Vibration and pain management
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Description[edit | edit source]
Vibration therapy uses vibration as a physical tool during treatment. Vibration is the propagation of elastic waves producing deformations and tensions on a continuous medium. The vibratory movement is very short and fast and repeated around an equilibrium position.
Vibration can be applied with different devices, as local therapy or as whole-body vibration.
Physiological basis[edit | edit source]
According to the closed-door theory of Melzack & Wall, low-intensity mechanical stimuli, not aggressive enough to stimulate nociceptors, activates the inhibiting interneurons. Inhibitory neurons intervenes in several processes of regulation of the neurological signal. Without their braking activity, we would have too many nociceptive stimuli/pain experiences. Therefore, applied mechanical vibration can have a summative effect, with other pain control strategies, in reducing behavioral and physiological pain responses.
In vibration therapy, the stimulation of muscle spindles and alpha-motor neurons muscle causes muscle contraction, and it increases electromyographic activity. Oxygen consumption, muscle temperature,and skin blood flow increase directly proportional to vibration. 
Indication[edit | edit source]
- Neuropathic pain: Whole body vibration has positive long term effects on neuropathic pain caused by diabetes. 
- Low back pain. Combined vibration and traction therapy are more effective than traction alone. 
- Heel lance pain among neonates: Mechanical vibration may be an effective and safe method for pain management of heel lance pain among neonates.
- Muscle Pain: Several articles investigate the effects of therapeutic vibration on the Delayed Onset Muscle Soreness (DOMS). Some of them conclude that both the vibration applied locally and the whole body vibration, reduces pain. Furthermore, they point that vibration therapy improved muscular strength, power development, kinesthetic awareness, range of motion, and increased blood flow under the skin.  
Other applications of vibration in Physical Therapy:
Some studies evaluate the effectiveness of vibration as a treatment for spasticity with good results. An article concluded that local vibration can be a safe and effective alternative for chronic post-stroke patients.
As vibrations induce muscle contractions, they may be used to enhance osteoclast metabolism and prevent osteoporosis in patients with reduced mobility.
Contraindications[edit | edit source]
- Blood-thinning medications
- Advanced diabetes
- Heart disease
Clinical Presentation[edit | edit source]
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Key Evidence[edit | edit source]
Resources[edit | edit source]
Case Studies[edit | edit source]
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References[edit | edit source]
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- Butler D, Moseley L.2015. Explain Pain
- McGinnis K, Murray E, Cherven B, McCracken C, Travers C. Effect of Vibration on Pain Response to Heel Lance: A Pilot Randomized Control Trial. Adv Neonatal Care. 2016 Aug 16. Epub ahead of print.
- Ayangco M, Bosco C. The use of vibration as an exercise intervention. Exercise and sport sciences reviews. 2003;31(1):3–7
- Cochrane DJ, Stannard SR, Sargeant AJ, Rittweger J. The rate of muscle temperature increase during acute whole-body vibration exercise. European journal of Applied Physiology. 2008;103(4):441–8.
- Wang S, Wang L, Wang Y, Du C, Zhang M, Fan Y. Biomechanical analysis of combining head-down tilt traction with vibration for different grades of degeneration of the lumbar spine. Medical Engineering and Physics 2016. Published online 2 november
- McGinnis K, Murray E, Cherven B, McCracken C, Travers C.Effect of Vibration on Pain Response to Heel Lance: A Pilot Randomized Control Trial.Adv Neonatal Care. 2016 Aug 16. [Epub ahead of print]
- King L, Almeida QJ, Ahonen H. Short-term effects of vibration therapy on motor impairments in Parkinson's. Neurorehabilitation 2009, vol. 25, no. 4, pp. 297-306
- Shyns F, Paul L, Finlay K, Fergusson C, Noble E. Vibration therapy in multiple sclerosis: a pilot study exploring its effects on tone, muscle force, sensation and functional performance. Clin Rehabil September 2009 vol. 23 no. 9 771-781
- Rittweger J, Beller G, Felsenberg D. Acute physiological effects of exhaustive wholebody vibration exercise in man. Clin Physiol. 2000;20:134–42.
- Hong J, Barnes MJ, Kessler NJ. Case study: Use of vibration therapy in the treatment of diabetic peripheral small fiber neuropathy. International Journal of Diabetes Mellitus. Volume 3, Issue 1, May 2015,72–75
- King LK, Almeida QJ, Ahonen H. Short-term effects of vibration therapy on motor impairments in Parkinson's. NeuroRehabilitation. 2009;25(4):297-306.
- Yang F, Estrada EF, Sanchez MC. Vibration training improves disability status in multiple sclerosis: A pretest-posttest pilot study.J Neurol Sci. 2016 Oct 15;369:96-101.
- Rauch F. Vibration Therapy. Developmental Medicine and Child Neurology 2009, 51 (Suppl. 4): 166–168
- University of Florida Health. Vibration helps reduces pain in chronic sufferers, UF researchers find. Avalaible from https://www.youtube.com/watch?v=u1y-19z-2-I