Innate properties of H-wave® device, a small fiber stimulator provides the basis for a paradigm shift of electro-therapeutic treatment of pain with increased functional restoration associated with human neuropathies: a hypothesis

Townsend Letter for Doctors and Patients,  Jan, 2005  by Kenneth Blum,  Thomas J.H. Chen,  Brian D. Ross

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Summary

The hypothesis that H-wave device, a small diameter fiber stimulator is a paradigm shift of electro-therapeutic treatment of pain associated with human neuropathies is based upon a number of its properties. (1) The H-wave device specifically and directly stimulates the small smooth muscle fibers within the lymphatic vessels. (2) When the lymphatic smooth muscles are stimulated by H-wave device a rhythmic milking action is produced. (3) Chronic inflammation/edema, due to a buildup of large proteins into the lymph fluid, a major factor of pain and disability, is reduced by the milking action of H-wave device and the subsequent elimination of tissue inflammation by the induction of a normalization of transcapillary fluid shifts. (4) Normalization of these fluid shifts produces a negative pressure in the lymphatic system and maintains correct fluid shifts ensuring tissue homeostasis. The H-Wave device assists this function by direct stimulation to the small fiber muscle of the lymphatic system and by indirect stimulation of the small fiber muscles of the skeletal system. The H-wave device was designed to produce the optimal type of muscle contraction for the smooth muscle, "lymphatic" muscle, and skeletal "red slow twitch" muscle fibers via ultra low frequency (2Hz), having quality characteristics of low tension, non-tetanizing and non-fatiguing qualities, which closely mimics voluntary or natural muscle contraction. (5) The H-wave device can stimulate small fibers due in part to its exponentially decaying waveform and constant current generator activity. (6) The main advantage of these technologies, over current applied electrical stimulators (e.g. TENS, IF, NMES etc.), is that H-wave small fiber contraction does not trigger an activation of the motor nerves of the large white muscle fibers or the sensory Delta and C pain nerve fibers, thus eliminating the negative and painful effects of tetanizing fatigue which reduces transcapillary fluid shifts. (7) Another function of the H-Wave device is an anesthetic effect on pain conditions unlike a TENS unit which in the short term, activates a hypersensory overload effect (gate theory) to stop pain signals from reaching the thalamic region of the brain; when the H-wave device is used at high frequency, 60Hz, it acts intrinsically upon the nerve to deactivate the sodium pump within the nerve fiber leading to a long lasting anesthetic/analgesic effect due to an accumulative post synaptic depression. Thus, we hypothesize that because of these innate properties of H-wave device it may provide a paradigm shift for the treatment of chronic inflammatory conditions associated with pain such as compartmental swelling of peripheral entrapment syndromes including, Carpal Tunnel, IVF encroachment among other conditions.

Key words: H-Wave Device, Human Neuropathies, Functional Restoration, Pain, Electro-therapeutic muscle stimulator

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Introduction

The intent of this paper is to illustrate through scientific documentation and referenced evidence-based medical studies that a new paradigm shift in electro-therapeutic treatment utilizing H-wave device, a small diameter fiber stimulator, is a therapeutic alternative to other forms of treatment for human neuropathies.

While the prevention and treatment of neuropathies are global in importance, according to the American Physical Therapy Association of the United States, the current standards for practice of adjunctive therapy of muscle stimulation by an electrical device is an accepted standard in physical therapy in many conditions. The H-Wave device is a specialized muscle stimulator and as the following hypothesis paper will present, is a paradigm shift of electro-therapeutic treatment of pain associated with neuropathies, scientifically- and evidence-based.

H-Wave Device: A description

The primary purpose of the device is to reduce or eliminate chronic pain and inflammation to the affected body part. The primary function is to create interstitial fluid shifts through direct stimulation to the small diameter red muscle fibers and to the smooth muscles of the lymphatic system at very low frequencies. Thus, creating long durational rhythmic milking type of contractions. (1,2) This pumping action eliminates the inflammation, which is so often the cause of disability in accumulative trauma or chronic injuries. (3,4) H-Wave is an exclusive smooth muscle/slow twitch red muscle fiber stimulator.

Mechanisms Involved in Chronic Inflammation

Chronic inflammation/edema is one of the main factors in causing disability while prolonging healing and immobilization of the injured body part. Indeed, reduced functional mobility and decreased healing rates are recognized scientifically as secondary complications associated with unchecked inflammation/edema or reduced fluid shifts within the transcapillary bed. (5-8) Excessive protein accumulation within the interstitial tissue spaces produces this traumatic or irritant inflammation. (9-12)