My initial posting was mainly as a reaction to the loss of respect for 
intuitive trials when one insists on only using EBP ( yet I accept the 
possibility of inherent legal and ethical risks.)
I do notpropose that anyone should use this treatment. I will relay my 
experience for interest. Maybe someone would like to conduct a research 
project . I am not against research, in fact it fascinates me. But I do get 
very tired of reading so-called research which seems to be only looking 
backwards and can only come up with "nothing works" because there isn't 
enough proof to say that it does work.
I want to use research to trial and prove ideas. I don't want research 
dictating treatment and preventing the development of new ideas.
Anyway...
I have used arnica as a homeopathic remedy in my family for 23 years. The 
ointment is not a homeopathic strength, it is a tincture in a base. I buy it 
from various pharmacies and have my preferred brands usually based on the 
least added ingredients.
I tried it with the ultrasound almost accidentally at first. My husband had 
not long applied the arnica for his gout (Ist MTP) and was still in pain. I 
had the ultrasound nearby and suggested it might help, as we had no usual 
medications on hand and it was Saturday!
The reported relief was greater than ultrasound had given previously, plus 
the visual reduction in redness was apparent within 10 minutes.
Having read articles on phonophoresis I thought I would trial this again, 
with a similar outcome. I treated him morning and night for 2 days, then 
night only for two more days. On this occasion, the treatment was at the 
initial acute phase of the "flare up". He did not need to get the tablets 
after all as it continued to settle well. I think we were probably just 
lucky and since then when the ultrasound is not handy, and the medication 
is, then it is the tablets first.
Other patients asked me to trial it and I did so after consulting their 
physicians. With healthy scepticism we proceeded -  patients had significant 
relief after each treatment and only needed it for a few days for that 
initial inflammation thaaat causes so much pain that it inhibits walking. We 
did not alter the medications. The arnica and ultrasound were only to give 
an immediate relief. I have only applied it once daily and not on very many 
people as it is usually not worth the explanation time. Most patients I see 
would have already commenced medication and would be obtaining enough 
relief.
No I have never tried anything else.
Arnica should be used with care with any patient as it has similar 
properties to other NSAIDS. Believe it or not I am a very cautious person.
Hope you find this interesting.
Lynda.



>From: Kam-wah Mak <[log in to unmask]>
>Reply-To: [log in to unmask]
>To: "[log in to unmask]" <[log in to unmask]>,        
>"[log in to unmask]" <[log in to unmask]>
>Subject: RE: EPA and evidence based practice
>Date: Mon, 23 Oct 2000 13:34:19 +0100
>
>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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> >>
> >> Share information about yourself,
> >create your own public profile at
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> >

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