how to treat all neck most common conditions by using

WEBINARHow to treat

all Neck most common conditions by using

TECAR therapy

WHAT WILL WE SEE TODAY?

• TECAR Therapy: What is it, How it works, What is it for

• Neck Pain guideline, diagnoisis, physical examination

• Myofascial pain syndromes

• Disc and facet disease

• Nerve entrapment

WHAT IS IT ?

Tecar therapy, also known as Tecar, is a Medical device that uses high frequency currents to generate

heat and biostimulation within

the body tissues to treat acute and

chronic pathologies of the musculo-skeletal

system.

TECAR CLINIC

DiaCaRe - TECAR 400-1200KHz

WHAT IS IT ?

It transfers energy to the tissues without radiant energy, inducing

displacement currents within the tissues through the alternating

movement of natural electrical charges, present in the body in the

form of ions

TECAR CLINIC

HOW IT WORKS ?

• Electro chemical –Polarization of cell membrane

• Thermal – Hyperemia on target tissue

• Mechanical – Mechanical stimulation performed by the Therapist

TECAR CLINIC

HOW IT WORKS ?

▪ Effect of Capacitive and Resistive electric transfer on haemoglobin saturation and tissue temperature. Tashiro Y, Hasegawa S, Yokota Y et al. Int J

Hyperthermia. 2017 Sep;33(6):696-702.

▪ Effect of Capacitive and Resistive electric transfer on changes in muscle flexibility and lumbopelvic alignment after fatiguing exercise. Yokota Y, Sonoda T,

Tashiro Y et al. J Phys Ther Sci. 2018 May

▪ Chondrogenic Differentiation of Adipose-Derived Stem Cells by

Radiofrequency Electric Stimulation

María Luisa Hernández-Bule, María Ángeles Trillo, María Ángeles Martínez-García, Carlos Abilahoud and Alejandro Úbeda. Journal of Stem Cell

Research & Therapy 2017

• Pulsed Radiofrequency for Chronic Pain

David Byrd, MD, MPH and Sean Mackey, MD, PhD

Curr Pain Headache Rep. Author manuscript; available in PMC 2010

EVIDENCE BASED?

TISSUE OXYGENATIONVISCOSITY OF CONNECTIVE TISSUE

ELASTICITY OF MUSCLE FIBERSPAIN

PROLIFERATION OF FIBROBLASTS,

CARTILAGE AND BONE TISSUE

FROM MESENCHYMAL CELLSADIPOGENESIS

38-42°C - Definitely thermal effects Deep muscle relaxing action, treatment of muscular tensions, contractures, rigidity and fibrosis, (reduction of adipogenesis)

WHAT IS IT FOR?

TECAR CLINIC

30-42°C – THERAPEUTIC WINDOW

30-35°C - Effects without heat production Algosedative, anti-inflammatory, biostimulant effects; it can also be used on acute phase

35-38°C - Moderately thermal effectsOxygenation, vascularization, drainage and tissue regeneration. (The stimulation of fibroblasts induces elastin, collagen, extracellular matrix production and the stimulation of cellular growth

BRIEF SUMMARY OF THERAPEUTIC INDICATIONS

Muscle diseases• Contractures

• Strains and Tears

• Bruises

• Edema

Spine disorders• Lumbago

• Back pain

• Cervicalgia

• Nerve compression

Shoulder disorders• Tendonitis and tenosynovitis

• Insertional tendinopathies

• Adhesive capsulitis

Elbow disorders• Lateral and Medial Epicondylitis

Wrist and hand disorders• Tendinitis and tenosynovitis

• Rhizarthrosis

Hip disorders• Coxarthrosis

• Bursitis

• Groin pain

Knee disorders• Patellar chondropathy

• Gonarthrosis

• Anterior and Posterior cruciate ligaments Lesions

Ankle and foot disorders• Fractures

• Sprains

• Plantar fasciitis

• Achilles tendinopathy

Post-surgical rehabilitation

Pre-Post Competition

CAPACITIVE (with insulated electrodes) to direct the treatment

near the electrode

RESISTIVE (with conductive electrodes) to direct the treatment

in depth

TECAR CLINIC

2 SPECIFIC MODALITIES

Watch Globus Academy Videos:Knowing Tecar Therapy

Life-time prevalence of 70%

The key Role of Anamnesis:• Pain Description?

• Traumatic or work related?

• Alleviating Factors?

• Previous injury?

• Phycological attitude?

• Comorbidities?

• Where to start??

NECK PAIN GUIDELINE

High recurrence with 50-85%within 5 years after the first episode


The guideline categorizes neck pain according to different grades:

NECK PAIN GUIDELINE


According to KNGF 2016

Grade 1 Neck pain without signs & symptoms of serious pathology and no or mild

influence on ADLs

Grade 2 Neck pain without signs & symptoms of serious pathology and strong

influence on ADLs

Grade 3 Neck pain without signs & symptoms of serious pathology, but neurological

signs & symptoms

Grade 4 Neck pain with serious signs & symptoms

1. Fractures

2. Cervical Artery Dysfunction (CAD)

3. Spinal Cords Symptoms or Cervical Myelopathy

4. Infection (including urinary tract and skin infections)

5. Malignant tumors

6. Systemic diseases (herpes zoster, ankylosig spondylitis, inflammatory arthris, reumatoid arthritis)

NECK PAIN GUIDELINE



The guideline categorizes neck pain according to different grades:

NECK PAIN GUIDELINE



Grade 1 Neck pain without signs & symptoms of serious pathology and no or mild

influence on ADLs

Grade 2 Neck pain without signs & symptoms of serious pathology and strong

influence on ADLs

Grade 3 Neck pain without signs & symptoms of serious pathology, but neurological

signs & symptoms

Grade 4 Neck pain with serious signs & symptoms

Functional Evaluation

Neurological Examination

• Test diminished biceps and triceps reflex, diminished touch sense in the dermatomes, riduced muscle strenght in the myotomes.

• Spurling’s test to confirm radiculopathy

• ULTT1 Upper Limb Tension Test to exclude radiculopathy

NECK PAIN GUIDELINE


Joint Examination

• Examination of the cervical and thoracic spine, shoulder joint and shoulder girdle on

• ROM, direction of movement, resistance, end feel

• Provocation or reduction of pain and radiation

Muscle Examination• Length, elasticity, end feel, sensibility

• Strenght and endurance of deep neck flexors

Analysis

Myofascial Pain Sindrome

NECK PAIN GUIDELINE

FacetDisc

Nerve entrapment

Respiratory dysfunction

InstabilityAnxiety

Posture

Shoulder

Myofascial pain syndrome (MPS) is a common clinical problem of muscle pain involving sensory, motor and autonomic

symptoms caused by myofascial trigger points (TP).

TP:

- Hyperirritable spot

- Taut band

- Painful on compression or deep palpation

- Referred Pain

- Motor dysfunction

- Autonomic phenomena

MYOFASCIAL PAIN SYNDROMES

Mosby A. Mosby's

dictionary of medicine,

nursing & health

professions. Mosby; 2009

.

Mense S, Gerwin RD.

Muscle pain: understanding

the mechanisms. New

York: Springer; 2010

.

Travell J, Simons D. Travell

& Simons’ myofascial pain

and dysfunction: the trigger

point manual. Philadelphia:

Lippincott Williams &

Wilkins; 1992.


Gerwin, R. D., Dommerholt, J., Shah, J. P. (2004). An expansion of Simons’ integrated hypothesis of trigger

point formation. Current pain and headache reports, 8(6), 468-475.

Simmons' integrated hypothesis is a six-link chain that starts with the abnormal release of acetylcholine:

Therapeutic Progression1. Patient Education

2. Capacitive & Resisitive

3. Capacitive & Fascia Tools

4. Hands Free + Exercises


Watch Globus Academy Videos:Chronic Neck Pain

Disc pain

• Deep and widespread

• Diminished touch sense in the dermatomes,

• Riduced muscle strenght in the myotomes

• Morning pain

DISC & JOINT DYSFUNCTION

Disc pain

Therapeutic Progression1. Hands Free + Soft mobilization

2. Act upstream

a. Diaphragm

b. Lumbar & Dorsal

3. Capacitive & Resisitive




Facet dysfunction

• Pain in a specificspot specially in acute phase


Facet dysfunction

Therapeutic Progression1. Act upstream

a. Diaphragm

b. Lumbar & Dorsal




Suprascapular Nerve

NERVE ENTRAPMENTAxillary Nerve

spinoglenoid notch

Radial Nerve

NERVE ENTRAPMENTUlnar Nerve

Posterior

interosseous

nerve (PIN)

entrapment

Flexor Carpi

Ulnaris muscle Arcuate Ligament

NERVE ENTRAPMENT

pronator teres muscle

flexor digitorum sublimis

Therapeutic Progression

1. Capacitive & Resisitve2. Fascia Tools + Ecography

WHAT WE SAW TODAY?






TECAR CLINIC

Thank you for your attention

how to treat all neck most common conditions by using

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