Arthritis

Osteoarthritis is a degenerative joint pathology characterized by the progressive destruction of joint cartilage, bone sclerosis and particular osteochondral proliferation, which is clinically manifested by pain exacerbated by movement (initially localized to one or few joints) and progressive functional impotence.

Symptomatology onset, often limited to just one joint, is insidious and undermined by subjective symptoms: pain is initially exacerbated by movement of the joint, especially after a period of immobility, typically on waking in the morning. In a successive phase the pain also appears after prolonged use of the joint, especially in the evening, and goes away on resting. In severely affected joints the pain may reappear even during nightly rest. Intensification in pain may occur on the appearance of a more important inflammation, independently of joint use. There is also a muscular contribution to the onset of pain, as there is often an accompanying antalgic contraction. Pain is often intensified by changes in the weather. Morning stiffness lasting just a few minutes is common, such duration being considerably less than that seen with inflammatory joint diseases. The stiffness recedes with gradual mobilization of the joint which progressively warms up and regains functionality.

Objectively, the joint may present hard swellings due to osteophytic proliferation and capsule thickening. Palpation may highlight localized pain. The skin above may be hot, but is not usually reddened, unless inflammation is increased in which case fluid build-up may also be noted. On passive mobilization there may be joint crepitation.

In addition, there will also be some limitation in joint function, at first limited to a few of the possible movements, initially due to antalgic muscular contraction and subsequently to altered morphology. Osteoarthritis therapy is multi-disciplinary. When the affected joint is not too painful, gradual exercise is useful in maintaining mobility. Especially painful attacks may benefit from the assumption of various drugs, such as salicylates (acetylsalicylic acid) or other non-steroidal antiinflammatories (NSAIDS) such as naproxen, ibuprofen, ketoprofen, diclofenac, and nimesulide, which act as excellent pain symptom reducers. Pharmacological therapy can also make use of chondroprotecting drugs which offer excellent basic support.

Rehabilitation objectives are regaining of function, possibility of recovering new, more developed motor behavior and the adaptability of a skeletal region to more motor tasks. It is often the case that even for the most common motor actions the patient is constrained to use altered movements, in which compensation is sometimes excessive in comparison with that actually needed: the rehabilitative intervention will act exactly at this level.

However, while the problem of joint limitation and reduced muscle recruitment can be confronted with appropriate use of therapeutic exercise in its various applicative possibilities, the approach to pain is more complex, above all in relation to the multitude of possible originating structures and causes. This characterizes the therapeutic choice after careful and exhaustive evaluation.

As already noted, pharmacological treatment of painful symptomatology in these cases is obviated through opportune assumption of pain relievers. However, pharmacological therapy can also be flanked or even substituted in some case by the use of specific electric currents with an analgesic action. Numerous studies have demonstrated the efficacy and usefulness of electric therapies in the treatment of the pain characteristic of degenerative pathologies, while in international literature there have even been papers illustrating the action of new electrotherapy forms in a biological context.

Electrotherapy is considered as a branch of physical therapy which uses electrical current for therapeutic purposes.

All live tissue cells use both electricity and chemistry in every process: for example, electrical processes are used in metabolism, in trans-membrane mechanisms in transmission of pain signals, in inflammatory processes, in muscular contractions and for transmission of nerve signals.

All these processes are always accompanied by biochemical processes, and vice versa, i.e. chemical processes are always simultaneously accompanied by electrical processes.

The use of electricity in the form of electrical currents thus has the aim, within the therapeutic objectives, of influencing the electrical processes in cells.
Horizontal(R) Therapy is a generation of electrotherapy used in the treatment of osteoarthritis due to its ability to stimulate both deep-down and surface joint tissues, simultaneously obtaining both bioelectrical effects (deriving from low frequency, variable intensity stimulatory therapies) and biochemical effects (deriving from non-stimulatory, medium frequency alternating current therapies).