Lower back pain and tecar treatment: what do you need to know?
Lower back pain and its treatment with tecar is a topic that has been talked about for as long as humans can remember. Over the years of modern science, countless studies have taken place regarding its prevalence, epidemiology, etiology and possible solutions.
Despite being a studied topic, it is difficult to define a unique treatment protocol with tecar technology for the management of a lower back pain episode. In fact, the publications and the data available are heterogeneous and often arrive at contradicting conclusions.
After a review of the studies on lower back pain, we have identified these main factors:
1- The percentage between 59 and 89% of the population faces at least one episode of back pain in the course of their life. The variation fluctuates according to the study being considered.
2- Despite the widespread belief that back pain resolves spontaneously within 6 weeks, many studies report a recurrence of cases of low back pain at 3, 6 and 12 months that largely exceeds 70% of the cases.
3- In most cases (> 70%) there is no specific identifiable cause.
4- The available data and studies do not allow to identify a unique and elective therapy.
5- In more than 50% of cases, the episode of low back pain caused some form of disability associated with acute pain.
In short, lower back pain is a very common condition and represents one of the most frequent points of contact between patient and therapist. Whether or not it becomes an opportunity to trigger a positive relationship all depends on how well the therapist is able to solve the problem quickly and permanently.
From the diagnosis, lower back pain is a complex topic: there doesn’t seem to be a diagnostic process that at the same time guarantees high specificity and high sensitivity. Or rather, it seems that a large part of the diagnostics available is more oriented to identify possible “red flags” and therefore indicate what shouldn’t be done rather than investigating the non-specific contributing causes of back pain.
Given the heterogeneity of these causes, even in terms of treatment, it’s impossible to identify a golden standard. International guidelines on the management of lower back pain are often limited to giving indications on the information to be provided to the patient, recommending managing symptoms in the persistence of the clinical condition and emphasizing the importance of controlled physical exercise. They advise against prolonged workouts or treatment programs based solely on single passive therapies.
The result of this general context is:
- a large portion of the population continues to need quick and lasting solutions
- it is very difficult to find an answer in a standard protocol
- it seems that each patient needs a specific analysis and personalized treatment.
Therefore, many therapists who employ our technologies often ask us questions about how to use a tecar device in lower back pain episodes.
We reported the most frequently asked questions in this article and tried to give some answers. When reading them we suggest to take into consideration that they have been drawn up according to the specific characteristics of the T-Plus machine. It is therefore possible, if not likely, that some considerations do not apply to other tecar type equipment.
Is tecar therapy indicated in case of lower back pain?
The term tecar therapy identifies a therapy performed through a tecar machine, but this term can sometimes be misleading. A well-designed tecar device gives the possibility to selectively generate different reactions within the body and each of these could be indicated or contraindicated for the specific clinical condition being treated.
The question is not whether or not tecar therapy is indicated for lower back pain, but to understand which reactions it is useful to stimulate according to the clinical condition of the tissue being treated.
In the case of non-specific lower back pain where the diagnostic test cluster has identified, for example, that the pain comes from a trigger point located along the quadratus lumborum, the increase in temperature at a deep level and the increase in blood perfusion could be two useful reactions to be stimulated through a large resistive electrode and an amount of energy sufficient to trigger such reactions. On the other hand, if the problem were for example linked to localized inflammation at the level of the articular facets, the increase in temperature would be contraindicated and it would become much more useful to focus on the drainage and repair process of the tissue with more specific electrodes for this type of application.
Lower back pain and tecar treatment: how can I treat back pain with the support of a tecar device?
Defining a treatment without knowing the patient’s clinical condition is impossible. We can at least identify guidelines of a good practice that can be useful in many cases. The prerequisite is to have an instrument that allows you to measure the energy transferred and the current generated and that allows you to transfer good amounts of energy continuously (not pulsed) even without increasing the temperature of the tissue.
On the basis of the clinical practice of the centers of our network and support of the literature, we can argue that structures often involved in cases of nonspecific lower back pain are:
the quadratus lumborum, the sacroiliac joint, the iliopsoas, the diaphragm, the buttocks and the piriformis. In a single treatment it is possible to focus enough energy on each of these structures to trigger a rise in temperature sufficient to modify their viscoelasticity, reduce their stiffness and facilitate peripheral circulation. At the same time the energy transfer allows to increase oxygen and blood perfusion around the structures involved in the treatment.
Is it better to use the capacitive mode or the resistive mode in case of lower back pain?
There is no single answer to this question. At the most we can answer precisely what should be used to stimulate a certain reaction. Does clinical assessment or differential diagnosis indicate that the tissue needs an increase in blood perfusion? In this case it is better to use a large resistive. On the contrary, if we need to concentrate a thermal increase focused on a portion of soft tissue to facilitate the manipulation of the muscle fascia; a hyperthermic capacitive, which does not require the use of conductive cream, is the perfect choice. These are just examples, but the bottom line is that the answer is related to the type of tissue and the type of reactions we are trying to stimulate.
How many tecar treatments are necessary to obtain evident results in case of lower back pain?
Based on the clinical practice of the centers that are part of our network, the clinical picture of non-specific lower back pain must improve from the first treatment. On average in 3 treatments the symptoms should have practically disappeared. If after the third treatment there is no significant improvement, continuing with the same treatment strategy will not improve the situation. It will be necessary to go back to the diagnosis to understand what is missing to complete the clinical picture.
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¹Epidemiology of Low Back Pain; Topical Review; Laxmaiah Manchikanti, MD; Pain Physician, Volume 3; 2000
²European guidelines for the management of acute nonspecific low back pain in primary care; Eur Spine J; 2006; Van Tulder et al.
³Does the Application of Tecar Therapy Affect Temperature and Perfusion of Skin and Muscle Microcirculation? A pilot Feasibility Study on Healthy Subject; Clijsen et al; 2019; The Journal Of Alternative and Complementary Medicine