These can be used in conjunction to manual techniques to assist in the rate of healing.

H-Waves

This is used to stimulate muscle and nerve fibres. At low frequencies it is able to stimulate muscle contractions, which allows contractile tissue to contract stimulating circulation, venous return and lymphatic drainage. It also helps in slowing the atrophy of muscle bulk when the patient is unable to mobilise due to their injury. This may be used when there has been nerve damage to assist in the healing.

At higher frequencies the H-Wave can be used for pain relief, as it is able to work on the nerve fibres that cause pain relief. Although not a cure it is used as a treatment for the symptoms.

TENS

Transcutaneous electrical nerve stimulation is a method of pain relief by using pulsed biphasic rectangular waveform through electrodes on the skin. The principle it works on is on the pain gate theory. The closing of the pain gate by stimulation of the A Delta fibres and descending suppression of pain occurs at the suggested low frequency of 50 - 150 Hz. (similar to the H-Wave machines).It can be used in chronic and acute pain, as long as the area of pain is noted and that it is understood that the TENS is a pain suppressor and not a cure to the problem. Its main effectiveness is with chronic pain where the underlying cause is known and conventional pain relieving methods have not helped.

Ultrasound

This can be used for soft tissue injuries to aid in the healing process. It is able to work at the cellular level there are a number of properties to it which if used incorrectly can be dangerous to the body however one of the affective properties is stable cavitations.

Energy from the ultrasound causes the release of chemical mediators, leading to proliferation of granulation tissue and the activity of fibroblasts. Increased circulation is caused increasing cellular activity of phagocytes and microphages to reduce oedema. The end result is acceleration of the healing process and pain relief.

Another property is the thermal effect, which if used correctly can help with muscle spasm, increased blood flow and increase elasticity in scar tissue. Used in soft tissue injuries and in rare cases of fractures (in the early stages).
Uses of ultrasound:
• Ligamentous and tendon injuries.
• Management of scar tissue.
• Haematoma resolution.
• Increased circulation.
• Arthritic pains and inflammation.
• Bursitis.

Laser

Light Amplification by Stimulated Emission of Radiation. In therapeutic terms low-level laser is used, non-thermal. It works at a cellular level the energy emitted is absorbed by stimulates healing within the tissues. Specific substances are stimulated electrically to emit radiation's that produce greater energy levels. The probe used may be of a single wavelength or cluster. Laser can also be used over acupuncture points.
Uses of low-level laser:
• Wound management; ulcers, postoperative pressure sores.
• Skin conditions.
• Soft tissue injuries; haematomas, sprains.
• Joint conditions; OA, RA, capsulitis, tenosynovitis.
• Fractures
• Chronic pain.