Bob,

My 80 year old mother, a life long right leg amputee, had knee replacement surgery about 6 weeks ago. While she is mobile and is celebrating her increasing accomplishments, she is suffering from reoccurring leg cramps in her calf muscle (which she refers to as a “charley horse”). She describes the leg cramps as being very painful (note: she has a very high tolerance for pain, so I believe her). Her doctors have said that they have never heard of post operative leg cramps, and so, have not offered any possible solutions.

As a runner, I start eating bananas when I get cramps, but she is allergic to them… so this is not a possibility.

Questions: Have you ever heard of this situation following knee replacement surgery? Do you have any suggestions?

Thanks (in advance),

John P.

Answer to consider:

Hi John,

Historically when a person was having surgery they would put a tens unit on them immediately post operatively and at first the assumptions were the stimulation would:

1.        Lessen need for pain meds

2.       In abdominal area would reduce “gas”, therefore less pain.

Over time it became apparent:

1.        For most surgeries not worth the time, hassle, cost to use tens when drugs did the job and patient only used for couple days in most cases

2.       The “less gas” was probably the result of restoring muscle tone by accelerating tissue repair with the electricity.  The muscle had been literally “cut” and the stimulation we know accelerates tissue repair.

In your Mom’s case what may be happening is she is “favoring” her leg, due to the pain from the knee, and has put additional stress on the calf muscle not only due to pain but has probably shifted her posture which adds additional stress.   Now the issue is not to treat the cramps but to prevent the cramps.

One of reasons tens has helped is it literally reduces the “tenseness, tightness” of the muscles involved and there is less “tightening” of the muscles which often results in “spasms”.  One would intervene when it is felt the calf muscles are getting tense and apply the estim then.  The estim will literally make the muscle relax and prevent the buildup of lactic acid which is what happens when muscles are in constant tightness.  The lactic acid from the fatigue builds up and the result is muscle spasticity or spasms/cramps.

Also before doing any tens have her use warm, MOIST heat to her calf couple times per day to prevent.  The moist heat attracts blood which in turn removes the lactic acid that is building up to cause the cramps.

Both of the above methods do not involve drugs and can be done externally so there is or should be no questions on her alertness, drug interactions, dosage etc.   Of course the two above will be even better if used conjunctively.    When your Mom can, be sure to make sure she is inverting her foot to stretch those calf muscles and increase the elasticity as long term that is also a solution.

Happy Thanksgiving.

bobj

Back pain can result from a biomechanical imbalance in spinal structures.

Your doctor can advise any of these”

• movements to avoid
• may know of a good teacher
• modifications for safety.
• possible interactions with  your medication.

Best to Find a Good Teacher.

Be sure to inform your yoga teacher of any pain or problems in your body, BEFORE the class starts. A good yoga teacher will be able to offer modifications like props and variations to make each pose right for you. You should never feel pain while doing yoga. A stretch and maybe a challenge to the muscle, but if it hurts, back off or stop.

Which Style of Yoga Do I Choose

There are about as many types of yoga, as there are denominations in the church.  Well maybe not quite.

Iyengar yoga is very popular among back pain sufferers, as well as yoga teachers who focus on improving back pain for people. This style of yoga, focuses a lot of attention on proper form. Do the  pose correctly, so you strenthen and stretch the body properly, without straining something. Lots of props, like bolsters, belts, blocks and more, are used to make the poses doable, by even stiff people. Almost anyone can participate. The poses are adapted to each individuals body.

The smartest and most experienced yoga yeacher I know is Lillah Schwartz. She has been teaching teachers for 25 years.

Enjoy one of her videos now. She shares with us a very relaxing pose, Supta Baddha Konasana. You don’t need to be able to pronounce it, in order to enjoy it.

Lillah has a back pain video on her website LightenUpYoga.com/DVDs/yoga_videos.htm

Depression often goes along with this scenario. A feeling of being stuck. People feel frustrated and isolated by their circumstances.

The Infrex Plus May Help

Imagine the freedom a portable pain relief device could bring. Something that works off batteries or AC power. The Infrex Plus is such a unit.

Simply place the electrodes on the skin over the painful area.  The Infrex Plus  delivers electrical impulses to the nerve fibers, underneath the skin surface. Pain signals going to the brain are blocked, via the spinal cord and peripheral nervous system.

The Infrex Plus itself can be placed in a belt pouch that you can wear wherever you go.

What Makes it Better Than TENS

Sure you could do the same thing with a TENS unit. The advantage offered by the Infrex Plus is this -  Interferential mode and TENS together in one unit.

Interferential therapy offers deeper penetration into the tissue. At the same time the electrical sensation from the unit is more comfortable than TENS. This usually also results in better circulation to the affected area. People are more likely to use the unit, because it is a more pleasing sensation. Folks who never got benefit from a TENS unit may be pleasantly surprised with the Infrex Plus.

Carryover relief is quite common with Interferential treatment. That means after you turn the unit off, the pain relief can continue for some time. This usually doesn’t happen with a TENS unit.

Will it Work For Me?

This is a great question. What’s good for the goose is not always good for the gander. The best way to find out is to just try it.

That’s why we offer a free trial. No gimmicks, no catch, we don’t even ask for payment up front. All you need is a doctor’s prescription. We can help you obtain one if you like.

To get started,  just fill out the form on the right side of this web site. Someone from our friendly staff will get one of these in your hands, so you can get going on a better more fullfilling life. Insurance often pays for the unit, so there may be no or little out of pocket cost for you. Don’t just sit there suffering, fill out the form now.

Watch Knee Pain Video - Click Image

A friend has just undergone her second knee replacement surgery and was in excruciating pain.  Prior to now she was using heavy duty narcotic pain meds and was tired of being doped out but also had this severe pain throughout her leg.  The first replacement knee surgery did not take, therefore this second procedure which was much more painful.

This has been an interesting week. I’ve had the opportunity to show her how to use the Infrex Plus unit.

Enlightening Experience

It has been literally decades since I’ve gone to a patient’s home to help so  new experience, but also very enlightening to me since once you see a patient it helps you keep focused on what your real mission is,  helping others not have pain and heal.   Here were my observations:

1.  The first day one major complication was the muscle cramping which occurred during any movement ( cpm being used as well as ice machine ).  Our first mission was to stop the cramping and our remedy was multiple IFT treatments on,  an as needed basis,  to calm the muscles trying  to move them away from tenseness to relaxation.   By second day with approximately 8 or 9,  30 minute interferential treatments the cramping was gone.

2.  The patient described the first day that the one place she was hurting most was the popliteal space ( directly behind knee in crease ) and wanted an electrode put there.  Well the normal electrodes we provided were lacking sufficient “tackiness” and would not stick well enough to go over popliteal area.  On day two I returned with a superior silver electrode which is much tackier and stuck well even allowing some movement.   Going forth we need to look at a larger, better adhering electrode for the patient.  It’ s on our “to do” list as I write.

3.  First day ( this is not first day after surgery, but first day when patient had actually called us,  since she could not take it anymore – hopefully later I’ll find out how long we were post surgery with her ), I saw our patient literally crying and agonizing over her pain so,  in addition to use of interferential,  I left her:

a.  one bergamot oil scented patch which is labeled to relieve “stress” and this was put on her chest so essential oils could be inhaled.

b.  put on lateral inside of knee one Tiger Balm patch

c.  on outside, lateral on affected knee,  rubbed Sombra lotion on.

All of above was done so we could immediately address her most  pressing needs first – pain, much of it due to cramping of leg muscles.  We attacked it with all we had as many of the above products are what are most effective over time for most of our chronic pain patients.

4.  Second day back I showed her and her husband, daughter,  and sister how to use the Tens aspect of the unit.  Width was set at 350 microseconds as we wanted greatest penetration.  Tens was not introduced nor explained on the first day, only on second, and reason for that was wanted to get new electrodes so could put on popliteal space and also patient in so much pain first day doubt she and her sister would have remembered too much information.  She had used only IFT first day and after that first day she was wanting to see if ok for her to get up and walk around house some so showed her tens as as assist modality so she could be more mobile and yet still use tens part as needed.   She had been told our preference was to use the IFT mode with the AC adaptor when possible.  The patient seemed to still prefer the interferential, IFT mode but did like the Tens and was going to use that.

5.  Also on first day had left her one lavender patch to place on her chest to help her sleep as she was in a sleep deprivation situation due to the pain which only made things worse.   By second day she was sleeping longer and more often.

What was learned:

* Better electrodes needed especially for acute situations – electrode tackiness should not dictate placement.

* Use topical pain relieving products when possible and if sleep cycle disrupted then do not fear using essential oils for inhalation.

* Try to intervene as early as possible with IFT post surgery – there’s no reason for the patient to suffer through this when if can start prior to the pain cycle starting then should be better results.  It’s harder to intervene and stop pain once it has been present for long time periods and already into the drug program.

* Cramping is extremely excruciating pain in the affected leg so use interferential to relax the muscles so that does not happen.

* Let the patient decide how often and for how long they want to use Ift mode when in pain.  On this patient she used multiple times during the first 24 hours depending on when was hurting.  I’m not sure one can “overtreat”   but this patient was bedridden the first day of treatment with the unit.

* It’s well documented and known that electrostim will make happen ( 80% of non-union fracture cases ) the healing of bone tissue so seems like e-stim could have helped in first surgery to heal,  rather than redo ( do not know what the complicating factors were such as infection, diabetes etc. so only can guess ). Would estim have prevented the first surgery from failing to mend?  Do not know but would have been cheap and easy to use the unit.  No telling what the second surgery costs and for sure there was a lot of patient discomfort due to pain and missed work.   This lady has a very active physical job.

* Estim,  such as PGS or Tens,  has been shown to help decubitus ulcers heal and accelerate soft tissue heal time in surgical situations so why not use anytime post surgery to facilitate faster heal rates, and less pain through the process.

*  Interferential is a very desirable muscle relaxing form of estim and if had been used earlier maybe the patient would not have had to endure the pain from cramping she did.

* EDUCATE the patient and family (caregivers) well so they understand and also can either help the patient or the patient can self help.  Better understanding then better results will happen.

Will drop by patient’s home tonight to leave some essential oil patches and couple of topical pain patches but from first day of usage of IFT, to second day of explanation of how to use the tens mode, she had improved dramatically as far as pain goes and could now sleep and cramps gone.  Made me feel good that we might have something going here that can help lots of folks not go through this.

Also very appreciative of the orthopedic doctor who was willing to do whatever he could to help his patient.   One phone call and prescription was here.

bobj