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Pain products offer variety of approaches
Monday January 21, 2013
The Frosty Mamas gel pack is designed to bend and conform to breast tissue.

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Relief is the goal for several new products, which mostly are new takes on longtime pain treatments based on philosophies about the nature of pain.

When you say ice pack, according to Roy Nicholson, DC, most people think of the "blue, flat, square thing with frost on the outside." Nicholson, a chiropractor for 20 years, developed a hot and cold gel pack after his daughter experienced painful swelling while breast-feeding and all he could suggest was a bag of frozen peas. He came up with a few ideas, but later, while steaming vegetables, Nicholson thought of designing a gel pack similar to the collapsible steamer basket, so it would conform to the tissue.

The Frosty Mamas gel packs have eight curved petal-like appendages that allow the pack to conform to the breast. While originally designed for nursing mothers, Nicholson said, the Frosty Mamas also are helpful for women undergoing cancer treatments or who have had breast surgeries. The gel packs come with a protective clamshell case and a medical-grade polypropylene cloth to protect the skin or provide moist heat therapy.

"It works for any body topography where thereís a bony part with tissue around it," Nicholson said. "When you put this on your skin, we just donít want a little bit of the area covered; we want to cover all of the skin thatís involved in the reaction."

The Frosty Mamas gel packs are pink. The same design is available in a cobalt blue color as Frosty Jocks and a half-size apple-green Frosty Kids version. After retiring from treating humans, Nicholson was certified in veterinary chiropractics and now treats dogs and cats. This led to the creation of the orange Frosty Pet packs.

Biofreeze Pain Reliever delivers cold therapy using 10% menthol, and a recent study focused on patients with knee osteoarthritis showed a clinically significant reduction in pain during functional tasks. The study, led by Joseph A. "Tony" Brosky, PT, DHA, SCS, and Robert Topp, RN, PhD, was published online by the Journal of Geriatric Physical Therapy.

"They were looking at the influence of pain and function and were able to show that when they applied the Biofreeze, [patients] had significantly less pain when they performed those tasks," said Phil Page, PT, ATC, CSCS, FACSM, director of clinical education and research for Performance Health Inc., the producer of Biofreeze.

According to the study, the application of Biofreeze to the affected area also improved performance in three out of five functional tasks.

This month, Performance Health will release Biofreeze 360 Spray, which will allow application from any angle, according to a news release.


Frosty Jocks hot-cold gel pack
Waves of relief

The WellWave uses low-energy extracorporeal shock wave therapy to help patients with acute and chronic pain, according to Sumitra Giri, associate product manager for Richard Wolf Medical Instruments Corp. The WellWave produces targeted sound waves, which penetrate the painful area without harming nearby tissue, she said.

"The waves penetrate tissue to where there is damage, such as scar tissue or fibrosis," Giri said. "Cells in that state are frozen, so they canít heal or regenerate themselves."

The sound waves can promote increased circulation, which accelerates the bodyís healing processes, and provides pain relief, she said. The WellWave has 20 output intensity settings and seven focal lengths, so a clinician can control the amount of energy applied and the depth. The device also allows the clinician and patient to use biofeedback to pinpoint affected areas, which can keep the treatment focused in those places rather than in referred pain areas, Giri said. "If you put the device where there is no scar tissue or trigger point ... [the patient] doesnít feel anything," she said. If the clinician places the device where there is an issue, Giri said, the patient will feel a dull ache.

The WellWave can be used as adjunct therapy for musculoskeletal issues, such as plantar fasciitis and tendonitis. Giri said clinicians also have been successful in treating frozen shoulder using the device.

The ActiPatch, made by BioElectronics Corp., uses pulsed short wave diathermy to ease pain, according to Ian Rawe, PhD, director of clinical research for the company. In the past, similar treatments were delivered using a clinic-based device, but the ActiPatch is much smaller and delivers the same amount of energy to the painful area, but at a much lower intensity for an extended time, Rawe said. "The applications are diverse — any type of body pain, plantar fasciitis," Rawe said. He was part of a recent study, published in The Journal of Ankle and Foot Surgery, which looked at the effects of the ActiPatch on morning pain from plantar fasciitis. The study found ActiPatch users reported a 40% decrease in pain after wearing the device overnight for six days, compared with a 7% decrease in the control group after the same amount of time.

"At the moment, it is available in the U.S. by physician prescription only," Rawe said, adding the device must be applied by a trained clinician. The ActiPatch is affordable, weighs 8 grams, has a battery life of 720 hours and an on-off switch, he said.


Inflam-X Pro addresses inflammation, bruising and pain.
Homeopathic treatment

Gensco Laboratories, the makers of SpeedGel, have released Inflam-X Pro to address inflammation, bruising and pain, according to Gary Walters, PT, vice president of corporate development. Inflam-X Pro contains 13 homeopathic active ingredients in a patented gel that allows the medications to travel through the skin into underlying tissue, Walters said. The over-the-counter product does not cause heating or cooling sensations and has no odor, he said. "It is helping the body facilitate healing," Walters said, instead of blocking the pain signals like products using counterirritants. The FDA in September warned consumers about rare cases of burns after using products containing counterirritants such as menthol, methyl salicylate or capsaicin, Walters noted.

"Because it doesnít enter the bloodstream, if a patient is currently on a regime that includes NSAIDs, they can still use our product and thereís no interaction," Walters said. Inflam-X Pro is contraindicated for women who are breast-feeding because it hasnít been studied, and Walters said the company suggests the gel be applied a minimum of 1 inch away from an open wound or incision.

Gensco also introduced prescription-strength SpeedGel Rx, and several new products are scheduled to launch in 2013.

The future

As the field progresses, Gil Haight, PT, said he thinks a growing market in pain relief will be educational products. "Explain pain. Get patients to understand the mechanisms that the pain system uses," he said. Thanks to neurologic research, clinicians have insight into how some modalities help patients with pain, he said. "The common denominator is that somehow it triggered a therapeutic response from the patientís brain."

Haight and his wife, Cheryl Conard Haight, PT, own Current Physical Therapy in the Green Bay, Wis., area and focus on treating pain using manual therapy, breathing and each patientís instinctive, natural movements. As a patient moves into the later stages of recovery, the goal is to help the person learn a way of moving effortlessly that relieves pain, he said. "If you are training for something, then the experience is very different than therapy for pain relief," Haight said. "You know the last repetition is the hardest, most painful one. If you are managing the pain, as you perform the movements, they should become easier and less painful as you continue." •

Bonnie Benton is a copy editor.


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Monday January 21, 2013
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