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Pain Management

Iontophoresis / Phonophoresis

Iontophoresis and phonophoresis are technologies that are capable of enhancing drug penetration through the skin. Phonophoresis uses ultrasonic waves to transmit molecules of drug through the skin, as opposed to iontophoresis, which uses low level electric current. Both techniques are used to treat inflammatory conditions such as arthritis, plantar fasciitis, tendonitis, bursitis, and carpal tunnel syndrome.

Iontophoresis: Many ionic drugs are available including several antivirals, various antibiotics, and other specific drugs. Iontophoresis of ionized drugs provided a 20-60 fold increase in penetration over topical application. Examples of successful applications of iontophoresis include:
• treatment of inflammation/pain of muscles and tendons, including the Achilles tendon
• rapid, noninvasive local anesthesia, particularly for children
• relief of heel pain from bone spurs
• controlling the pain of tennis elbow
• relief of pain from rheumatoid arthritis of the knee
• relief of pain associated with plantar fasciitis
• improvement of jaw function in patients with temporomandibular joint (TMJ) disorders
• management of hip pain in patients with sickle cell disorders (SCD)
• an alternative to steroid injections for therapy of Carpal Tunnel Syndrome
• treatment for scar and tendon adhesions

Phonophoresis (or sonophoresis) combines ultrasound with topical drug therapy to achieve therapeutic drug concentrations at target sites below the skin. A cream or gel containing medications such as corticosteroids, local anesthetics, electrolytes, or antibiotics is applied to the treatment area and then massaged with a transducer head. The technique has been widely used in sports medicine since the 1960s by podiatrists, orthopedists, and physical therapists.

The method of preparation and quality of ingredients used for solutions or gels for iontophoresis or phonophoresis are critical to the success of the therapy and minimizing side effects.

Am J Sports Med. 1997 May-Jun;25(3):312-6
Treatment of plantar fasciitis by iontophoresis of 0.4% dexamethasone. A randomized, double-blind, placebo-controlled study.
Click here to access the PubMed abstract of this article.

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