Dear Sarah,
Thanks for your message. Comments below to your message.
>Are you sure that use of a preparation containing arnica would be illegal
in UK?
I do know that the use of homeopathic remedy is freely available in the UK.
But we are talking about using Ultrasound with a homeopathic preparation.
Surely this is outside of what we have been taught in the normal epa
application. In UK, we have a strict code of professional conduct (from our
professional body) that confines PT's to practise what have been trained.
Any practice outside that is not acceptable, in view of the safety of the
patients if we all 'dabble' everything that we have come across on our
professional travel.
In this litigation era, I think all PT's should walk carefully in their
clinical practice. What would happen if there is an adverse reaction /
incident while operating under these circumstances (epa + arnica)?
Regards,
Kam
>-----Original Message-----
>From: Sarah Fern Striffler [mailto:[log in to unmask]]
>Sent: 22 October 2000 23:48
>To: [log in to unmask]
>Subject: Re: EPA and evidence based practice
>
>
>Dear Kam,
>
>I appreciate your concern. I practice in the US, & have never
>used Arnica,
>which, BTW, is not necessarily only available in homeopathic
>concentration.
>It is also available as a simple herbal ointment.
>
>Although I know of no preparation containing arnica marketed for use w/
>ultrasound, there are a few herbal preparations now available
>from physical
>therapy supply companies, one of which is "Biofreeze" which
>contains ilex.
>
>My electro & ultrasound professor (who sits on several PT
>boards) clearly
>stated that in this country, any over-the-counter preparation
>can be used
>w/ ultrasound w/o a prescription.
>
>Now, my country does not have any medical school devoted to herbal
>medicine, whereas your country does. Therefore, I would expect your
>country's laws about the use of herbal preparations to be more
>inclusive
>than my country's. There is no official US Herbal Pharmacopeia; I own
>a copy of the (wonderful) British Herbal Pharmacopeia.
>
>Are you sure that use of a preparation containing arnica would
>be illegal
>in UK?
>
>Sarah Fern Striffler, PT
>
>
>
>
>Kam-wah Mak wrote:
>
>> Hi Sarah and Lynda,
>>
>> It is with interest that you have brought up the subject of
>Ultrasound and
>> arnica ointment as coupling medium.
>>
>> I am a bit concerned with using homeopathic remedy
>(basically a drug) as
>> coupling medium and to drive this drug into the tissue with
>US. This is not
>> the norm for the application of US in UK.
>>
>> Just a few questions to ask:-
>> Are you breaking the law of using epa in this manner?
>> Do you have to have specific training (i.e. knowledge on
>remedy etc.) to do
>> this and is the application of US in the manner described in
>your message,
>> recognised by your professional body.
>>
>> I just think we have to be careful on deviating from the
>normal practice of
>> epa, otherwise it is free for all and some will try all
>sorts of techniques
>> on the patients. Their safety must come first.
>>
>> Regards,
>> Kam
>>
>> >-----Original Message-----
>> >From: Sarah Fern Striffler [mailto:[log in to unmask]]
>> >Sent: 22 October 2000 10:24
>> >To: [log in to unmask]
>> >Subject: Re: EPA and evidence based practice
>> >
>> >
>> >Dear Lynda,
>> >
>> >Please share if you have used other herbal preparations or other
>> >applications for arnica w/ ultrasound in your clinic.
>> >
>> >Many thanks.
>> >
>> >Sarah Fern Striffler, PT
>> >
>> >
>> >Lynda Bennett wrote:
>> >
>> >> Re treating gout
>> >> no research project, but if evidence is actually seeing the
>> >benefit... I
>> >> have treated my husband with ice packs - soothes for a short
>> >time; arnica
>> >> ointment after the ice lasts a bit longer as an
>> >anti-inflammatory; but the
>> >> best is ultrasound using the arnica as the contact medium. I
>> >have trialled
>> >> it with several other patients as well - all with almost
>> >instant relief.
>> >> This does not replace medications, but, as an adjunct, it
>> >does give a great
>> >> deal of reduction in pain and consequent improvement in
>> >return to full
>> >> function. Isn't that what physio is about? Trying things out
>> >is how we
>> >> discover things. If it doesn't help your patients, the
>> >question needs to be
>> >> asked "is it the treatment or the method of application, or
>> >the person
>> >> applying it that is the problem?"
>> >> Lynda Bennett
>> >> Australia.
>> >>
>> >> >From: "Goh Ah Cheng" <[log in to unmask]>
>> >> >Reply-To: [log in to unmask]
>> >> >To: <[log in to unmask]>, "'Bruce Gray'" <[log in to unmask]>
>> >> >CC: <[log in to unmask]>
>> >> >Subject: EPA and evidence based practice
>> >> >Date: Wed, 18 Oct 2000 20:26:56 +0900
>> >> >
>> >> >Dear Bruce,
>> >> >You certainly seem to be on a crusade, for some reason or
>> >other. It seems
>> >> >my colleagues on the EPA mail-list feels that your comments
>> >should not go
>> >> >unchallenged. At the very least, your condescending and
>> >inflammatory (no
>> >> >pun intended) language deserves some sort of a response.
>> >> >Yes, there is a parallel mail-list on mailbase dealing
>solely with
>> >> >electrophysical agents and evidence based practice.
>> >Believe it or not,
>> >> >there is actually evidence behind those "ping" machines
>> >that you've chosen
>> >> >to banish to an un-named storeroom in your department.
>> >Believe it or not,
>> >> >also, most of us on the EPA list aren't "a bunch of
>> >conservative old women
>> >> >who know no better". But let's not dwell on beliefs
>> >alone.... lets look at
>> >> >the evidence.
>> >> >If you really are interested in "finding truth", perhaps
>> >you can spend some
>> >> >of the time that you've saved from abandoning a "flawed
>> >anachronistic
>> >> >paradigm", do a MEDLINE or CINAHL or PEDro search and come
>> >back to the
>> >> >list
>> >> >with something more constructive than "electrotherapy sucks".
>> >> >Any self-respecting Physical Therapist in any corner of the
>> >world can tell
>> >> >you that there are problems with some of the modalities
>> >that we use (but
>> >> >perhaps not in the language that you've chosen to taunt us
>> >with). No one
>> >> >can deny that there are many issues that needs further
>investigation
>> >> >regarding its clinical application. Indeed, I can even
>> >agree with you that
>> >> >some of the modalities currently in use (I won't be so bold
>> >as to name
>> >> >them)
>> >> >should be similarly banished to your un-named storeroom.
>> >If you wanted to
>> >> >draw attention to any of this, all you had to do was to be
>> >a bit more
>> >> >specific. But like the Razor (who or what the hell is
>> >Occam??!!) that you
>> >> >were so willing to brandish, your sweeping generalizations
>> >had the reverse
>> >> >effect. There is no way anyone can respond to your
>comments without
>> >> >producing a thesis. This, I am sure, would not go down
>> >well with the rest
>> >> >of the members on PHYSIO or any mailing list. So, instead
>> >of giving you
>> >> >counter arguments that could confine me to this chair I am
>> >sitting on for
>> >> >the rest of my life, let me instead direct you to the
>> >Electrophysical
>> >> >Agents
>> >> >Home Page at
>> >http://health.shinshu-u.ac.jp/PT/electro/index.htm . You
>> >> >won't
>> >> >find all the answers there of course (unlike you, no one
>> >can claim to have
>> >> >all the answers). But at least, you will find some of the
>> >evidence for and
>> >> >some against the modalities that all of us have taken
>for granted.
>> >> >Finally, may I just add that it is my firm belief that
>> >often it is not the
>> >> >modality that is ineffective, but the inappropriate and
>> >sloppy application
>> >> >of the modality that dooms the treatment from the start.
>> >> >Best regards,
>> >> >Goh Ah Cheng, MAppSc (Sydney), PhD candidate (Curtin)
>> >> >Department of Physical Therapy
>> >> >School of Allied Medical Sciences
>> >> >Shinshu University, JAPAN
>> >> >EPA mail-list co-owner
>> >> >Webmaster, EPA Home Page
>> >> >(http://health.shinshu-u.ac.jp/PT/electro/index.htm)
>> >> >Webmaster, EMG Home Page
>> >(http://health.shinshu-u.ac.jp/PT/emg/index.htm)
>> >> >Webmaster, Singapore Physiotherapy Association Home Page
>> >> >(http://www.physiotherapy.org.sg)
>> >> >
>> >> >
>> >> > > -----Original Message-----
>> >> > > From: Bruce Gray [mailto:[log in to unmask]]
>> >> > > Sent: 17 October 2000 09:11
>> >> > > To: [log in to unmask]
>> >> > > Subject: RE: evidence based practice...
>> >> > >
>> >> > >
>> >> > > Just to get the thread back on topic, I am the sole OPD
>> >physio at a Qld
>> >> > > country 90 bed hospital in Australia. I recently put all
>> >the machines
>> >> >that
>> >> > > go "ping" into the back storage room, and there are many
>> >other hospital
>> >> > > storerooms like this.
>> >> > >
>> >> > > So to affirm my point, electrotherapy sucks. There is no
>> >convincing
>> >> > > comparative invivo studies that show it is a better
>> >treatment then the
>> >> > > intelligent appn of ice/heat, rest/movement, and
>> >anti-inflamms. I am
>> >> >talking
>> >> > > everything from US to SWD to laser. My litmus test for
>> >the benefits of
>> >> > > electrotherapy is to go and try the putated anti-inflamm
>> >properties of
>> >> >US
>> >> >on
>> >> > > an acute gout attack.......any of you out there charging
>> >good money to
>> >> >treat
>> >> > > inflammation with electrotherapy instead of encouraging
>> >your patients to
>> >> >go
>> >> > > and get a script for NSAIDs cannot call yourselves
>scientifically
>> >> >trained.
>> >> > >
>> >> > > If you think 30 mins of electrotherapy 2x/wk (if you are
>> >lucky) can do
>> >> > > anything significant to fibroblast or leucocyte
>> >function, then you are a
>> >> > > captive of the dogma of a conservative bunch of old
>> >women who know no
>> >> > > better.
>> >> > >
>> >> > > I urge you all to come join the revolution- throw your
>> >placebo "ping"
>> >> > > machines away, draw out Occam's Razor and slash the ties
>> >that bind you
>> >> >to
>> >> >a
>> >> > > flawed anachronistic paradigm.....choose instead to
>> >never compromise on
>> >> > > finding truth again......
>> >> > >
>> >> > >
>> >> > >
>> >> >
>> >>
>> >>
>> >_______________________________________________________________
>> >__________
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>> >>
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>> >
>
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