If you have an injury that causes pain and limited mobility, you may benefit from working with a physical therapist (PT) to help decrease your pain and improve your function. Your PT may use various treatments to augment your rehab program. One such treatment is iontophoresis.
Iontophoresis is a therapeutic modality often used by physical therapists to treat a variety of conditions. It is a type of electrical stimulation that is used to administer medication into your body through your skin.
How Iontophoresis Work
To understand the basic principles of iontophoresis, you should remember some basic lessons from physics and chemistry class. In general, ionic charges that are alike will repel one another, while ions that are oppositely charged will be attracted to one another.
So if you have a medicine in a solution that is negatively charged and you apply a negative electrical charge to it, the medicine in solution will be pushed away, or repelled, from the negative electricity. When using iontophoresis, your physical therapist is using electricity to push medicine into your injured tissues.
The medication used in iontophoresis is ionically charged. So if your physical therapist decides to introduce medication into your injured tissues via iontophoresis and that medication is negatively charged, he or she will use a negative current to drive that medication into your body.
There are many different uses for iontophoresis. These include, but are not limited to:
- Decrease inflammation
- Decrease pain
- Decrease muscle spasm
- Decrease swelling and edema
- Reduce calcium deposits in the body
- Manage scar tissue
Your PT will work with you to decide on the treatment goals and the rationale for using iontophoresis.
Before applying iontophoresis, your PT must first decide on which type of medication to use. The medication used in iontophoresis depends on the goals of the treatment. Different medications have different effects on the body, and your PT will decide on the best medication for your specific condition.
Iontophoresis can be used in physical therapy for the local delivery of anesthetics (such as lidocaine), cortisteroids, anti-inflammatory drugs. and analgesics to inflamed joints, muscles, and subcutaneous tissues.
Many states require that your PT obtain a prescription from your healthcare provider before administering the medication into your body via iontophoresis. Don't be surprised if your therapist contacts your healthcare provider or asks you to contact your healthcare provider prior to administering iontophoresis medication.
A direct current electrical stimulation unit is used to apply iontophoresis. The unit has two electrodes; one electrode is for the negative current, and one is for the positive current. Your PT will apply medication to either the positive electrode or the negative one, depending on the type of medication that is being used for iontophoresis.
The electrodes are then applied to your body. The electrode with the medication is applied to the area of your body that is being treated. The electrode without the medication is applied to your body nearby. The electrical stimulation unit is then turned on, and the electricity pushes the medication into your injured body part while you relax.
What to Expect
When your physical therapist applies iontophoresis to your body, he or she uses an electrical stimulation device. When the electrical current is turned on, you will likely feel a slight tingling sensation. Sometimes the stimulation feels like a tiny bee sting. If you are uncomfortable during the iontophoresis treatment, notify your physical therapist and adjustments can be made.
A typical iontophoresis treatment takes 10 to 20 minutes, depending on the amount of medication that your PT is administering to you. When your iontophoresis treatment is completed, your PT will remove the electrodes and inspect your skin. Don't be surprised if your skin is red where the medication electrode was placed; this is common after iontophoresis.
Once you receive your iontophoresis treatment, your PT will give you specific instructions. Many times, withholding ice or heat treatments after iontophoresis is recommended since these treatments alter circulation to the injured area. This altered circulation might "wash away" the medication that was just introduced to your body. If you have any questions about what to do after iontophoresis, be sure to ask your physical therapist.
Iontophoresis is a safe procedure, and side effects are minimal. While receiving the stimulation, you may feel a slight pin prick tingling sensation. Redness may also occur underneath the electrodes used for it. Some patients notice some dryness or rough skin in the area where the iontophoresis was administered. This can be mitigated by using skin lotion over the area several hours after receiving the treatment.
In the literature review of 25 iontophoresis studies, including 13 randomized trials, rates of adverse skin reactions varied widely but were mostly mild and did not require treatment.
Keep in mind that iontophoresis is a passive treatment, and the most successful physical therapy programs require you to be actively involved in your care. Active exercises are often the most important component of your rehabilitation, so be sure that your PT gives you a strategy to manage your condition when you are not in the physical therapy clinic.
While generally considered safe, the procedure is not without its limitations and safety issues. When used for systemic drug delivery, iontophoresis machines are classified by the U.S. Food and Drug Administration (FDA) as a class 3 device alongside total artificial disc replacements and implanted neurostimulators.
Due to the lack of research into its affect on fetal health, iontophoresis is contraindicated in pregnancy. It is also contraindicated if you have a pacemaker, metal implant, cardiac arrhythmia, a skin rash, or skin disease.
If your physical therapist considers using iontophoresis for your treatment, you should know if it is likely to be of benefit for your condition. Studies investigating iontophoresis have been performed, some of which are promising than eithe.
A 2015 study published in the journal Physiotherapy examined the role of lidocaine iontophoresis in the treatment of spasticity in children with cerebral palsy. Thirty children were randomized to one of two groups: those who received PT and iontophoresis, and those who only received PT. The group that received iontophoresis showed greater improvements in certain walking variables compared to the PT-only group.
Another study examined the effect of iontophoresis for shoulder impingement syndrome. Eighty-eight subjects with shoulder impingement were randomized into one of three groups: one with placebo ultrasonophoresis and placebo iontophoresis; another with placebo ultrasonophoresis and real iontophoresis; and a third with a real ultrasonophoresis and placebo iontophoresis. The group that received only iontophoresis (without ultrasonophoresis) showed no significant improvements when added to the standard treatment.
In terms of systemic drug delivery, a 2013 study published in the British Journal of Clinical Pharmacology concluded that iontopheresis is "theoretically promising" and, depending on the aims of treatment, may offer advantages over a transdermal patch.
So, iontophoresis may be helpful for some conditions and not in others. But the most important study participant is you. If your PT suggests iontophoresis for your condition, it may be worth a try, but it should not be considered a panacea by any means.
A Word From Verywell
Iontophoresis, a form of electrical stimulation, can be an important part of your physical therapy treatment. It is used to introduce medication into your body to achieve specific therapeutic goals. Iontophoresis may be one treatment that can help you return to normal activity quickly and safely after injury.
Medications Used in Iontophoresis
Frequently Asked Questions
What are the benefits of iontophoresis for sports injuries?
Iontophoresis treatments used with anti-inflammatory medicines can help relieve soft-tissue injuries, joint swelling, and pain related to sprains or bursitis. The advantage of using iontophoresis instead of some other treatments is that it’s non-invasive; it's also faster to administer and it's easy to control the dosage.
Learn More:Common Ways Physical Therapists Treat Sports Injuries
What does iontophoresis feel like?(Video) IONTOPHORESIS | V.V.I TOPIC | FREE 💥 HANDWRITTEN NOTES | ELECTROTHERAPY | PHYSIOTHERAPY| (PART 1/2)
Iontophoresisinvolves electrical currents going through an area of your body. This can cause a tingling sensation while the machine is on. You shouldn’t feel pain or a serious electrical shock, though.
Learn More:Types of Electrical Stimulations Used in PT
How long does iontophoresis take to heal a knee injury?
The number of sessions of iontophoresis you need to help with an injury depends on the injury and your overall health. Research has shown that six sessions of iontophoresis can result in improvement.
Learn More:What You Should Know About Knee Pain(Video) NPTE Practice Questions: PTA/PT Responsibility
Iontophoresis is a non-invasive method of systemic and local drug delivery using an electric field. Iontophoresis enables diffusion of the selected drug via skin, mucosa, enamel, dentin, and other tissues. The amount of delivered therapeutic molecules is about 10–2000 times greater than conventional forms of delivery.
Iontophoresis works by using electricity to deliver medication through your skin and into your injured tissues. It is often used to decrease sweating, especially in the hands and feet, but it can also be used in physical therapy to decrease inflammation and scar tissue, and to reduce pain.
Iontophoresis is a treatment that allows medication to be delivered across your skin to the painful area without having to have an injection into your muscle or soft tissue, through a vein in your arm, or taking a pill.
The electrode with the medication is applied to the area of your body that is being treated. The electrode without the medication is applied to your body nearby. The electrical stimulation unit is then turned on, and the electricity pushes the medication into your injured body part while you relax.
Take off any jewelry you're wearing before you start treatments. Cover any sore spots with petroleum jelly before you start treatment. Remember that petroleum jelly blocks the iontophoresis, so don't use more than you need. If treatments dry out your skin, use a moisturizer afterward.
There are several settings on an iontophoresis machine that can be adjusted to increase effectiveness. These include the session length, current strength, type of current, and anode or cathode settings. Turning up the voltage can make iontophoresis more efficient if a lower voltage setting is not working.
Iontophoresis is generally effective in treating hyperhidrosis. People often undergo 20- to 40-minute treatment sessions several times per week until sweating decreases to a desirable level. At that point, treatments are scheduled less frequently, usually about once per week.
Iontophoresis has many theoretical advantages, including non-invasiveness and avoidance of first-pass metabolism for systemic administration, as well as faster administration and better control of the delivered dose in comparison to the usual passive transdermal formulations.
The operation of the Drionic® Wireless Devices is simple, safe, effective and affordable. The user wets two small felt pads with tap water, slide the pads back into the pad trays turn each device on, place the device under each armpit for 30 minutes. Turn the device off.
By stimulating the iontophoresis electrodes, the electrical current “pushes” the medication into the skin. Treatments can last from 15 to 40 minutes.
Contraindications to iontophoresis include those related to direct electrical stimulation and from the therapeutic agent involved. Patients with a history of hypersensitivity or adverse reactions associated with the delivered drug in question should avoid iontophoresis of the offending agent.
There are two mechanisms that are usually involved in iontophoretic transport. Electro-migration: It is also referred to as electro-repulsion. There occurs movement of ions across a membrane (the skin) under the direct influence of an electric field. There are two electrodes, cathode and anode.
Note that a prescription from a medical professional is often required in the US. For mild to moderate hyperhidrosis, a battery-operated, non-prescription iontophoresis device may suffice, but note that their reported sweat reduction rates are often less than that those of plug-in devices.
- Prepare Site. Prepare the site by trimming hair, cleaning the skin, and drying the area thoroughly.
- Clean Area with Soap and Water. Dry thoroughly. ...
- Fill Electrode with Medication. ...
- Position Joint. ...
- Place Patch. ...
- Secure Patch.
Lidocaine iontophoresis is a method of topical anesthesia where lidocaine is driven into the skin under the influence of electric current. We performed a prospective double-blind, placebo-controlled evaluation of iontophoresis of 2% lidocaine with 1:100,000 epinephrine.
The basis of successful ion transfer lies in physics principle “like poles repel and unlike poles attract'. So, the ions are repelled into the skin by an identical charge on the electrode surface placed over it.
Current was administered using two electrodes. One electrode was filled with the medication. This is the active electrode, and one carbon adhesive electrode as the dispersive electrode.