Physical Medicine in Podiatry:
A New Concept
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JEROME J. ERMAN, D.P.M., A.N.C.F.S. |
Additional Chapters
1. Foot Lesions
2. Podiatry
The basis of all life on earth is furnished by physical forces,
such as the radiant rays of the sun, the movement of the waters,
the static electrical charges in some of the bodies around us.
All of these various elements help to form nature’s indefinable
array of forces. If we take these same physical forces and channel
them properly, we may use them in the practice of podiatric
medicine. These forces may help to increase circulation, improve
local and general metabolism, stimulate nerve function or alleviate
irritable nerve endings, inhibit the increase of infectious
bacteria or eventually remove them from the presence of the
patient. From our knowledge of all these effects we must therefore
conclude that physical agents may accelerate the repair of injured
or diseased tissues, are able to restore disturbed function,
relieve pain and improve the condition of the body.
Physical medicine is not a new method for recognizing and treating
disease. It should be a part of the armamentarium of the active
practice of podiatric medicine. It can be of the utmost value
in the treatment of podiatric problems when properly employed
by the podiatrist who has learned that there is a scientific
basis for its use. Physical medicine should not be used indiscriminately.
It should be applied by the podiatrist with a broad knowledge
of clinical diagnosis.
Physical medicine serves in acute disease conditions to relieve
symptoms and accelerate recovery. In chronic disease, physical
medicine is a most dependable and safe agent for relieving pain
and frequently offers an opportunity for full recovery by bringing
about gradual resolution of the chronic inflammatory processes.
Among the many conditions in which physical medicine proves
of definite value are:
A. Trauma, both acute and chronic
B. Forms of arthritis and its rheumatic states
C. Organic and functional affections of the nervous system
D. Chronic diseases of the blood vessels
E. Acute and chronic inflammatory conditions of the skin
There are some obvious advantages in the use of physical medicine.
In most cases it can be applied directly to the affected parts
and in acute conditions, as a rule, it gives immediate relief.
In chronic conditions, patient and systematic application is
essential. In some cases physical medicine will enable the clearing
up of lesions otherwise requiring surgery.
A large array of machinery is not necessary to produce the basic
physical and physiological effects. Modern mechanical and electrical
progress has made available to the practitioners many types
of efficient apparatus, which produce a saving in expenditure
of one’s own energy, and a saving of time in achieving
results.
In nearly twenty-five years of private practice I have run the
gamut of physical medicine, having used every type of equipment
manufactured, as follows:
A. Electrotherapy
1. Galvanic or direct current
2. Low Frequency currents
3. High
Frequency currents
4. Static electricity
B. Light Therapy
C. Hydrotherapy
D. Hyperthermy and Hypothermy
E. Mechanotherapy
Three years ago I was first introduced to pulsed high frequency
electromagnetic energy (Diapulse). Here I found a physical medical
asset that supersedes most of the physical medical equipment
in my office.
The theory behind Diapulse is attributed to Dr. Abraham J. Ginsberg,
a New York physician who in the early 1930’s conceived
the idea of using high frequency energy for the treatment of
his patients. With this unit of physical medicine he could administer
treatment without the danger of overheating or burning his patients.
He employed a pulsing technique which permitted the use of high
intensity energy, allowing deep penetration of the body and
still not have any destructive heat buildup. Today, some 36
years later, this theory has been put to more extensive use.
In our practice we have been able to observe the clinical effects
of pulsed high frequency electromagnetic energy (Diapulse) in
the lower extremities, and have come to the conclusion that
these effects are due to increased peripheral blood flow. We
were able to observe an increase of arterial and venous circulation
of the lower extremities.
The effect of pulsed high frequency electromagnetic energy (Diapulse)
on circulation shows an increase in the pathological area. We
also find it has a marked sedative effect on pain, spasms and
cramps. I could find no explanation for this pain-relieving
effect except that some investigators made note that increased
circulation stimulates the vegetative nervous system through
the nerve endings in the skin.
Table 1
Clinical uses of pulsed high frequency electromagnetic energy
(Diapulse)
| Subject |
Area Treated |
Duration |
Results |
| Neuritis |
affected area & liver |
30 min daily. 4 to 5 ov weekly. Up to
10 ov. |
Excellent |
| Neuralgia |
affected area & liver |
30 min daily. 4 to 5 ov weekly. Up to
10 ov. |
Good |
Intermittent
Claudication |
Affected area & epigastrium |
30 min daily. 4 to 5 ov weekly. Up to
20 ov. Some results by 5 ov |
Excellent |
Arthritis
(Rheumatoid) |
Affected area, liver, & adrenals |
30 min daily. 4 to 5 ov weekly |
Good, but slow. Long duration of treatments. |
| Bursae |
affected area & liver |
30 min daily. 3 to 4 ov in one week
|
Excellent. No returns in 6 mos. |
| Bone cysts, Exostosis, Heel Spurs, Sesamoiditis |
affected area & liver |
30 min daily. 4 ov weekly. 9 to 12 ov.
|
Good |
| Joint Pain |
affected area & liver |
30 min daily. 3 to 4 ov weekly. 6 to
8 ov. |
Good |
| Neoplasms Verruca |
Affected area & liver |
30 min daily. 2 ov weekly. Indefinite. |
Poor |
| Fractures |
Affected area & liver |
30 min daily. 4 to 5 ov. |
Excellent, decreases healing time by one half |
Sprains & Strains
Trauma |
Affected area & liver |
30 min daily. 3 to 4 ov weekly. Consecutive
Treatments. |
Excellent |
| Hematoma |
Affected area & liver |
30 minutes daily. 2 ov |
Excellent |
| Edema |
Affected area & liver |
30 minutes |
Excellent. Marked improvement |
| Foot Ulcers |
Affected area & liver |
30 min daily. 3 to 4 ov weekly |
Excellent. Improves rapidly |
| Surgery |
Affected area & liver |
30 min preoperative
30 min postoperative |
Excellent. Controls hemorrhage* |
* Continue use of Diapulse for two to three days at the same
rate of treatment time. This effects very rapid healing of tissues
and results in practically no postoperative pain.
Pulsed high frequency electromagnetic energy is most often indicated
in the following conditions: traumatic and inflammatory conditions
of the bones and joints, fractures, bursae, painful tissue areas,
sprains, and strains, neuritis, neuralgia and myalgia, intermittent
claudication, rheumatoid arthritis, cysts, neoplasms and basically
any condition relating to pain, soreness, etc. There are no
known contra-indications to the use of pulsed high frequency
electromagnetic energy (Diapulse) with the basic exception of
administering treatment to a person having a cardiac electro-stimulator
(pacemaker), since the electromagnetic pulse of one may interfere
with the other.
After introducing pulsed high frequency electromagnetic energy
into my practice, I noticed about a 500% patient increase daily,
without any additional physical labor on my part. The machine
(Diapulse) is very versatile in a variety of podiatric problems
for which it can be used effectively. I have listed below the
conditions that we have treated with pulsed high frequency electromagnetic
energy (Diapulse). The study is based on a total of over 685
treatments.
I wish to make note of the fact that the treatments were rendered
in series so that they were spaced as evenly as possible with
a time lapse of no more than two days between treatments. Less
frequent treatments would be undesirable since this would inhibit
a steady increase of circulation to the area involved.
In conclusion, I would certainly recommend that the podiatrist
investigate all concepts of this wide field of physical medicine
and place this important phase of our practice in its proper
use.
Jerome J. Erman, D.P.M., A.N.C.F.S.
1801 Vauxhall Road
Union, New Jersey |
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