"Pulsed Shortwave Therapy": Quackery?

[steve30]

I recently went to see a local "physiotherapist" to see if he could assist with a problem with my hip. I was anticipating that we might discuss the problem in detail, diagnose what's wrong, what causes it, what I can do to prevent it/improve it etc. But no, his solution was to stick me under some machine for half an hour and bugger off to attend to another patient.

This machine was for "Pulsed Shortwave Therapy", which apparently uses shortwave radio, delivered in pulses to the affected area. I've attached a photo of said machine. Its the tall one on the left. According to the "physiotherapist" it stimulates blood flow to the affected area.

Does anyone have any experience with this kind of stuff? It seems like the kind of thing that patients and practitioners would discuss on the world wide web, but I can't find much about people's actual experiences.

I felt a very slight warming of the area where the antenna was pointed, but its possible that I was just imagining it. More importantly though I came over all faint. When I went to the reception desk afterwards I actually fainted. Is this fainting likely to be down to the "therapy"? Or just coincidence?

Of course I was no better after the "therapy", and it cost me £36  .

Is this just quackery, or do people actually derive benefit from it?

[digsys]

This is likely similar to this thread - www.eevblog.com/forum/projects/magnet-therapy-device/  involving magnetic fields (I was involved in).
It's a pretty complete pro / con / flat-earth / solar roadways discussion :-)  You need to read it ALL though
PS: I'm guessing it is using a very similar principle.

[cdev]

There are a number of technologies that many people assume are quackery (and skepticism is a reasonable response when you see devices of this nature) but some aren't.Transcranial direct current stimulation and transcranial magnetic stimulation are both legitimate areas of research, and lots of people with various health issues have been helped by them. .

They are helping scientists understand the brain.

[Cyberdragon]

That looks legit and expensive, of course that doesn't necessarily mean anything. But if that really is some sort of real diathermy machine (it would have to be microwave then) that he just willy-nilly threw you under just to get your measly 36 pounds... Those things can be somewhat dangerous and shouldn't just be played with like that on people. How do people like that even have any sort of medical license? They should probably even be in jail for this kind of crap.

[Raj]

Sounds like microwave. he might be calling it with all kinds of wankey names cause people might freak out of they were to know, they're being cooked.

Can't confirm that. Just guessing

[Keicar]

Shortwave Diathermy is a real thing if the Wikipedia page is anything to go by:

"Short wave diathermy operations use the ISM band frequencies of 13.56, 27.12, and 40.68 megahertz. Most commercial machines operate at a frequency of 27.12 MHz, a wavelength of approximately 11 meters."

[steve30]

This is likely similar to this thread - www.eevblog.com/forum/projects/magnet-therapy-device/  involving magnetic fields (I was involved in).
It's a pretty complete pro / con / flat-earth / solar roadways discussion :-)  You need to read it ALL though
PS: I'm guessing it is using a very similar principle.

Interesting topic, thanks.

Maybe these things only work if you power them with solar roadway energy?

That looks legit and expensive, of course that doesn't necessarily mean anything. But if that really is some sort of real diathermy machine (it would have to be microwave then) that he just willy-nilly threw you under just to get your measly 36 pounds...

Looking at manufacturers specs, it definitely appears to be shortwave, and not microwave.
Example: https://www.jpmproducts.co.uk/equipment/electrotherapy/curapuls-670-pulsed-shortwave?sku=JPMSHORT670

[Towger]

Example: https://www.jpmproducts.co.uk/equipment/electrotherapy/curapuls-670-pulsed-shortwave?sku=JPMSHORT670

A CD Radio on Channel 13/14, with a 200W burner pointer at you. Thanks, but no thanks. 

[Marco]

Microwave would have next to no penetration, so it would have to be shortwave ... I wonder what the HAMs think about these machines.

Transcranial direct current stimulation and transcranial magnetic stimulation are both legitimate areas of research, and lots of people with various health issues have been helped by them.

How many have been hurt though? How many innocents? The occasional murder spree is after all a side effect of SSRIs for instance. Psychiatric medicine consists mostly of throwing shit at a wall and seeing what sticks ... and occasionally it sticks really really wrongly. It's less science and more the equivalent of percussive maintenance, on unpredictable machines which can do a lot of damage.

[Marco]

Of course I was no better after the "therapy", and it cost me £36  .

Did he tell you to come back if the problem persists? Just putting people under a fancy heat lamp can help with pain and this is a very fancy one. If they are a bit hypochondriac that might be enough or if the problem was transient it would obviate the need for further diagnosis.

Physicians in public healthcare nations make Bayesian decisions to limit healthcare costs. My GP has told me to walk it off on occasion for some pretty crippling pain and I've been lucky enough he was always right. If he was ever substantially wrong I might have preferred to have US healthcare where a battery of expensive tests is standard operating procedure, but it hasn't come to that.

[GeoffreyF]

This is also known as Diathermy.  It's not microwaves.  It's short waves.

The principle of it is medically sound. It is to warm tissues deeper than a simple warm towel could accomplish.  This will relieve a muscle spasm, especially in a deeper muscle.   The job of a physiotherapist is to carry out a doctors prescription, not to diagnose.  Whether you respond to this treatment or not will be used by the doctor to diagnose.

I had problem's with my hip as well. There were attempts at physiotherapy to relieve what I was experiencing.  In the end it provided some relief but did not solve the problem or provide a long term fix.  I ended up with hip replacements.   It's a bit off topic here (though there were many electronic devices involved) but I will say, if it comes to that,  that you should find the best surgeon and simply go with what they advise for treatment.  There are many types of hip and procedures.  I went full nerd on all that, which included an excellent knowledge of human anatomy.   It's all about the surgeon's skill and success.  All the other parts are going to be selected by a good surgeon.  Don't shop for parts, tempting as that might be.

Hopefully you don't need hip replacements.  But, I just thought I would mention it. I delayed that out of understandable fear.  It has been really great except for the metal detectors at airports.  See - we are now back on topic.

[steve30]

Of course I was no better after the "therapy", and it cost me £36  .

Did he tell you to come back if the problem persists? Just putting people under a fancy heat lamp can help with pain and this is a very fancy one. If they are a bit hypochondriac that might be enough or if the problem was transient it would obviate the need for further diagnosis.

Strangely no. I thought he might, as £36 to stick someone under a machine could be quite lucrative, and some people are very enthusiastic about trying these kinds of things. To be honest, I think he'd had enough of me when I fainted at the reception desk.

Hopefully you don't need hip replacements.  But, I just thought I would mention it. I delayed that out of understandable fear.  It has been really great except for the metal detectors at airports.  See - we are now back on topic.

They aren't that bad... yet.

I have some hypermobile joints which can cause pain. This was diagnosed by a physiotherapist years ago when I was complaining about a shoulder problem.  I expect the hip issue is the same kind of problem.

[G7PSK]

Doctors can be pretty useless sometimes, i was sent to a pysio for back pain which would not go away.
It was only when I went back to the quack with a jar of bright red pee that I was sent for a scan and found to have renal cancer, cought just in time as it was beginning to invade the main arteries in the kidney.
Luckily they got it all out just in time,that was nine years ago now.

The physio was also useless gave me two sheets of A4 with some exercises on them and said there was no reason to come back.

[cdev]

TDCS is basically the increase in nerve growth potential facilitated by very low current DC. The equipment is as simple as can be, its just very low voltage -DC current limited - applied in specific places on the person's head using a special hat and gel coated electrodes. Its timed, they use a specific amount of current and time. Ive never done it but Ive read a fair amount about it.

SSRIs are indeed a blunt instrument that I think are likely to cause mood swings in people. I think the thing we need to realize is - its smart to minimize the stress we impose on people. I think one of the major causes of depression is stress, stress hormones - if the stress continues for more than a few days unabated, the corticosteroids start to cause brain damage. Stress hormones are neurotoxic.

How many have been hurt though? How many innocents? The occasional murder spree is after all a side effect of SSRIs for instance.

Hard to say. I do think the brain is fascinating and we have barely begun our learning voyage with regards to it.

[tggzzz]

The job of a physiotherapist is to carry out a doctors prescription, not to diagnose.  Whether you respond to this treatment or not will be used by the doctor to diagnose.

Your other points are sound, but that's incorrect in the OP's country.

I have a lot of time for physiotherapists here. They are unlikely to cause harm (cf chiropractors or osteopaths!). They are self-limiting; there is rarely need for more than 6 sessions. They are cheap and effective for the right problems - often more effective than doctors.

I will note that sometimes "muscular" problems respond best to heating, sometimes to cooling - and there's no diagnostic test to indicate which would be more effective in a given case.

[steve30]

The job of a physiotherapist is to carry out a doctors prescription, not to diagnose.  Whether you respond to this treatment or not will be used by the doctor to diagnose.

Your other points are sound, but that's incorrect in the OP's country.

I have a lot of time for physiotherapists here. They are unlikely to cause harm (cf chiropractors or osteopaths!). They are self-limiting; there is rarely need for more than 6 sessions. They are cheap and effective for the right problems - often more effective than doctors.

Yeah, when my shoulder problem was diagnosed by a physiotherapist several years ago, I was referred by a doctor. There wasn't really much the doctor would have been able to do in a 10 minute NHS appointment other than prescribe some painkillers and give basic advice.

[tggzzz]

The job of a physiotherapist is to carry out a doctors prescription, not to diagnose.  Whether you respond to this treatment or not will be used by the doctor to diagnose.

Your other points are sound, but that's incorrect in the OP's country.

I have a lot of time for physiotherapists here. They are unlikely to cause harm (cf chiropractors or osteopaths!). They are self-limiting; there is rarely need for more than 6 sessions. They are cheap and effective for the right problems - often more effective than doctors.

Yeah, when my shoulder problem was diagnosed by a physiotherapist several years ago, I was referred by a doctor. There wasn't really much the doctor would have been able to do in a 10 minute NHS appointment other than prescribe some painkillers and give basic advice.

The problem in the UK is that there is often a delay of several weeks before you can get an NHS physio appointment. If I feel I might benefit from physio, I prefer to just make a private appointment directly myself, and pay the ~£40.

(To avoid this spiralling off into a political debate, I'll note that is the only case I do that; in all other cases for serious problems I actively choose the NHS over the private route. NHS-vs-private responses will be ignored!).

[wbeaty]

This is also known as Diathermy.  It's not microwaves.  It's short waves.

Not neccessarily.  Microwave diathermy is a thing.  It doesn't give the deep-heating of typical 27MHz units.  But it gets well past the skin, unlike say, IR lamps would.

Google images: microwave diathermy

Find a skin-depth calculator and look up the depth at 30MHz and 2GHz, for salt water or blood: 1.4 ohm-meters.    If you don't want to heat up your joint capsules or internal organs, then use microwave diathermy.

On the other hand, diathermy was one of the only things to fall out of the electrical quack-medical scams of the 1880s-1930s.   Antique diathermy boxes are insanely cool, and some AREN'T based on power-oscillators using 811 tubes, but instead rely on small Tesla Coils and adjustable series-gaps with heatsinks.   The original 1930s catalogs offered violet wands for curing baldness and cancer, and also x-ray tubes for examining your own bones.

Google images: diathermy quack

[rcarlton]

I'm a PT in the USA. When I was in school some 3 decades ago we were taught diathermy did not work and was on the way out. I don't believe in using passive devices for PT much. Closest I come now is electrical muscle stimulation (EMS) which makes the muscles contract 30% harder than you could on your own. Gives you a heck of a work out. Kinesio tape sometimes works, more likely placebo effect. Good old fashion exercise does the most good.

[steve30]

I'm a PT in the USA. When I was in school some 3 decades ago we were taught diathermy did not work and was on the way out. I don't believe in using passive devices for PT much. Closest I come now is electrical muscle stimulation (EMS) which makes the muscles contract 30% harder than you could on your own. Gives you a heck of a work out. Kinesio tape sometimes works, more likely placebo effect. Good old fashion exercise does the most good.

Interesting to hear.

In case anyone is interested, I found a better physiotherapist (who was £4 cheaper), who examined my hip in detail, decided the issue was with ligaments, gave it a good massage, and advised me on home exercises, and reckoned I didn't need to cut down on any sporting activities  . I also went to see him again regarding my hypermobile toe, and he was able to recommend strengthening exercises for me. I'm pleased to report that I am making good progress with both the hip and the toe  .

[Zero999]

It's funny how attitudes change. It turns out that shortwave diathermy is a real thing and it's used quite a lot nowadays. I expect it's mostly a near field effect, as the wavelength of 11m is still long, compared to the antenna used and is probably why indicative or capacitive types are used.

https://en.wikipedia.org/wiki/Diathermy#Short_wave

[cdev]

For people with joint and back problems, you should look into resveratrol, it turns out that several of the things it does are extremely good for joints and the intervertebral discs in the back. Its the go to thing I take whenever I have any kind of ache in any of my joints. It works really quite well. There is a growing body of science on it. It actually helps repair joints, it reduces the pain by reducing the causes of the pain.

Its a brown, dirt like powder, which works the best if you spoon a tiny bit into the corner of your cheek and just let it absorb in several times a day. This is a good thing to know. I'm embarrassed to say my age (very very old! ) but I would not be lying at all to say I felt much older 10 or 15 years ago than I do today.