Physical agent modalities (PAMs), such as the use of iontophoresis, are used in hand & upper extremity therapy to prepare tissues to receive the best benefit of the therapeutic activities that follow (mobility, strengthening, manual therapy techniques). PAMs help
Reduce swelling and inflammation
Reduce pain and muscle spasm
Decrease joint stiffness
Improve scar mobility
Enhance joint mobility and muscle performance
Promote tissue healing.
Iontophoresis is a treatment technique that is ordered by a physician and can be applied by the hand therapist in which a low-voltage direct current is used to deliver an anti-inflammatory medication, usually a corticosteroid, through the skin to the underlying tissues. This treatment delivers the medication superficially and non-invasively. This is an alternative to corticosteroid injections with a number of advantages:
Does not have a side effect of rare but possible infections associated with invasive treatments
Delivers a smaller amount of medication
Does not get delivered deeply enough into the tissues to affect the body systemically
no side effects
no change in blood sugar levels
does not affect other medications
Works best for superficial and localized inflammations such as a tendinitis. Will not work into deep tissues or over large areas or for non-specific pain sites.
How it works: An electrode is placed on the skin with the medication of choice, typically Dexamethasone. The medication, composed of negative ions, is placed over the negative electrode. Like charges repel each other and opposite charges attract. The electrical stimulation opens the sweat pores and the medication is driven into the tissues.