Micro-current TENS in treating ligament injuries

At the 18th AESM Meeting, Dr. Deborah Marshall presented three representative case studies in which Micro-TENS (micro-current transcutaneous electro-nerve stimulation) treatment was used in the treatment of ligament injuries. It was demonstrated that when used in conjunction with conventional therapy, enhanced healing and shortened recovery time occurred for traumatized ligamental tissue.

One case was a 22-year-old gelding exhibiting clinical signs of trauma within 24 hours after strenuous exercise. Such signs included inflammation, edema and pain on palpation to the medial third of the suspensory area of the right forelimb. Immediate treatment commenced, consisting of soaking the afflicted limb in ice water for 20 minutes, followed by poultice application and oral administration of flunixin meglumine (1.1 mg per kg, b.i.d).

Diagnostic ultrasonography examination within the following 24 hours revealed a lesion in the suspensory ligament, which would normally take up to three months to heal. The anti-inflammatory treatment of the previous day continued, with the addition of an IM injection of 5-ml polysulfated glycosaminoglycan (PSGAG). The animal was placed on stall rest for four days to reduce the chance of further trauma to the ligament.

On the third day, Micro-TENS treatment began, using a MICRO 100 T M Micro Current TENS with the anode and cathode electrode pads covered with conductive gel and respectively placed proximally and distally to the afflicted area. The unit was set up with a current setting of 900 microamperes and a frequency of 9.1 Hz, producing a sloped wave with a 50% duty cycle at a load of 5K ohms. Each cycle is 2 seconds long with polarity positive for one second followed by one second negative. The use of Micro-TENS to accelerate healing of ligament and tendon injuries has been reported elsewhere and seems to enhance cell multiplication in connective tissue and speeds formation of new collagen in injured tendons.

At the end of the two-hour treatment, the unit was shutdown, removed and standing support bandages applied to both forelegs. This treatment was continued daily for the next 21 days, with the animal allowed hand-walking for a week, then given limited turn-out in a small paddock. Each day, prior to placement of the Micro-TENS unit, inspection of the foreleg revealed no signs of edema and associated inflammation.

At the end of the 21-day period, monitoring the injury with another diagnostic ultrasonography examination showed significant healing in the area where the lesion was first discovered. The animal was now permitted to walk under saddle for two weeks, then start jogging. The Micro-TENS therapy continued once a week for a two-hour duration until the animal returned to full exercise.

Dr. Deborah Marshall is a veterinary acupuncturist and chiroprac- tor in Coral Gables, Florida.

794 JOURNAL OF EQUINE VETERINARY SCIENCE