Treatment outcome is highly dependent on the operator's ability to correctly identify electrode positioning areas and fine-tune stimulation intensity. When the procedure is carried out correctly, pain is zeroed out immediately, and the rest of the treatment is automated. To be successful also in more complicated cases the following basic rules must always be followed:
· follow the pain
· listen to the patient
· no pain no treatment
1. Always place and check one channel at a time.
2. Ask the patient to indicate where his/her maximum area of pain is located. In cases when the pain occurs only in specific positions, make sure to position electrodes and monitor efficacy only when there is pain, otherwise the therapy cannot be effective.
3. Imagine a straight line that cuts across the area of maximum pain and place the electrodes outside the area of pain at its extremities. Place the electrodes (horizontally, vertically or diagonally) by following the prevalent direction of pain.
4. Inform the patient that you are going to start increasing the intensity and that he must immediately tell you when he feels the electrodes. The patient will always feel one electrode more than the other.
5. Steadily increase the intensity . When the patient starts feeling a "burn" or a "single sting" under one electrode or the other inform him that you are going to slightly increase the intensity. If after the intensity increase he still feels a constant burn, single sting or feeling of discomfort, you must turn off the electrode intensity and change position. You must move the electrode slightly and resume the procedure from the very beginning.
6. Ask the patient to guide you to maximum intensity. The intensity has to reach the maximum bearable by the patient. The patient must never feel discomfort.
7. Now that the channel has been regulated to patient’s maximum intensity, ask the patient how he feels in the area of pain covered by the electrodes. The patient should immediately feel pain free in that area. If not try to slightly increase intensity. Make sure that the patient is comfortable with the intensity increase. During the treatment increase intensity if necessary.
8. Once the area is free from pain start treating other areas of residual pain by following the same procedure.
9. The treatment session should last at least 30 minutes after the basic regulation to be effective.
10. The standard treatment lasts for 10 consecutive sessions, a two day interruption (for example Saturday and Sunday) is acceptable. Once you are certain of the correct positioning, the patient have to choose the position he is more comfortable with to continue the treatment. Probably the patient’s area of pain will change after the first treatments, this is the reason why if you listen to the patient you will know where to position the electrodes correctly. Never assume that you will place the electrodes in the same area as the previous treatment. Always remember to position one electrode pair at a time. By not checking channel effectiveness one at a time the patient can suffer from a pain increase after the treatment.
Probably the patient’s area of pain will change after the first treatments, this is the reason why if you listen to the patient you will know where to position the electrodes correctly. Never assume that you will place the electrodes in the same area as the previous treatment.
Always remember to position one electrode pair at a time. By not checking channel effectiveness one at a time the patient can suffer from a pain increase after the treatment.
These basic rule are not meant to replace the user manual, that must be carefully read for further important information on the device efficacy and safety.