In our last week’s blog we spoke about pelvic floor exercises being the primary treatment for both stress and urge urinary incontinence. As outlined in the American Family Physician journal “Bladder retraining and pelvic floor muscle exercises are first-line treatments for persons without cognitive impairment who present with urge incontinence… Pelvic floor muscle exercises are considered first-line treatment for stress incontinence”. While this is true there are some instances where exercises alone are not enough and additional methods are needed.
According to Swiss Medical Weekly journal interferential current can have a positive effect on stress urinary incontinence. That particular study looked at incontinence severity, pelvic floor muscle strength and quality of life and concluded that “All of the parameters improved after the treatments”.
If you suffer from incontinence what does this mean for you? Knowing this should reassure you that there are a number of treatment options available and that if one does not work another one might.
It is very important, though, to realise that interferential therapy should not be the first line of treatment. As discussed in our previous blog the initial step should always be specific pelvic floor exercises prescribed by your physiotherapist following Real Time Ultrasound assessment. Clinical Pilates is a very effective treatment option as the pelvic floor exercises will be incorporated into your program and you will be supervised by your physiotherapist which will ensure that you are performing them correctly. Dietary and lifestyle changes should also be taken into consideration.
If, however, this does not result in a significant improvement, we progress to the next step - interferential therapy. This is a completely pain free and non-invasive treatment which involves placing electrodes on your lower back, where the nerves that supply your pelvic floor muscles pass through. All you will feel will be slight tingling and possibly vibrations, but no pain or discomfort. This is a highly effective treatment as it helps the pelvic floor muscles to work better. Bear in mind, though, that this is a supplementary treatment only. As soon as your pelvic floor strength improves you will once again resume pelvic floor exercises with the aid of Real Time Ultrasound.
Interferential therapy can be utilised at any stage of your treatment. In our practice we have occasionally seen patients progress well initially but then plateau. Also occasionally patients will do well at one phase, for example during lying down exercises, but will then have trouble transitioning to the next stage – sitting down exercises. A few sessions of interferential therapy can then be performed to boost the process and speed up the results. While your physiotherapist will determine how well you are progressing with the exercises and will suggest when it is necessary to include interferential therapy you should always be an active participant in your treatment and work together with your physiotherapist. Often the physiotherapist will rely on your feedback as to how you are going with the exercises and this information will help them in their decision making process.
 Hersh L, Salzman B. Clinical management of urinary incontinence in women. Am Fam Physician 2013; 87 (9): 634-640
 Demirturk F. et al. Interferential current versus biofeedback results in urinary incontinence. Swiss Med Wkly 2008; 138 (21-22): 317-321