Analgesic Effects of Interferential Current Therapy: A Narrative Review

Érika Patrícia Rampazo, Richard Eloin Liebano, Érika Patrícia Rampazo, Richard Eloin Liebano

Abstract

Background and Objectives: Transcutaneous electrical stimulation of low- and medium-frequency currents is commonly used in pain management. Interferential current (IFC) therapy, a medium frequency alternating current therapy that reportedly reduces skin impedance, can reach deeper tissues. IFC therapy can provide several different treatment possibilities by adjusting its parameters (carrier frequency, amplitudemodulated frequency, sweep frequency, sweep mode or swing pattern, type of application (bipolar or quadripolar), time of application and intensity). The objective of this review article is to discuss the literature findings on the analgesic efficacy of IFC therapy. Conclusions: According to the literature, IFC therapy shows significant analgesic effects in patients with neck pain, low back pain, knee osteoarthritis and post-operative knee pain. Most of the IFC parameters seem not to influence its analgesic effects. We encourage further studies to investigate the mechanism of action of IFC therapy.

Keywords: burst-modulated alternating currents; electrical stimulation; electroanalgesia; interferential current; kilohertz-frequency alternating current; medium-frequency alternating currents; physical therapy modalities.

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
The two out-of-phase medium-frequency alternating currents (4000 Hz and 4100 Hz) “interfere” within the tissues and produce an amplitude-modulated frequency (AMF) of 100 Hz. The resulting frequency is 4050 Hz, and the duration of each burst is 10 milliseconds (ms). Hz: hertz.
Figure 2
Figure 2
Sweep mode, slope or swing patterns: (A) 1:1—variation every 1 s; (B) 1:5:1—frequencies increase and decrease in 1 s and are maintained for 5 s; (C) 6:6—frequencies increase and decrease in 6 s; AMF: amplitude-modulated frequency; Hz: hertz; s: seconds.

References

    1. Ozcan J., Ward A.R., Robertson V.J. A comparison of true and premodulated interferential currents. Arch. Phys. Med. Rehabil. 2004;85:409–415. doi: 10.1016/S0003-9993(03)00478-7.
    1. Ward A.R., Robertson V.J., Makowski R.J. Optimal frequencies for electric stimulation using medium-frequency alternating current. Arch. Phys. Med. Rehabil. 2002;83:1024–1027. doi: 10.1053/apmr.2002.33116.
    1. Goats G.C. Interferential current therapy. Br. J. Sports Med. 1990;24:87–92. doi: 10.1136/bjsm.24.2.87.
    1. Jarit G.J., Mohr K.J., Waller R., Glousman R.E. The Effects of Home Interferential Therapy on Post-Operative Pain, Edema, and Range of Motion of the Knee. Clin. J. Sport Med. 2003;13:16–20. doi: 10.1097/00042752-200301000-00004.
    1. De-La-Cruz-Torres B., Martínez-Jiménez E., Navarro-Flores E., Palomo-López P., Abuín-Porras V., Díaz-Meco-Conde R., López-López D., Romero-Morales C. Heart Rate Variability Monitoring during Interferential Current Application in the Lower Back Area: A Cross-Sectional Study. Int. J. Environ. Res. Public Health. 2021;18:3394. doi: 10.3390/ijerph18073394.
    1. Jin H.-K., Hwang T.-Y., Cho S.-H. Effect of electrical stimulation on blood flow velocity and vessel size. Open Med. 2017;12:5–11. doi: 10.1515/med-2017-0002.
    1. Ward A.R. Electrical Stimulation Using Kilohertz-Frequency Alternating Current. Phys. Ther. 2009;89:181–190. doi: 10.2522/ptj.20080060.
    1. Johnson I.M., Tabasam G. An Investigation into the Analgesic Effects of Interferential Currents and Transcutaneous Electrical Nerve Stimulation on Experimentally Induced Ischemic Pain in Otherwise Pain-Free Volunteers. Phys. Ther. 2003;83:208–223. doi: 10.1093/ptj/83.3.208.
    1. Buenavente M.L., Gonzalez-Suarez C., Lee-Ledesma M.A., Liao L. Evidence on the effectiveness of interferential current therapy in the treatment of knee osteoarthritis: A meta-analysis. OA Arthritis. 2014;2:1–9.
    1. Ariel E., Ratmansky M., Levkovitz Y., Goor-Aryeh I. Efficiency of Tissue Penetration by Currents Induced by 3 Electrotherapeutic Techniques: A Comparative Study Using a Novel Deep-Tissue Measuring Technique. Phys. Ther. 2019;99:540–548. doi: 10.1093/ptj/pzz005.
    1. Bellew J.W., Beiswanger Z., Freeman E., Gaerte C., Trafton J. Interferential and burst-modulated biphasic pulsed currents yield greater muscular force than Russian current. Physiother. Theory Pract. 2011;28:384–390. doi: 10.3109/09593985.2011.637286.
    1. Ganne J.M. Interferential therapy. Aust. J. Physiother. 1976;22:101–110. doi: 10.1016/S0004-9514(14)61005-9.
    1. Beatti A., Rayner A., Chipchase L., Souvlis T. Penetration and spread of interferential current in cutaneous, subcutaneous and muscle tissues. Physiotherapy. 2011;97:319–326. doi: 10.1016/j.physio.2011.01.008.
    1. Noble G.J., Lowe A.S., Walsh D.M. Interferential Therapy Review. Part Mechanism of Analgesic Action and Clinical Usage. Phys. Ther. Rev. 2000;5:239–245. doi: 10.1179/108331900786166588.
    1. Melzack R., Wall P.D. Pain mechanisms: A new theory. Science. 1965;150:971–979. doi: 10.1126/science.150.3699.971.
    1. De Domenico G. Pain relief with interferential therapy. Aust. J. Physiother. 1982;28:14–18. doi: 10.1016/S0004-9514(14)60769-8.
    1. Sánchez-Romero E.A., González-Zamorano Y., Arribas-Romano A., Martínez-Pozas O., Fernández Espinar E., Pedersini P., Villafañe J.H., Alonso Pérez J.L., Fernández-Carnero J. Efficacy of manual therapy on facilitatory nociception and endogenous pain modulation in older adults with knee osteoarthritis: A case series. Appl. Sci. 2021;11:1895. doi: 10.3390/app11041895.
    1. Sánchez Romero E.A., Lim T., Villafañe J.H., Boutin G., Riquelme Aguado V., Pintado-Zugasti A.M., Alonso Pérez J.L., Fernández-Carnero J. The Influence of Verbal Suggestion on Post-Needling Soreness and Pain Processing after Dry Needling Treatment: An Experimental Study. Int. J. Environ. Res. Public Health. 2021;18:4206. doi: 10.3390/ijerph18084206.
    1. Johnson I.M. The Mystique of Interferential Currents When Used to Manage Pain. Physiotherapy. 1999;85:294–297. doi: 10.1016/S0031-9406(05)67132-5.
    1. Venancio R.C., Pelegrini S., Gomes D.Q., Nakano E.Y., Liebano R.E. Effects of Carrier Frequency of Interferential Current on Pressure Pain Threshold and Sensory Comfort in Humans. Arch. Phys. Med. Rehabil. 2013;94:95–102. doi: 10.1016/j.apmr.2012.08.204.
    1. Corrêa J., Costa L., Oliveira N., Lima W., Sluka K., Liebano R. Effects of the carrier frequency of interferential current on pain modulation and central hypersensitivity in people with chronic nonspecific low back pain: A randomized placebo-controlled trial. Eur. J. Pain. 2016;20:1653–1666. doi: 10.1002/ejp.889.
    1. Almeida N., Paladini L.H., Korelo R.I.G., Liebano R.E., De Macedo A.C.B. Immediate Effects of the Combination of Interferential Therapy Parameters on Chronic Low Back Pain: A Randomized Controlled Trial. Pain Pract. 2020;20:615–625. doi: 10.1111/papr.12888.
    1. Fuentes C.J., Armijo-Olivo S., Magee D.J., Gross D. Does amplitude-modulated frequency have a role in the hypoalgesic response of interferential current on pressure pain sensitivity in healthy subjects? A randomised crossover study. Physiotherapy. 2010;96:22–29. doi: 10.1016/j.physio.2009.06.009.
    1. Johnson I.M., Tabasam G. An investigation into the analgesic effects of different frequencies of the amplitude-modulated wave of interferential current therapy on cold-induced pain in normal subjects. Arch. Phys. Med. Rehabil. 2003;84:1387–1394. doi: 10.1016/S0003-9993(03)00151-5.
    1. Palmer S.T., Martin D.J., Steedman W.M., Ravey J. Alteration of interferential current and transcutaneous electrical nerve stimulation frequency: Effects on nerve excitation. Arch. Phys. Med. Rehabil. 1999;80:1065–1071. doi: 10.1016/S0003-9993(99)90062-X.
    1. Gundog M., Atamaz F., Kanyilmaz S., Kirazli Y., Celepoglu G. Interferential current therapy in patients with knee osteoarthritis: Comparison of the effectiveness of different amplitude-modulated frequencies. Am. J. Phys. Med. Rehabil. 2012;91:107–113. doi: 10.1097/PHM.0b013e3182328687.
    1. Adedoyin R.A., Ob Olaogun M., Onipede T.O. Effects of different swing patterns of interferential currents on patients with low back pain: A single control trial. Fiz. Rehabil. 2005;16:61–66.
    1. Pivetta K.M., Bertolini G.R.F. ΔF effects on the interferential current accommodation in healthy subjects. Ver. Bras. Med. Esporte. 2012;18:330–332.
    1. Guerra T.E.C., Bertolini G.R.F. Efeitos da variação da rampa de entrega do delta F sobre a acomodação da corrente interferencial em mulheres saudáveis. Ver. Dor. 2012;13:25–29.
    1. Johnson M.I., Tabasam G. A single-blind investigation into the hypoalgesic effects of different swing patterns of interferential currents on cold-induced pain in healthy volunteers. Arch. Phys. Med. Rehabil. 2003;84:350–357. doi: 10.1053/apmr.2003.50005.
    1. Dounavi M.D., Chesterton L.S., Sim J. Effects of Interferential Therapy Parameter Combinations Upon Experimentally Induced Pain in Pain-Free Participants: A Randomized Controlled Trial. Phys. Ther. 2012;92:911–923. doi: 10.2522/ptj.20110104.
    1. Fuentes J.P., Olivo S.A., Magee D.J., Gross D.P. Effectiveness of Interferential Current Therapy in the Management of Musculoskeletal Pain: A Systematic Review and Meta-Analysis. Phys. Ther. 2010;90:1219–1238. doi: 10.2522/ptj.20090335.
    1. Hussein H.M., Alshammari R.S., Al-Barak S.S., Alshammari N.D., Alajlan S.N., Althomali O.W. A systematic review and meta-analysis investigating the pain-relieving effect of interferential current on musculoskeletal pain. Am. J. Phys. Med. Rehabil. 2021 doi: 10.1097/PHM.0000000000001870.
    1. Zeng C., Li H., Yang T., Deng Z.-H., Yang Y., Zhang Y., Lei G.-H. Electrical stimulation for pain relief in knee osteoarthritis: Systematic review and network meta-analysis. Osteoarthr. Cartil. 2014;23:189–202. doi: 10.1016/j.joca.2014.11.014.
    1. Johnson M.I., Tabasam G. A single-blind placebo-controlled investigation into the analgesic effects of interferential currents on experimentally induced ischaemic pain in healthy subjects. Clin. Physiol. Funct. Imaging. 2002;22:187–196. doi: 10.1046/j.1475-097X.2002.00416.x.
    1. Gomes C.A.F.d.P., Dibai-Filho A.V., Moreira W.A., Rivas S.Q., Silva E.d.S., Garrido A.C.B. Effect of adding interferential current in an exercise and manual therapy program for patients with unilateral shoulder impingement syndrome: A randomized clinical trial. J. Manip. Physiol. Ther. 2018;41:218–226. doi: 10.1016/j.jmpt.2017.09.009.
    1. Nazligul T., Akpinar P., Aktas I., Unlu O.F., Cagliyan Hartevioglu H. The effect of interferential current therapy on patients with subacromial impingement syndrome: A randomized, double-blind, sham-controlled study. Eur. J. Phys. Rehabil. Med. 2018;54:351–357. doi: 10.23736/S1973-9087.17.04743-8.
    1. Albornoz-Cabello M., Pérez-Mármol J.M., Quinta C.J.B., A Matarán-Peñarrocha G., Castro-Sánchez A.M., Olivares B.D.L.C. Effect of adding interferential current stimulation to exercise on outcomes in primary care patients with chronic neck pain: A randomized controlled trial. Clin. Rehabil. 2019;33:1458–1467. doi: 10.1177/0269215519844554.
    1. Liu Y., Qu L., Wang X., Xiong W., Li W., Abula H. Effects of warm acupuncture combined with stereo-dynamic interferential electrotherapy on clinical efficacy and hemodynamics of cervical spondylotic radiculopathy. Int. J. Clin. Exp. Med. 2020;13:3556–3563.
    1. Lara-Palomo I.C., Ferrandiz M.E.A., Matarán-Peñarrocha G.-A., Saavedra-Hernández M., Granero-Molina J., Fernández-Sola C., Castro-Sánchez A.M. Short-term effects of interferential current electro-massage in adults with chronic non-specific low back pain: A randomized controlled trial. Clin. Rehabil. 2012;27:439–449. doi: 10.1177/0269215512460780.
    1. Albornoz-Cabello M., Maya-Martín J., Domínguez-Maldonado G., Espejo-Antúnez L., Heredia-Rizo A.M. Effect of interferential current therapy on pain perception and disability level in subjects with chronic low back pain: A randomized controlled trial. Clin. Rehabil. 2016;31:242–249. doi: 10.1177/0269215516639653.
    1. Franco K.M., Franco Y.D.S., Oliveira N.B.d., Miyamoto G.C., Santos M.O., Liebano R.E. Is interferential current before pilates exercises more effective than placebo in patients with chronic nonspecific low back pain? A randomized controlled trial. Arch. Phys. Med. Rehabil. 2017;98:320–328. doi: 10.1016/j.apmr.2016.08.485.
    1. Defrin R., Ariel E., Peretz C. Segmental noxious versus innocuous electrical stimulation for chronic pain relief and the effect of fading sensation during treatment. Pain. 2005;115:152–160. doi: 10.1016/j.pain.2005.02.018.
    1. de Paula Gomes C.A.F., Politti F., de Souza Bacelar Pereira C., da Silva A.C.B., Dibai-Filho A.V., de Oliveira A.R., Biasotto-Gonzalez D.A. Exercise program combined with electrophysical modalities in subjects with knee osteoarthritis: A randomised, placebo-controlled clinical trial. BMC Musculoskelet Disord. 2020;21:258. doi: 10.1186/s12891-020-03293-3.
    1. Alqualo-Costa R., Thomé G.R., Perracini M.R., Liebano R.E. Low-level laser therapy and interferential current in patients with knee osteoarthritis: A randomized controlled trial protocol. Pain Manag. 2018;8:157–166. doi: 10.2217/pmt-2017-0057.
    1. Kadı M.R., Hepgüler S., Atamaz F.C., DeDe E., Aydoğdu S., Aktuglu K., Ozkayın N., Ozturk C. Is interferential current effective in the management of pain, range of motion, and edema following total knee arthroplasty surgery? A randomized double-blind controlled trial. Clin. Rehabil. 2019;33:1027–1034. doi: 10.1177/0269215519829856.
    1. Franco Y.R., Franco K.F., Silva L.A., Silva M.O., Rodrigues M.N., Liebano R.E. Does the use of interferential current prior to pilates exercises accelerate improvement of chronic nonspecific low back pain? Pain Manag. 2018;8:465–474. doi: 10.2217/pmt-2018-0034.
    1. Adedoyin R.A., Olaogun M.O., Fagbeja O.O. Effect of Interferential Current Stimulation in Management of Osteo-arthritic Knee Pain. Physiotherapy. 2002;88:493–499. doi: 10.1016/S0031-9406(05)60851-6.

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