but there is no evidence they are correct. Or what is the evidence it is not save to apply IFC on abdomen during pregnancy? Yes electrical current is dangerous on a tiny person but I think no one proved that. I say it is only an assumption as many things in physical therapy. In fact many assumptions need to be studied carefully.
Thanks

[alophysio]

You are indeed right ramywhite...

But are you going to be able to live with yourself if you are wrong???

A lot of things (like interferential) are simply not worth the risk. If interferential was the most marvellous therapy that could cure someone's pain when nothing else can help, it may be worth a risk.

But for simple musculoskeletal pain that can probably wait 2 more months, it is not worth the risk of having an unborn baby damaged possibly for the rest of their life.

There is not safe way to test these things without putting babies at risk. I personally prefer to sleep well at night...

[ramywhite]

I am totally agree with you, alophysio. As a matter of fact, I always refuse to apply IFC on pregnant women what ever the place on pelvic region or shoulder region.

[sdkashif]

Here a look over the contra indications from the www.electrotherapy.org

It states that interferential should not be applied on Pelvis and trunk during pregnancy. I think application of interferentail on a joint that is not in close proximity with abdomen is safe.

[sjsrikanth]

It is not possible to exactly study the effects of Interferential currents on the foetus unless you experiment it on a foetus! Hence we have to go by the most sensible assumptions predicted.However I feel that animal studies should be encouraged give us more confidence in handling such issues. And If we assume that it is safe to apply in a part that is far away from the uterus---- How far? at what intensities? How far different intensities of the current has been recorded away from the site of treatment?

Assumptions are bad as ignorance unless proved!

[alophysio]

Ok, we can spend time and money on research into this...but really. Aren;t there so many more things that we can do to help pregnant women??

Is interferential really that good that nothing works equally well or better?

Again, if interferential is the very best thing available, then we should devote time and money into researching it. But with the limited time and money we have, i am happy to just say don't use it around the trunk and pelvis and be done with it.

Don't you think?

[asha]

I totally agree with alophysio. Its much better to get a peaceful sleep at night rather than experiment on a foetus. There are so many ways of reducing that pain. Just look for the cause of this pain & undo it. Most often what is needed in the last trimester is just posture care. Interferential is definitely not the best thing that happened to the physio profession for us to risk & harm a foetus, or spend time & money to research it.

[sjsrikanth]

Im quite surprised why would we want to stay away from research in these areas just because we asume the application of IFT to treatment of back pain in pregnancy alone??

These researches may prove fruitful in furure use of IFT during labor for pain reduction, and In case god knows even assisted contractions of the uterus!

I think it is our responsibility as physios to widen the horizon of our treatment modalities and think new, research more, rather than hiding safe behind assumptions.

We never know what potentials IFT has got untill we do animal research in these areas.

Let us not dismiss research in these areas becos we think of limited applications.

[alophysio]

Hi,

I understand your point. However, to do research on this, you will eventually have to tell a pregnant women that you want to pass an electric field thru her body to assess whether it is dangerous or not.

I don't know any women at all willing to risk their babies for that kind of research.

Your point is well taken but even one mistake is a cost too high. Not for interferential. A cure for terminal cancer in the patient may be worth that risk but not for interferential.

That is only my opinion. I just think that people can better spend their time and money on more useful things. That is all.

As physiotherapists, we need to protect our domains. Honestly, you don't need to be a physiotherapist to use a machine. There are millions of people who operate machines every day. All you need is to teach them when to put it on and how to set the settings.

Our skills are in our minds and our thinking. We then implement the BEST course of action to help our patients. We are trying to solve the CAUSE of people's problems, not just the source and symptoms.

Mark my words, if we aren't careful and don't produce research to support all aspects of our work, we will be marginalised. We are small fry in a big ocean - there are plenty of people more than happy to take away our autonomy.

If you feel that strongly about researching I/F for pregnant women, why don't you start with animal experiments and if that is proven to be safe, then test it on your pregnant wife with your firstborn - if you aren't willing to do that then no-one else should be subjected to the experiments.

Besides, you won't get it past the ethics committees. Not at this stage.

[emad]

It is better to avoid taking risk of applying Electrotherapy for a pegnant woman ,while there is strong evidence supports many techniques to deal with this problem .

The question is : why does this woman complains pain at her shoulder ??

cheers
Emad

[sjsrikanth]

we have already started animal research in this fields, infact we have even applied TENS for pain reduction during labor "Passed through the ethics commitee" after a series of animal trials and with consent of 6 women to pass 'electric field'.Though with non satisfactory results.

Iam confident that one day we will have enough animal research done and will be able to reduce pain during labor without running the risks associated with epidural anaethesia.

If we were able to research epidural anaethesia on pregnant women, application of ultrsonogram on pregnant women, paracetamol & ampicillin on pregnant women, which involve higher risks than IFT. I think it could be done.

And , since I already have a first born and too late for the second I think my daughter will reap the benefits of pain free labor wit IFT.

[sjsrikanth]

Anyway thanks for the varied opinions..Good luck

[alophysio]

My friend, let us know when you start the research!

My understanding of TENS is that is is fairly shallow and different to interferential which uses a interference pattern at higher frequencies to generate the effects in deeper tissues. For this reason, it MAY be seen to be potentially dangerous to a pregnant woman.

But good luck to you. I hope it goes well for your children - may they grow up to be strong and healthy and never need our treatment!!!

[sdkashif]

Have a look over the information as an attached file.

[Mairi]

The risk of miscarriage in the first trimester of pregnancy is fairly high anyway, that it would be very easy for a pregnant women who miscarried and had recently had Interferential to suggest a causal relationship between the two and you would leave yourself wide open to a law suit.

I wouldn't use interferential as a treatment modality anyway, but I certainly wouldn't use it in a pregnant women for exactly the reasons said.
I do not believe you could clinically reason that it would be severely detrimental to the patient if IFT was not used for a shoulder pain and this I think is the key to the argument.
As has already been said, surely the risk of miscarriage (evidence or no evidence) cannot be outweighed by a need for pain relief- there are plenty of alternative treatment choices out there, even if it is a case of no intervention during the few months of pregnancy.

This is similar to the arguments for ACP in pregnancy which I researched recently, again a serious lack of research but ethically you can't do this kind of research on pregnant women!

M

[Physio-Oms]

According to my knwledge if the treatment of IFT is being away from the treatment area. Its is Ok to treat. There is no guraantee that the fetus will get mutated, if thats the worry here.
But....if the patients hx states that she has had miscarriages before.......dont bother of treating the shoulder with IFT. Its not worth the risk!
Good luck.
O

[stephanotis]

Hi I found out yesterday I am pregnant-- 5 weeks and 5 days. They saw the flicker of a heartbeat; however, I also go to a Chiropractor for Siatic pain. My Chiropractor uses an interferential on my lower back and has for the past two weeks. Yesterday, when I told him the news he said we should stop the interferential treatment. I am now very uneasy and began to research this and stumbled upon this website. I see that there is a possibility of miscarriage-- are there other possible problems, retardation, deformities, etc?

Many thanks for your feedback!

[alophysio]

Hi Stephanotis,

THe risk of Interferential is mainly theoretical simply because we cannot find out for sure. To find out for sure, we would have to do human trials and potentially harm unborn babies in the name of science - which is bad science.

Therefore, we advise that you do not get interferential.

Having said that, you have had some interferential before you found out you were pregnant. That is ok usually. Your chiropractor has probably placed the electrodes on your back only so the current would probably be shallow. Also, your uterus would still be quite low in your pelvic cavity and so your baby is likely to be safe.

Again, it is more because we would rather be overly cautious and have nothing go wrong than be blase and have something untoward go wrong.

Like someone posted above, there are other back pain treatments available...Your chiropractor probably put you on the machine while he worked on someone else anyway so it is no great loss. I personally haven't heard of interferentially curing someones back pain before so don't worry.

Please remember that while everything in life is risky, being pregnant in a first world country improves the odds of everything being ok.

Hope this helps!

[permanent_establishment]

Hi,

I am currently 30 weeks and 6 days pregnant. I began seeing my husband's chiropractor when I was 28 weeks and 1 day pregnant for the treatment of moderate to severe lower back pain and sciatica related to pregnancy. During this time, I have had 4 treatments (consisting of 2 session each) of IFC therapy and ultrasound therapy to my lower back. Over the weekend, I started looking into IFC and ultrasound therapy, and to my dismay, found that both are contraindicated for pregnant women.

I thought I was "safe" with this chiropractor, as he indicated repeatedly that he has treated many pregnant patients in his 35+ years in practice.

I raised the issue with him today, and he indicated that he would have used the same treatment on a family member. Nevertheless, I am now completely panicking - and obviously will NOT be returning to his practice.

Any words of advice or issues that I should put my obstetrician on the look out for?

Many thanks.

[alophysio]

Hi,

I have been treating pregnancy-related problems in close association with OB-GYNs for over a decade.

Firstly, i wouldn't worry too much - i personally haven't heard of any problems associated with treatment with Ultrasound or interferential. My understanding is that the risks are theoretical but we are talking about precious life here so why risk it, right?

Secondly, if you have moderate to severe low back pain, then i would consider TENS as an alternative for pain modulation. To purchase a unit is relatively inexpensive and a lot of women use it during labour. It is safe for use during pregnancy becuase the current doesn't dive deeply like interferential does.

Ultrasound is likely to be more damaging to the baby in earlier stages of development, when things are still rapidly developing. You have to remember that going via the back, there are at least 2 inches of tissue/muscle/bone to get through before you get to the baby. I would only really be concerned (IMO) if he did U/S directly over your tummy.

Interferential is also likely to be a problem (again IMO) if the electrodes are placed so they go through your abdominal cavity. If the electrodes are ALL placed on you back, then it is unlikely that the current is passing through your baby. The reason why is because the electricity seeks the easiest path to the other electrode - and that is via muscle which is very water/blood rich.

Lastly, though the pain may be bad, there are other physical treatments that may help. We can't 'fix' everyone but we can usually provide some measure of relief - and let's face it, a little relief is better than nothing!

If you feel REALLY unsure about what has happened, then you can always check on your baby via a diagnostic ultrasound. Costs money but the peace of mind for you may be worth it...

I hope that has allayed some of your fears and concerns. I am not advocating for the chiropractor, simply just trying to present some information...

Best of luck with having your baby. I hope all is fine - i think there are many more risks coming your way that are more dangerous than U/S and interferential (birth!!).

Cheers

[permanent_establishment]

Alophysio,

I can't thank you enough for helping to put things in perspective and adding a bit of data to the mix - much easier than trying to sort my way through the diagrams and charts in the user's manuals for these devices!

Initially, I thought that the device that the chiro was using was a TENS device - I did a bit of research on that, and was comfortable with it. Until I saw the manufacturer's label on the machine after my last treatment where it clearly said "interferential".

Anyway, we're flying through Sydney at the end of July on our way to Melbourne (I may be a Yank, but I'm married into a family of wonderful Australians who are already clamoring to see the baby ). I'll wave hello and more thanks when we come through!

thanks again,

P_E

[alophysio]

Hi P_E,

Thanks for the thanks - you are welcome!

Interesting that you use the word "Yank" - does that mean you are from New York? Or at least the northeast states?

If you need any physio while in town, let us know!

Altohealth, just wondering... are you a health professional? Cheers

alophysio