The technology is supported by multiple medical studies, and used by top tennis player Rafael Nadal, football club Barcelona, the French Tennis Federation, as well as multiple national teams in the 2012 London Olympics.

The system is externally applied, non-invasive, and uses patented long wave radio frequencies to create intense tissue stimulation.

To date over 82 papers and studies have been completed highlighting the capability, effects and safety of the INDIBA® system:

* 155 Quotations
* 96 Scientific papers released
* 70 Clinical trials completed/Open series
* 9 References books/Book chapters
* 14 Clinical trials planned and/or ongoing
* 5 Thesis completed
* 1 Thesis ongoing
* 3 Completion of final projects
* 2 Post masters degree completed and ongoing

The Clinical Studies demonstrated that INDIBA® activ ProRecovery:

* Speeds recovery
* Can improve chronic conditions
* Helps reduce pain from the first application
* Aids soft and hard tissue rehabilitation
* Is safe to use

Lifestyle Changes

• Behavior modification
• Exercise
• Support devices

A wide range of treatment options exist for the treatment of knee arthritis. Effectiveness of different treatment varies from person to person. The goal is to reduce pain and increase function of the knee. Behavior modifications involving weight loss, exercise changes and minimizing aggravating activities can accomplish such goals. Losing weight can decrease excess stress on weight-bearing knee joints, which decreases pain while increasing mobility. Switching to activities such as swimming and cycling are less stressful on joints than running and jumping.

Prescribed exercise and physical therapy can strengthen leg muscles around arthritic joints. Stronger muscles can help reduce stress on the knee joints, which can alleviate pain while improving function. Also, supportive devices such as canes, shoe inserts and knee braces have the ability to reduce symptoms. Shoe inserts can cushion mechanical strain during walking to reduce stress on knee joints. Braces can be unloaded or supportive. Unloaded braces shift weight away from the joint, while a supportive brace supports the entire knee during weight loading.

Drug Treatment

• Anti-inflammatory
• Corticosteroids
• Others

Medication treatment is dependent on each individual. Usually, anti-inflammatory pain relievers are the first choice for treatment of early knee arthritis. Non-steroidal anti-inflammatory drugs and COX-2 inhibitors are commonly used for cases of knee arthritis with swelling and pain.

Corticosteroid injections may be prescribed for moderate to severe knee arthritis. A corticosteroid is a hormone normally produced by the adrenal cortex, which has a synthetic equivalent. Corticosteroid injections have been somewhat useful for swelling caused by knee arthritis, but may not be very beneficial in joint mechanics. Also, corticosteroid injections may cause joint damage when used long-term.

Other pharmaceutical treatment options involve a variety of different joint injection compounds. Some doctors feel that hyaluronic acid injections can increase the viscoelasticity of the fluid within the painful joint, which assists in joint mobility. Some rheumatoid arthritis injections use gold salt or other medications.

Surgical Treatment

• Arthroscopic debridement
• Osteotomy
• Total or partial arthroplasty
• Cartilage grafts

Arthroscopic surgery uses fiber optics to remove joint debris and repair torn cartilage, which may exacerbate or cause pain and inflammation in knee arthritis. An osteotomy is used to cut the long bones of the leg to improve knee alignment to reduce symptoms. Partial and total knee arthroplasty removes damaged knee joint cartilage and bone, which is replaced by plastic or metal implants. Cartilage grafting is used to replace damaged knee cartilage with healthy cartilage from other bones in your body. The aim is for the graft to repair the damaged area and alleviate knee discomfort.

Alternative Therapies

Glucosamine and chondroitin can be used as a dietary supplement to reduce knee pain. Both compounds are found in normal joints and it is thought that oral supplementation may help replace decreased amounts of both substances.

As a person ages the discs lose water and become thinner. Older discs may become torn and slip out of place, which can press on spinal nerves and cause pain. Also, thinner disc space causes decreased flexibility and increased friction between vertebrae. Bones and ligaments become enlarged as they try to compensate for the changes.

Spondylosis Defined

Lumbar and cervical spondylosis can be caused by age-related changes, although injury, arthritis and osteoporosis can instigate or aggravate the condition. Since bony changes seen in X-rays of patients with osteoarthritis and degenerative disc disease look the same, spondylosis is often used interchangeably to describe such conditions. Spinal changes usually begin around age 30, but symptoms of spondylosis don’t commonly occur until after 55 years old. In a 1991 study, 85.5 percent of 45 to 64 year olds demonstrated bony growths in the lumbar spine. Also, bony growths were more common in physically active individuals.

Lumbar Spondylosis

The lumbar vertebrae lie in the curvature of the lower back and make up the largest bones of the spinal column. Medical terminology for degenerative diseases in the lumbar spine include vertebral osteophytes, facet arthrosis and disc degeneration. Lumbar spondylosis results in progressive degenerative conditions that can cause spinal instability and nerve entrapment leading to nerve damage. This type of spondylosis may result in lower back, hip, groin or thigh pain, as well as nerve damage affecting the bowel or bladder.

Cervical Spondylosis

Abnormal wear and tear on the bones and cartilage in the neck commonly cause cervical spondylosis. Very active people may be more likely to develop cervical spondylosis. Pain from cervical spondylosis may be near the shoulder blade or spread to the upper arm, forearm or fingers. Muscles may become weaker in one arm more than the other. Long-term degenerative cervical changes may compress spinal nerves and cause permanent disability.

Spondylosis Treatment Options

Many patients who experience symptoms of lumbar or cervical spondylosis will have some long-term symptoms. Often, the symptoms get worse and then improve, although some patients may live with chronic pain. The goal of medical treatment is to alleviate pain and maintain daily living activities.

Since most cases of spondylosis result from aging, non-surgical management is usually prescribed as the first level of treatment. Physical therapy and posture therapy can help strengthen muscles in areas around the affected vertebrae. Medications can be used to treat pain and inflammation, as well as cervical collars, alternating heat and ice, steroid injections and injected anesthetics.

It is uncommon for a person with spondylosis to need surgical treatment. Usually, surgery is only used in cases of severe pain not relieved by other treatments. People who experience neurological symptoms, such as weakness, numbness and unsteady limb control should discuss with their doctor whether to consider surgery is helpful.

Fibromyalgia Defined

The cause of fibromyalgia is unclear, though it runs in families and affects women nine times more than men. Often something, such as a spinal injury, car accident or physical stress, will trigger the beginning of fibromyalgia. A number of causative factors may be involved. Also, a prior diagnosis of other rheumatic diseases may increase your risk of developing fibromyalgia.

Symptoms of Fibromyalgia

Fibromyalgia is a chronic disorder causing pain throughout your musculoskeletal system. Pain and stiffness occur in muscles and tendons, which affect your sleep and cause fatigue. The pain is usually widespread as a dull ache beginning in your muscles. A variety of other symptoms, including headaches, temperature sensitivity, light sensitivity and memory problems, may occur. Such symptoms may be very similar to other rheumatic diseases and diagnosis may be difficult.

Diagnosis of Fibromyalgia

A diagnosis of fibromyalgia should be based on a history of widespread pain lasting more than three months and the presence of tender points. When pressure is put on 18 specific body points and you experience pain from at least 11 of the points, fibromyalgia may be the culprit. Since fibromyalgia does not have a specific test, other diseases with similar symptoms need to be ruled out. For example, hypothyroidism and polymyalgia rheumatica can mimic fibromyalgia symptoms, but can be diagnosed with blood investigations.

Treatments for Fibromyalgia

Treating rheumatism caused by fibromyalgia can be difficult and frustrating. Pharmacological treatments may be prescribed to change chemicals in the brain in response to pain, such as serotonin, norepinephrine and neurotonin. Also, pain blockers or anti-inflammatory medications may be beneficial, as well as sleep assisting medications.

Natural methods of controlling fibromyalgia symptoms can be used alone or in conjunction with medications. Body-based therapies using Tai Chi or yoga may be helpful.

Behavioral therapy can teach symptom reduction skills in your response to fibromyalgia pain. Accupressure, acupuncture and message therapy have been used to treat fibromyalgia as well. Relaxation, sleep and a regular exercise program have proven beneficial to those suffering from fibromyalgia.

How Does It Work?

It is thought that electromagnetic pulses can permeate cells, which enhances intracellular molecular exchange and increases the use of oxygen within cells. Such processes may normalize cellular metabolism, which speeds healing and reduces pain. Normal cell electrical charge is about 90 millivolts, while inflammatory cells register near 120 millivolts and degenerating cells may exhibit charges around 30 millivolts.

Research Results

Even though electromagnetic medical treatments have been around for a long time, current medical practice does not embrace pulsed electromagnetic field therapy. Conflicting research results and a lack of physiological understanding limit the clinical usage of this type of therapy.

Research by P.B. Lee published in “The Journal of International Medical Research” during 2006 supports the use of pulsed electromagnetic field therapy to reduce pain and disability in patients with chronic lower-back pain. Also, it was found that pulsed electromagnetic field therapy is helpful in the management of osteoarthritis in the knee. This study was discussed in 2001 by K. Pfeiffer in correspondence for “Annals of the Rheumatic Diseases.”

Even though further proof of beneficial effects using pulsed electromagnetic field therapy were found for cervical osteoarthritis in 2006 and fibromyalgia in 2009, many other studies indicated no benefit or inconclusive results. A study by Abdelrahim in 2011 found no positive effects of using pulsed electromagnetic field for increased healing in tibial fractures, while a meta-analysis by Schmidt-Rohlfing done in 2011 stated that conclusions about pulsed electromagnetic field therapy efficacy could not be drawn.

Increased amounts of scientific research for the use of pulsed electromagnetic field therapy may provide the answers that the medical community needs to promote such a treatment. With increased knowledge and universal parameter settings, the beneficial effects of using pulsed electromagnetic field therapy to decrease pain and increase healing may be better understood. Until that time, this type of treatment is not generally supported as a treatment option by most doctors.

This type of therapy is used to stimulate cellular response towards repair of damaged and painful tissue. It is an FDA approved device that has been used for skin treatment, dental problems, low-back pain, tendonitis and other inflammatory conditions.

How Does Microcurrent Therapy Work?

Electrical current has been used to treat medical ailments since the early 1900’s, but declined in popularity when the American Medical Association declared electromagnetic therapies unscientific in 1934. In the 1990’s research in using electrical current increased and since then many studies have investigated the use of microcurrent therapy.

Microcurrent increases adenosine triphosphate, or ATP, production in cells during treatment. Since cellular ATP helps with protein synthesis and healing, it is believed that microcurrent therapy speeds healing and recovery. Also, it is believed that natural cellular current is disrupted during injury and microcurrent realignment is needed to aid tissue repair. Microcurrent therapy is generally not used as a treatment, but as a method to alleviate pain associated with particular conditions.

Back Pain

One of the first supported uses of microcurrent therapy was for sciatica caused by disc injuries. Later, studies using microcurrent therapy for back pain in 2004, 2005 and 2009 support its use. Carolyn R. McMakin observed inflammatory protein response and microcurrent therapy for pain associated with spinal trauma and low-back myofascial pain in the “Journal of Bodywork and Movement Therapies” 2004 and 2005. Both studies showed decreased pain scores with microcurrent therapy. Recently, in a 2009 study by J.S. Koopman published in the “Clinical Journal of Pain”, microcurrent therapy showed a positive trend towards its use in aleviating chronic low-back pain.

Tendonitis

Many athletes experience inflammation of tendons, or tendonitis. Tendons connect bone to muscle and receive a large amount of mechanical strain during exercise. Elbow, heal and knee pain from tendonitis is common. Microcurrent therapy has been used in treating Achilles tendonitis, tennis elbow and knee pain. Therapy for tendonitis by R. Aliyev and L. Poltawski in the “Georgian Medical News” and “Physiotherapy Research International” respectively, has shown reduction of pain from microcurrent therapy in both tennis elbow and Achilles pain.

Dental

Dental pain can be caused by a variety of conditions, such as periodontitis, teeth grinding and temporomandibular joint disease. Microcurrent therapy has recently been used for decreasing dental pain in these suffering individuals. Jaw pain was reduced by microcurrent therapy in research by Bharat Rajpurohit in the “Indian Journal of Dental Research” published in 2010. Also, pain from chronic periodontis treatment was reduced by using microcurrent researched by I. Puhar and published in the “Journal of Periodontal Implant Science” for June 2011. Microcurrent therapy may be useful in a variety of dental procedures or conditions that cause pain.

Other Clinical Uses

Data by Michael I. Lambert published in “Medicine & Science in Sports & Exercise” suggests that microcurrent therapy can reduce pain for patients experiencing muscle damage. They also measured reduced inflammatory protein markers in the blood of these patients. In the area of skin care, microcurrent therapy has been used to increase blood flow, decrease muscular spasms, prevent muscular degeneration and treat varicose veins. For others it is used to prevent delayed onset muscle soreness after exercise and decrease pain in those who suffer from fibromyalgia. Microcurrent therapy can be used to reduce pain in a variety of medical conditions.

How Does Cold Laser Work?

Cold lasers use irradiation with minimal temperature elevation of no more than 0.5 degrees Celsius. Non-thermal photons of light emit from the laser, and pass through layers of skin and fat to a depth of 2 to 5 centimeters. The light photons interact with cells to initiate a series of events that promote healing. The laser is a small handheld device, usually the size of a flashlight. During therapy it is placed over the painful area from 30 seconds to a few minutes, depending on the size of the treatment area and the dosage supplied by the laser.

What has the FDA Approved?

The FDA approved the first cold laser for pain therapy in 2002. The 830 Laser was approved for the treatment of carpal tunnel syndrome, a serious ailment affecting the hands and wrists of millions. A variety of cold laser manufacturers exist, and each device is legally marketed for a specific use. The Q Laser System was approved for use in treating osteoarthritis of the hands, while the PL 5000 Laser was approved for use in neck and shoulder pain.

Advantages of Cold Laser Therapy

The procedure is non-invasive, meaning that it does not require any surgical incisions. Also it generally does not react with medications and is sometimes promoted as a way to decrease medication intake. The procedure can be performed during regular office visits and is not painful.

Disadvantages of Cold Laser Therapy

The clinical effectiveness of cold laser therapy has been questioned by some medical practitioners. Many patients do not appear to get satisfactory pain relief from cold laser therapy.

In research by G.E. Djavid published in the “Australian Journal of Physiotherapy”, cold laser therapy combined with exercise was more beneficial than exercise alone in treatment of chronic low back pain. Another disadvantage is that most insurance companies will not pay for cold laser therapy and more than one treatment is needed.

Does It Work?

Controversy still exists over the use of cold laser therapy for treatments of certain conditions. Some clinical trial results seem to support the use of cold laser therapy in hand, shoulder and neck pain.

In research studies using cold laser therapy for carpal tunnel pain by E. Wong G Lee and Baylor University, therapy rapidly alleviated pain, tingling and tenderness, while improving functional hand-wrist performance at a success rate of 77 percent. Also, improvement with cold laser therapy has been reported for fibromyalgia, osteoarthritis and elbow pain. Cold laser therapy research has shown promising results for treating post-mastectomy lymphedema and dental surgery inflammation, but has failed to improve tissues in rheumatoid arthritis or sensorineural hearing loss exhibiting tinnitus.

As the clinical results for cold laser is still unclear, more studies are required to determine its role in clinical practice.

Introduction

It is often promoted in the media that we need calcium and vitamin D supplements. Our skeleton contains the vast majority of the body’s calcium and vitamin D is required to facilitate absorption of dietary calcium. Calcium cannot be created by the body; it can only be obtained through dietary sources. Vitamin D is obtained through sun exposure, food and supplements. The Institute of Medicine recommended increased dietary allowance values in 2010.

How Much Calcium?

The Institute of Medicine recommends a dietary allowance of calcium intake according to age.

Teenagers need the most at 1300 mg per day. Adults only need 800 mg per day, but calcium needs increase again after age 50 for women and age 70 for men. If you consume less than the recommended dietary allowance, supplementation may be recommended by your doctor.

How Much Vitamin D?

Infants need a dietary allowance of 400 international units (IU) per day of vitamin D, while children through adults of age 69 need 600 IU per day. Once a person reaches 70 years old, recommendations increase to 800 IU per day. Supplements may contain vitamin D2 or D3. Vitamin D3 is more effective at maintaining blood calcium levels, the primary physiological function of vitamin D.

Dietary Consumption of Calcium & Vitamin D

Calcium is readily available in certain foods and calcium-fortified foods. Normal dietary sources include dairy products, small fish and some vegetables. Sardines can be a good source of calcium, as well as spinach. Recently, calcium-fortified foods have become very popular. For example, calcium has been added to orange juice, cereal, margarine, bread, water and frozen waffles.

Vitamin D is a bit harder to find in your diet. Good sources of vitamin D include fatty fish, beef liver, cheese and egg yolks. Fortification is often present in orange juice, yogurt, milk and cereal. The best way to activate vitamin D in your body is to expose your skin to sunlight. The ultra-violet light activates vitamin D3 in your skin, where it’s carried to the liver to assist in regulation of blood calcium.

Considerations

Rickets is a disease caused by the lack of vitamin D, calcium or phosphate in your body. If blood calcium is too low, your body will release calcium from your bones to compensate for the insufficiency and your bones will become soft. Rickets was common among children around 1900, but was eradicated once vitamin D supplementation was implemented. Recently, cases of rickets have been increasing. A study in Maine revealed that 48 percent of preadolescent girls were vitamin D deficient and a study in Boston, Massachusetts indicated that 52 percent of Hispanic and black adolescents were deficient.

Exclusively breast-fed infants have a high risk of vitamin D deficiency and low vitamin D levels in the mothers can compound the condition. Reduced exposure to sunlight by using sunscreen, staying indoors or covering your skin will increase your chance of calcium and vitamin D deficiencies. Studies on individuals living in sunny Middle Eastern countries, where most of the skin must be covered, showed 30 to 50 percent of children and adults have insufficient vitamin D levels. Also, as immigration increases and dark-skinned individuals move to higher latitudes, vitamin D deficiency can become a problem. Dark skin pigment prevents low levels of UV light in such latitudes from penetrating the skin to activate vitamin D. In any of these high-risk categories, calcium and vitamin D supplements may be beneficial.

Dietary Glucosamine

The United States Food and Drug Administration, or FDA, does not regulate dietary supplements. No guarantee of purity or safety is enforced in these products. Read the labels carefully and compare the price per day. A typical daily dosage is 1500 milligrams per day. When glucosamine products were analyzed, it was found that some of the product labels did not represent the true glucosamine content. Actual amounts ranged from 0 to 100 percent. It is thought that liquid forms of glucosamine will be less likely to contain fillers than pill forms.

A study published in the “New England Journal of Medicine” by D.O. Clegg and co-authors, suggests that glucosamine and chondroitin given separately to different patients did not reduce osteoarthritis knee pain. Glucosamine given in combination with chondroitin showed a possible effect for reducing pain in those with moderate-to-severe knee osteoarthritis. Others believe that it is the sulfate that is important to cartilage. Therefore, glucosamine sulfate has the potential to be more beneficial than the other two, though no clear proven physiological value has been found for any of the dietary glucosamine supplements.

Topical Glucosamine

Topical glucosamine is sold as a cream to apply directly over the area of pain. A study by M. Cohen in the “Journal of Rheumatology” suggests that topical glucosamine with chondroitin was effective in relieving arthritis pain, though other reputable medical authorities indicate that there is no clear evidence of topical glucosamine helping patients with joint pain.

Glucosamine & Diabetics

Since glucosamine is considered to be a type of sugar, concerns arise about glucosamine supplementation in patients with diabetes. Research has found that glucosamine did not significantly affect blood glucose levels in diabetics, nor did it increase insulin resistance in patients with type 2 diabetes. However, more long-term studies need to be completed to thoroughly evaluate diabetic patient response to dietary glucosamine.

Considerations

Most glucosamine is made from the outer skeletons of shellfish. Vegetarian glucosamine, made from corn, is available as well. Allergic reactions to glucosamine products may be a concern for those with shellfish allergies, although they typically react to the shellfish meat, not the shells.

What is Platelet-Rich Plasma?

Platelet-rich plasma is made from a portion of a patient’s own blood. During the process, the blood is centrifuged to collect the blood platelets into plasma at a concentration 3 to 5 times that of native plasma. Platelets contain numerous grow factors, as well as substances important to wound healing. Once activated, platelet-rich plasma is used to accelerate healing and enhance tissue regeneration.

What Does Platelet-Rich Plasma Do?

Some of the major growth factor proteins in platelet-rich plasma include transforming growth factor beta (TGF-beta), platelet-derived growth factors (PDGF), insulin-like growth factor (IGF) and vascular endothelial growth factors (VEGF). TGF-beta stimulates cellular matrix growth, while VEGF accelerates blood vessel formation. Each growth factor has a particular role in tissue healing and regeneration, some more beneficial than others.

As an injury progresses beyond the initial growth factor inflammatory phase, cellular multiplication and remodeling occur. Along with growth factors, platelet-rich plasma also contains numerous proteins that assist the body in building scaffolds to support the invasion of new cellular growth. Scaffold components include fibronectin, vitronectin and collagen. Since the healing components of blood have been concentrated within platelet-rich plasma, it is proposed that such plasma has the ability to greatly accelerate wound healing and maybe even decrease scar formation in the process.

Regenerative Potential

The potential of platelet-rich plasma therapy to regenerate tissues depends on the levels of released proteins. The concentration of the proteins will vary depending on the patient’s platelet concentration, the processing technique and the activation phase. Since growth and healing proteins have to be released from the platelets before they can be measured, the method chosen for activation may provide more or less release of such factors. Also, the platelet concentration may not always predict the levels of protein factors.

Clinical Use

While the clinical use of platelet rich plasma therapy shows much promise as a regenerative treatment for many conditions, especially patients with tennis elbow, knee pain, and shoulder injuries, it is important to discuss with your doctor what results to expect, and consider any alternatives which may be also effective in your situation.