Treatments

A review of The American College of Rheumatology guidelines from their current “Recommendations for the Medical Management of Osteoarthritis of the Hip and Knee” indicates the importance of non-drug therapies.

"The goals of the contemporary management of the patient with OA continue to include control of pain and improvement in function and health-related quality of life, with avoidance, if possible of toxic effects of therapy. The recommended approach to the medical management of hip or knee OA includes nonpharmacological modalities and drug therapy."

"All pharmacologic agents,...should be considered additions to non-pharmacologic measures, which are the cornerstone of OA management and should be maintained throughout the treatment period."
-ACR-

Treatments offered at the Arthritis Treatment Centers are non-invasive, safe, and conform to the American College of Rheumatology guidelines and recommendations. All treatments are adjunctive to your patient’s current drug therapies. They do not compromise the effects of prescribed pharmaceuticals, over-the-counter, or herbal medicines.

enSonix

At the core of the ATCA treatments and clinic protocols is the new, proprietary enSonix medical device. Patients are exposed to defined sound pressure waves. From the transducer module placed in front of them. Each session takes 25 minutes. After eight to ten initial treatments administered within a five-week period, ongoing longer-term maintenance therapy is defined. On average, one session per month is sufficient to sustain increased mobility and lower pain levels.

Regulatory Compliance

The enSonix medical device is registered with the FDA (United States Food and Drug Administration) under the Code of Federal Regulations in the Physical Medicine category. On June 3, 2002 the enSonix was assigned a class 1 designation, the safest of all classifications.

Indications and Clinical Use

The enSonix device is currently cleared for the relief of aches and pain and muscle relaxation. It is used in the Clinics for the treatment of pain associated with arthritis, muscle stiffness and soft tissue injuries.

enSonix Mode of Action

The sound pressure waves generated by the enSonix medical device are believed to work in three ways to provide pain relief and relax muscles.

• Sound pressure waves stimulate mechanoreceptors in the skin which in turn communicate with the brain thus blocking any other message from getting to the brain - including pain. This is referred to as the pain gate control theory.
• They also create an exercise effect in the muscles by gently vibrating the muscle fibers: this effect encourages the production and release of endorphins, the body's natural pain killers.
• Finally, sound pressure waves can increase cell membrane flow and blood circulation, resulting in further pain reduction, muscle toning and relaxation.

The illustration below shows how the sound waves block the pain message from an arthritic knee:

enSonix Treatment Protocol

Eight to ten initial treatments are administered in short succession within a five-week period. Each session takes twenty-five minutes. For ongoing maintenance therapy one enSonix treatment per month is usually sufficient to sustain reduced pain levels. Response to the enSonix treatment, like every other medical procedure, will vary by individual. If in between treatments, the pain resurfaces or becomes more intense, patients are encouraged to call the clinic to reschedule their appointment to an earlier date.

i) Pre-Treatment Procedures
Registration forms are completed, the enSonix treatment procedures are explained and current pain, stiffness, and physical function levels are recorded using the WOMAC, the self-administered arthritis questionnaire. A consent form is signed. The physiotherapist then escorts the patient to a treatment room and chair. Adjustments are made to the treatment chair back, the footrest and headset volume to ensure patient comfort. Casual clothing is recommended. Patients are offered a blanket. Many patients fall asleep during treatment so they are reminded to remove either their contact lenses or glasses, should sleeping with them be uncomfortable.
ii) Treatment Procedures
Patients listen to relaxing music while they receive the treatment. A call button is available should the attendant be needed. When the treatment is over, a chime signal is heard through the headset, and the attendant enters the room to provide assistance. Patients who have fallen asleep may need a glass of water and a few minutes to re-orient themselves.
iii) Post-Treatment Procedures
Most patients feel relaxed and refreshed. The patients’ physiologic and psychological reactions to the treatment are noted on their treatment history forms. Reduced pain and improved mobility may tempt some people to over-exert themselves. Patients are cautioned to increase their activities gradually.

Adjunctive Treatments

In addition to the enSonix which treats the whole body, the following treatments and auxiliary programs are used:

• Low Level Laser Treatment (Protocol adjusted for Arthritis) to reduce pain and accelerate tissue healing
• FAR Infra Red Heat Therapy which creates a thermal gradient that increases local blood supply
• Topical Analgesic applications and recommended use of health supplements
• Myo-Fascial Release where the physiotherapist stretches muscles around the joint to reduce tension in the muscle and joint
• Physical therapy range-of-motion exercises to increase strength, stamina and endorphin release, which creates a sense of well being
• Nutritional counseling to introduce foods that reduce inflammation and optimize metabolic processes
• Psycho Social Support to address anxiety and depression associated with arthritis
• Patient education and Arthritis self-management programs
• Monitoring of Patient Progress