While you have iontophoresis, your physical therapist may have you lie down on a treatment table. They will then place two electrodes near the problem area (where there is inflammation). One of the electrodes will contain pain medication — whether it’s dexamethasone, lidoxane, or something else.
Full Answer
What is iontophoresis with dexamethasone?
Experimental: Iontophoresis with Dexamethasone. Iontophoresis is a non-invasive delivery mechanism for transmitting a medication to a local area of the body. The I-Bresis™ System and I-Bresis™ Patch will be the delivery system used for this study.
How is iontophoresis administered in the body?
The medication is delivered by a mild electrical current. The most common drug used with iontophoresis for pain caused by such things as apophysitis of the knee is dexamethasone sodium phosphate (dexamethasone).
What drugs can be used with iontophoresis?
Corticosteroids are the primary drugs used with iontophoresis in physical therapy and rehabilitation medicine in general. Formulated as a water soluble salt, the corticosteroid molecule has a negative charge and so the negative-electrode drug reservoir must be used.
How does iontophoresis patch work?
Iontophoresis Patch. Attached to the patch is a small pouch of medication. Both patch and pouch are connected to an ionto machine. As the medication is delivered through the pores of your skin, the ionto machine also applies a small electrical current, which further increases your skin's permeability to the medication.
How much dexamethasone is used for iontophoresis?
1.5 ml of the dexamethasone sodium phosphate (4ml/1mL) will be placed on one side and 1.5 ml of 0.9% sodium chloride (saline) solution will be placed on the other. Duration of exposure: 123 minutes.
Which drug is used in iontophoresis?
According to related literature, the most important drugs studied or administered by iontophoresis are: Local anesthetics, opioids, steroids, non-steroidal anti-inflammatory drugs, antibacterial drugs, antifungal drugs, antiviral drugs, anticancer drugs, fluorides, and vitamins.
Is dexamethasone positive or negative for iontophoresis?
In this case, dexamethasone sodium phosphate is a negatively charged ion and is applied to the negative pole (anode) of the bipolar iontophoresis set-up; electrical charge applied to the anode forces the drug ions to be pushed through the skin into the deeper tissues.
What does acetic acid do in iontophoresis?
It is theorized that acetic acid delivered via iontophoresis is effective for ossifying conditions because the acetate ion combines with the insoluble calcium carbonate that is present with ossifying structures.
Can physical therapist use dexamethasone?
Dexamethasone is a common anti-inflammatory medication used during iontophoresis treatments in many physical therapy clinics. 1 It is helpful in decreasing localized inflammation that occurs in musculoskeletal conditions such as tendonitis or bursitis.
Do you need a prescription for iontophoresis?
You'll need a prescription from your doctor to buy a plug-in device to use at home, and your insurance may cover its cost. If plain tap water or tap water with baking soda isn't effective for you, your doctor may prescribe an anticholinergic, which is a medicine used to treat hyperhidrosis.
How do you set up iontophoresis with dexamethasone?
1:373:03Iontophoresis in Physical Therapy - YouTubeYouTubeStart of suggested clipEnd of suggested clipAnd apply the Dex. Right at the focal point of the achilles tendonitis. The other pad would go aboutMoreAnd apply the Dex. Right at the focal point of the achilles tendonitis. The other pad would go about a foot. Away as a ground the negative side goes on the disperse.
What are the two types of electrodes used in iontophoresis?
The unit has two electrodes; one electrode is for the negative current, and one is for the positive current. Your PT will apply medication to either the positive electrode or the negative one, depending on the type of medication that is being used for iontophoresis. The electrodes are then applied to your body.
What is iontophoresis in physical therapy?
Iontophoresis is a modality used by physical therapists to treat a wide variety of conditions, including bursitis, tendonitis/ tendinopathy, and to help manage scar tissue. It uses electrical stimulation to help administer medication into your body through the skin.
What are contraindications for iontophoresis?
Contraindications to iontophoresis include those related to direct electrical stimulation and from the therapeutic agent involved. Patients with a history of hypersensitivity or adverse reactions associated with the delivered drug in question should avoid iontophoresis of the offending agent.
What is lidocaine iontophoresis?
Lidocaine iontophoresis is a method of topical anesthesia where lidocaine is driven into the skin under the influence of electric current. We performed a prospective double-blind, placebo-controlled evaluation of iontophoresis of 2% lidocaine with 1:100,000 epinephrine.
Is dexamethasone a steroid?
Dexamethasone is a steroid (corticosteroid) medicine. Steroids closely copy the effects of natural hormones produced in your adrenal glands. The adrenal glands sit above your kidneys. When prescribed in doses higher than your body's usual levels, steroids like dexamethasone reduce inflammation.
Why do you need an iontophoresis patch?
An iontophoresis patch is known for enabling a high concentration of medication to reach deeply—all the way to the muscles, with few, if any, side effects. But it also helps distribute the dexamethasone, lidocane, etc to a larger surface area.
What is iontophoresis?
Iontophoresis is actively being developed by biomedical researchers in a variety of ways. Experts are trying to increase the ability of the drug to permeate the skin, and also to decrease side effects. And they are interested in improved drug delivery programming.
How does electric current affect iontophoresis?
As mentioned above, with iontophoresis treatments, the electric current enhances the delivery of the pain-relieving medication as it moves through the barrier of the skin into where it can exert its effect. 2
What is an ionto patch?
Iontophoresis Patch. One such treatment modality is called iontophoresis, or ionto, for short. This procedure involves a patch that is placed on your skin. It is used most frequently to reduce inflammation and relieve pain. Attached to the patch is a small pouch of medication. Both patch and pouch are connected to an ionto machine.
What is attached to a patch?
Attached to the patch is a small pouch of medication. Both patch and pouch are connected to an ionto machine. As the medication is delivered through the pores of your skin, the ionto machine also applies a small electrical current, which further increases your skin's permeability to the medication.
How long does ionto last?
Ionto treatment lasts between 10 and 15 minutes and may be given either before or after the exercise portion of your session. Ionto is not painful, but the study mentioned above found that it does not offer better outcomes than a course of physical therapy that does not include ionto.
Does dexamethasone help with pain?
A dexamethasone patch simulates the corticosteroid cortisol (but is more potent), an important hormone produced naturally by your adrenal glands. Dexamethasone has anti-inflammatory properties, which means it relieves or reduces swelling, heat, redness and pain.
What is iontophoresis therapy?
One such treatment is iontophoresis. Iontophoresis is a therapeutic modality often used by physical therapists to treat a variety of conditions. It is a type of electrical stimulation that is used to administer medication into your body through your skin. Illustration by Lisa Fasol, Verywell.
What class is iontophoresis?
When used for systemic drug delivery, iontophoresis machines are classified by the U.S. Food and Drug Administration (FDA) as a class 3 device alongside total artificial disc replacements and implanted neurostimulators. 4 .
Why is iontophoresis important?
It is used to introduce medication into your body to achieve specific therapeutic goals. Iontophoresis may be one treatment that can help you return to normal activity quickly and safely after injury.
What is ionically charged medication?
The medication used in iontophoresis is ionically charged. So if your physical therapist decides to introduce medication into your injured tissues via iontophoresis and that medication is negatively charged, he or she will use a negative current to drive that medication into your body. 1 .
What do you need to know before iontophoresis?
Before applying iontophoresis, your PT must first decide on which type of medication to use. The medication used in iontophoresis depends on the goals of the treatment. Different medications have different effects on the body, and your PT will decide on the best medication for your specific condition.
How long does it take to get iontophoresis?
A typical iontophoresis treatment takes 10 to 20 minutes, depending on the amount of medication that your PT is administering to you.
How does an electrode work with a medication?
The electrode with the medication is applied to the area of your body that is being treated. The electrode without the medication is applied to your body nearby. The electrical stimulation unit is then turned on , and the electricity pushes the medication into your injured body part while you relax.
What is iontophoresis used for?
Common Uses for Iontophoresis. In rehabilitation medicine, including physical therapy, iontophoresis is used to reduce inflammation that might be seen in musculoskeletal conditions such as lateral epicondylitis, medial epicondylitis, plantar fasciitis, tendo-nitis/bursitis, rheumatoid arthritis, and enthesopathic conditions of various origins.
What drugs can be used for inflammation?
Iontophoresis for Inflammation. There are a number of drugs that can be driven into the subcutaneous tissues including steroids, NSAIDS, local anesthetics, salicylates, and individual substances such as zinc oxide, iodine, acetic acid, and calcium chloride, to name a few.
How long does iontophoresis treatment take?
The treatment is administered clinically for 15-20 minutes per session. In a physical therapy setting, iontophoresis is typically one of several treatment interventions applied, so the addition of another 15-20 minutes to a pre-existing 60 minute program is a time burden for some patients.
How old is the most likely to have calcific tendinitis?
The highest incidence is in adults aged between 30-50 years old. The overall incidence of calcific tendinitis appears to have declined in the last few decades. The epidemiology of the condition seems to favor women more than men, and is more often seen in the dominant shoulder.
What is an electrode patch?
Electrode patches have a unique composition that allows ionic movement into human skin tissue. One patch, for example, is made up of embedded zinc and silver chloride electrodes and is activated when the treatment solution bathing one electrode comes into contact with the saline solution bathing the opposite electrode.
What are nonsurgical treatments?
Nonsurgical treatment remains the standard of care and reports show that conservative methods such as ultrasound, cold laser, iontophoresis, phonophoresis and therapeutic exercise applications can eventually lead to full restoration of function . 6.
What is the main barrier to drug transport?
This article will focus on iontophoresis, a form of transdermal drug delivery (TDD) that utilizes electrical current to drive or push ionized drugs through the skin’s outermost layer (stratum corneum) which is typically the main barrier to drug transport.
What is iontophoresis in physical therapy?
Iontophoresis is an effective and well tolerated method for delivering ionized medications through the dermis using a controlled amount of electrical current. This mode of treatment offers benefits to a wide array of musculoskeletal disorders. In physical therapy, the use of dexamethasone for inflammation and acetic acid for calcific deposits has been used for many years in numerous clinical settings.
What is iontophoresis used for?
In rehabilitation medicine, including physical therapy and chiropractic, iontophoresis is used to reduce inflammation that might be seen in musculoskeletal conditions such as lateral epicondylitis, medial epicondylitis, plantar fasciitis, tendo-nitis/bursitis, rheumatoid arthritis, and enthesopathic conditions of various origins.
What drugs can be injected into the subcutaneous tissue?
There are a number of drugs that can be driven into the subcutaneous tissues, including steroids, NSAIDS, local anesthetics, salicylates, and individual substances such as zinc oxide, iodine, acetic acid, and calcium chloride to name a few.
How deep do ions penetrate the tissues?
It is usually considered that the penetration of the ions into the tissues is likely to be less than 1mm. Any deeper penetration is considered to be due to local capillary circulation effects. There is no evidence that the current itself is responsible for penetrations beyond this level (though some authors claim - without explicit evidence - that the ions are driven much further into the tissues. The bulk of the ions that enter the tissues accumulate under the stimulating electrode and it may be possible that recombination of the substance can occur under this (active) electrode, though this remains a controversial issue which has not been fully resolved by the available research evidence.
How long does an electrode patch last?
The electrode patch is preconfigured and delivers a smaller current than is normally employed in the department or clinic (typically 0.1mA). The patch is applied for 12 - 24 hours (depending on the intended dose) after which time, it is removed and disgarded (they can not be reused). The illustration of electrode systems (below) includes one such option (top right)
Can iontophoresis be specific?
There are some authors who identify very specific substance concentrations, volumes, electrode sizes, current intensity and treatment duration (the critical parameters for an iontophoresis treatment). Others provide general guidance, saying that it is not possible to be specific for a particular patients with a particular clinical presentation.
Can you use metal electrodes on skin?
It is not necessary to use these (commercial) electrodes , and for many years, therapists have used various metal / foil electrodes with the substance needed for the treatment applied to the wet/damp gauze between the metal electrode and the skin surface.
How Iontophoresis Work
Common Uses
- There are many different uses for iontophoresis. These include, but are not limited to:2 1. Decrease inflammation 2. Decrease pain 3. Decrease muscle spasm 4. Decrease swelling and edema 5. Reduce calcium deposits in the body 6. Manage scar tissue Your PT will work with you to decide on the treatment goals and the rationale for using iontophoresis.
Procedure
- Before applying iontophoresis, your PT must first decide on which type of medication to use. The medication used in iontophoresis depends on the goals of the treatment. Different medications have different effects on the body, and your PT will decide on the best medication for your specific condition. Many states require that your PT obtain a prescription from your healthcare p…
What to Expect
- When your physical therapist applies iontophoresis to your body, he or she uses an electrical stimulation device. When the electrical current is turned on, you will likely feel a slight tingling sensation. Sometimes the stimulation feels like a tiny bee sting. If you are uncomfortable during the iontophoresis treatment, notify your physical therapist and adjustments can be made. A typi…
Side Effects
- Iontophoresis is a safe procedure, and side effects are minimal. While receiving the stimulation, you may feel a slight pin prick tingling sensation. Redness may also occur underneath the electrodes used for it. Some patients notice some dryness or rough skin in the area where the iontophoresis was administered. This can be mitigated by using skin lotion over the area severa…
Contraindications
- While generally considered safe, the procedure is not without its limitations and safety issues. When used for systemic drug delivery, iontophoresis machines are classified by the U.S. Food and Drug Administration (FDA) as a class 3 device alongside total artificial disc replacements and implanted neurostimulators.4
Evidence
- If your physical therapist considers using iontophoresis for your treatment, you should know if it is likely to be of benefit for your condition. Studies investigating iontophoresis have been performed, some of which are promising than eithe. A 2015 study published in the journal Physiotherapy examined the role of lidocaine iontophoresis in the treatment of spasticity in children with cereb…