By May 2018, the entire left leg had swollen and the clinic gave a diagnosis of Secondary Lymphoedema (1), prescribing a class 1 compression garment (below knee, open toe) and the client was provided with skin care advice and simple exercises to be carried out.
In August 2018, the lady began to experience further pain to the lateral aspect of her knee which was diagnosed as Complete Regional Pain Syndrome (CRPS) (2). Three injections of steroids were administered to the lady in August, September and November 2018, which sadly, had little to no effect.
In July 2019, after several humid nights, the Lymphoedema transferred to the unaffected leg, (which can happen with the nature and anatomy of inguinal nodes), swelling started in the malleolar region which progressed up through the entire leg by December 2019.
Physical Examination
My client initially visited in May 2019. On examination the oedema was soft and non-pitting and there was no evidence of any hyperkeratosis. There were no other relevant underlying health conditions admitted. The client was marginally overweight with a BMI of 27.
Though the client knew the Lymphoedema needed to be treated, she felt that her main problem was the Chronic Regional Pain Syndrome, which was now presenting every night. Disturbed nights had led to exhaustion, both mentally and physically with digestion affected too, as her circadian rhythms were thrown into crisis (sleep ensures our bodies and minds function as they should). The effects of sleep deprivation have been documented throughout history.
Treatment Plan
Deep Oscillation Electrostatic Lymphatic Drainage (DOT)
Applied to both legs for twenty minutes at frequency 200Hz, mode 5, intensity 100. The sensation of DOT electrostatic lymph drainage is that of a gentle, relaxing vibration on the surface of the skin, delivered through the practitioners' vinyl gloved hands or applicators as shown above (which also enable self-treatment).
Some clients dislike being touched with bare hands and the gloves offer a barrier to the direct contact whilst providing protection too for the client and the practitioner; an important aspect of current treatment recommendations.
I use the HIVAMAT 200 (right) the original device created for delivery of this non-invasive therapy.
Deep Oscillation is clinically proven to permeate an 8 cm depth, impacting upon all tissue layers: including the connective tissue.
It is in the interstitial spaces of the connective tissue that we find the build-up of protein solids and excess lymphatic fluid which are in evidence in Lymphoedema.
Kinesio Taping
Applied to enhance volume reduction following treatment, with Client keeping on for two weeks afterwards to enhance effects.
Recommendations for self-care: Simple Lymphatic Drainage (SLD)
To improve the flow of lymph fluid in the healthy lymph vessels. Once the vessels have cleared, the excess fluid from the swollen area can drain away more easily.
Also taught Deep Breathing, Dry Brushing and Skin Care as is advised by Professor Peter Mortimer.
MAGCELL® MICROCIRC (added July 2020)
Magcell magnetic field therapy can positively influence symptoms of neurotoxicities like sensory ataxia, neuropathy and neuropathic pain symptoms.
Moreover, a significant increase in nerve conductivity speed (ulnar nerve) is achieved by the treatment.
After assessing my patient's suitability to Magcell magnetic therapy, it was applied for 15 minutes, 3 x 5 mins to the lateral aspect of the knee.
Results
Client responded well to DOT treatment with a volume reduction (measured by Lymph Cal) of 1 litre in operated left leg reducing volume from 9 litres to 8 litres. In the right leg a reduction of 0.5 litre from 8.3 litres to 7.8 litres. Client also reported a reduction in pain.
Magcell treatment was also well tolerated, with client reporting a 'funny' but not unpleasant, feeling while therapy was being applied. However, she telephoned the following day stating she had slept throughout the night, for a total of nine hours, the first time since surgery in January 2018. My client demanded the treatment again at the second appointment.
After initial providing weekly treatments for both conditions, I have been able to reduce sessions providing a monthly maintenance programme.
Follow up treatments have had the same results with continuing restful nights, now extended to an average of five 'decent' night’s sleep out of seven. On the other two nights, getting "four to five hours without disturbance."
Conclusion
Using Deep Oscillation has revolutionised the treatment I offer in all of my Lymphoedema clients and so these results are really as I anticipated; yet it was the addition of the Magcell magnetic field therapy that seemed to make a significant difference on the targeted CRPS, improving her sleep pattern and her quality of life. I highly recommend both products to practitioners and patients alike.
Dee Stringer, Private Lymphoedema Practitioner
______________________________________________________________________
1. What is Secondary Lymphoedema?
Secondary Lymphoedema may develop for many reasons but occurs generally when the lymphatic system is either damaged or overloaded.
A damaged lymphatic system maybe the result of:
- Complications from cancer treatment such as surgery (particularly when lymph nodes are removed), radiotherapy and some chemotherapy/hormone treatment. In addition, seroma formation and axillary web syndrome may contribute to the development of lymphoedema.
- A wound or skin infection (such as cellulitis), especially when repeated attacks of infection are problematic.
- Severe injury, surgery (for example, vein stripping for a heart by-pass), burns or other trauma
2. What is Complex Regional Pain Syndrome?
Complex regional pain syndrome (CRPS) is a chronic (lasting greater than six months) pain condition that most often affects one limb (arm, leg, hand, or foot) usually after an injury. CRPS is believed to be caused by damage to, or malfunction of, the peripheral and central nervous systems. The central nervous system is composed of the brain and spinal cord; the peripheral nervous system involves nerve signalling from the brain and spinal cord to the rest of the body. CRPS is characterised by prolonged or excessive pain and changes in skin colour, temperature, and/or swelling in the affected area.
Detailed Magcell Information
MAGCELL® is a portable hand device for electrode-free electrotherapy. Magnetic alternating fields are produced over rotation by permanent magnets. A sinusoidal pulsating electromagnetic field (PEMF) is generated over the special magnet arrangement and device function principle. However, with a value of 0,105 tesla field strength it is many times higher than for commercially available magnetic field therapy devices with coils or mats, which generally operate with field strengths of maximum 100 gauss or 0.01 tesla. By contrast MAGCELL®-therapy units produce field strengths, which are generally stronger by factor 10 than these devices.
According to induction law induced time-variable magnetic fields induce electric fields. The physical effects of MAGCELL® derive from the electric fields produced in living cells and tissue based on induction law. Depending on tissue conductivity the field incites an electric current. Considering the specific conductivity for various body tissue and liquids, this electric current can be calculated. Its strength, or more precisely, current density (= current strength per area, A/m²) determines biological effectiveness.
All calculated current densities exceed 10 mA/m² and are thus within the range of effects internationally confirmed and classified as ‘good‘: above the ‘subtle biological effects‘ and within the range of ‘confirmed macro effects‘ (10-100 mA/m²). Induced current densities are much higher again in blood and body fluids. The term ‘electrode-free electrotherapy‘ for MAGCELL® derives from the distinctly strong induced current densities and exceeding of the threshold value of 10 mA/m²: both of which are not found on equipment using coils or mats.
Body fluids (e.g. joint fluid) play a key role in the relevant therapy indications for MAGCELL® devices. The cells in this fluid or adjacent tissue are exposed to the established current densities. MAGCELL® exceeds by far the recognised effective current densities so that treatment is effective even at a tissue depth of 3-5 cm. MAGCELL® also induces above-threshold current densities in the blood, which are crucial for clinical therapy effects, for instance in respect of blood flow stimulation and immunomodulatory processes. The same applies for interstitial liquids, which moreover are found in virtually all organs and tissue. In bones and fatty tissue with low conductivity current densities are well below the effectiveness threshold of 10 mA/m², so a therapeutic effect in this tissue can scarcely be envisaged.
Magcell® References
Hitrov N.A., Portnov V.V. (2008): MAGCELL® ARTHRO in der Behandlung von Arthrose im Kniegelenk. Die Naturheilkunde 3, 25-27. - English translation (Hitrov N.A., Portnov V.V. (2008): MAGCELL® ARTHRO in the treatment of osteoarthritis of the knee joint. Naturopathy 3, 25-27.)
Reimschüssel A., Bodenburg P. (2009): Niederfrequente elektromagnetische Felder. Erfolgreich in der Therapie der Myoarthritis des Kiefergelenkes. Die Naturheilkunde 5, 28. - English translation: Reimschüssel A., Bodenburg P. (2009): Low-frequency electromagnetic fields. Successful in the therapy of myoarthritis of the temporomandibular joint. Naturopathy 5, 28.
View other articles on the benefits of Magcell in different fields of application:
- Magcell for osteoarthritis for knee in Lipoedema patient
- Diary of a Wound Healing
- MAGCELL® MICROCIRC leads to volume reduction in benign prostate hyperplasia (BPH) in a relatively short time
- Peripheral Neuropathy Pain Eased with Magcell Microcirc
- Psoriatic Arthritis Sufferer Reports MAGCELL® ARTHRO Relieves Pain And Reduces Anti-Inflammatory Reliance
- Physiotherapist Reports Positive Pain Management Effects of Magcell Arthro for Osteoarthritis
- Type 2 Diabetes Sufferer Describes Self Treatment With MAGCELL® MICROCIRC
- Clinical results and mechanisms of MAGCELL®-therapy in Chemotherapy-induced peripheral neuropathy (CIPN)
- MAGCELL® MICROCIRC successfully managing symptoms of enlarged prostate
- Video: Pulsed high-dose magnetic fields of more than 1000 Gauss are generated with the MAGCELL® ARTHRO
- Potent Stimulation of Blood Flow in Fingers with Magcell
- Study in The Prostate - MAGCELL® VETRI
Deep Oscillation References can be found here
For more information on both products please call 01159 167 685 or email info@physiopod.co.uk. Quotations provided on request.