Treatment of Resistant Myofascial Pain with Microcurrent
Using Specific Microcurrent Frequencies Applied with Graphite/Vinyl Gloves
Presented to the American Back Society, December 11, 1997

By

Carolyn McMakin, MA, DC
Private Practice
Portland, Oregon

Myofascial trigger points are a well-documented source of back, head, neck and face pain.  Travell and Simons have mapped myofascial trigger points in the muscles of the low back, skull, jaw, and cervical spine that refer pain in characteristic patterns.1 Myofascial pain can cause severe and even debilitating pain as well as restrictions in the normal biomechanical function of the joints. It can also cause impairment of normal neurologic function, circulation and lymphatic flow resulting in a variety of symptoms such as lymphatic congestion, vasomotor rhinitis, sinus congestion, difficulty swallowing, ear pain, dizziness, tinnitus, dry cough, blood pressure fluctuations, paresthesias in the face, itchy ears, toothaches, eye pain, blurred or double vision, migraines, tension headaches, bladder irritation, and restrictions in cervical, lumbar and thoracic motion.1, 2 In general, the patient perceives the pain and paresthesia as emanating from the referral area and is unaware of the location of the trigger point causing the pain.1  

When a muscle sustains trauma or when the body is exposed to repeated stressors, the muscle responds with spasm or, more commonly, contracture.  Contracture is a chemical rather than action potential mediated shortening of the muscle.1 Dr. Hans Selye observed that patients responded to repeated stressors with something that he called "calcyphylaxis".  He defined calcyphylaxis as "an induced hypersensitivity in which tissues respond to various challenging agents with a sudden calcification". 4 It didn't matter whether the stressor was chronic illness, severe emotional trauma, multiple or severe injuries to the tissue.  Repeated experience of a sympathetic stress response caused predictable tissue changes.4, 2 These tissue changes caused tightening of the myofascia and muscle contracture promoting formation of a trigger point.2 Travell proposes a more mechanical model in which a traumatic, rapid over-stretching of the muscle or crush injury can rupture the myofibrils causing leakage of calcium from the sarcomere and subsequent contracture.1 Whatever the proposed mechanism, mineral deposits in the myofascia set the stage for contracture and trigger point formation.

Both spasm and contracture cause a reduction in the blood supply to the area decreasing oxygen transport and waste removal, and causing the myofascia to tighten.  Dysfunction in this delicate fascial membrane, which encases each myofibril, disrupts the flow of neurotransmitters. Ground substance within the myofascia changes from a liquid to a gel to a solid further tightening the myofascial tissue.3, 1 The local ischemia in muscles containing myofascial trigger points decreases ATP production, disrupts the sodium pump and normal membrane conductance, and increases metabolic wastes creating a self sustaining cycle of dysfunction which perpetuates trigger point formation.

Treatment of these trigger points has been difficult due to the delicate nature of the structures underlying the cervical or abdominal muscles containing the trigger points.   In some muscles, such as the psoas, the pterygoids, and the suboccipitals, the location of the muscle has made access difficult.1 A series of coincidences has resulted in a very promising new treatment for trigger points using microcurrent applied with graphite/vinyl gloves. 

Traditional Microcurrent Therapy

Microcurrent has typically been used to increase the rate of healing in injured athletes, control pain, increase the rate of fracture repair, and treat myofascial pain and dysfunction.5, 6,7,8 It provides subsensory current to the tissues in millionths of an ampere.  Other widely used electro-therapies provide current in milliamps.  One microamp (ĉA) equals 1/1000 of a milliamp (mA).  

In a study done by Ngok Cheng, MD in rat skin, electro-stimulation of the tissues with microcurrent resulted in remarkably increased ATP concentrations, protein synthesis and membrane transport.  With currents from 50ĉA to 1000(A, the ATP levels were increased threefold to fivefold.  With currents from 100 to 500(A, the stimulatory effects were similar.  With currents exceeding 1000(A, the ATP concentration leveled, and with 5000(A, they were even reduced slightly as compared with the non-treated controls.    Similar effects were noted in regard to protein synthesis.  At about 500(A, there is a tremendous enhancement of protein synthesis, but when the current rose over 5000(A the trend reversed into suppression. 3  

Trauma effects the electrical potential of the damaged cells. The injured area has a higher electrical resistance than the surrounding tissue, decreased electrical conductance and decreased cellular capacitance, leading to impairment of the healing process and inflammation. Microcurrent applied to injured tissue supports the natural current flow in the tissue, allowing cells in the traumatized area to regain their normal capacitance. When microcurrent is applied, resistance is reduced, allowing bioelectricity to flow through and re-establish normal function.  This process helps to initiate and perpetuate the many biochemical reactions that occur in healing.
 
Microcurrent also effects the injured tissue by increasing ATP production and membrane active transport and by allowing the intracellular flow of nutrients and the extracellular flow of waste materials.5, 6,7,8 These effects reverse the ischemic changes and counteract the reduction in ATP synthesis seen in tissues with myofascial trigger points.  In addition, we found that specific microcurrent frequencies affected the tissues in different ways.

Developing a New Treatment Method 

The series of coincidences began in February of 1996 when we purchased a microcurrent instrument normally used for cosmetic purposes that came with a pair of graphite / vinyl gloves.  These lightweight gloves have electric micro-jacks cemented to the dorsal surface and are designed to conduct current and provide good tactile perception.  It was obvious that the gloves would be useful in applying microcurrent to muscular tissue.
 
The second coincidence occurred when one of the Naturopathic students interning in our clinic developed an interest in the work of Dr. Albert Abrams and the other medical physicians of the early 1900's who used specific electromagnetic frequencies to achieve specific therapeutic effects. We applied some of those frequencies to chronic fibrotic myofascial tissue and observed very positive effects. Traditional microcurrent therapies use a limited number of frequencies to affect the tissues.  The most commonly used frequencies are .3 Hz, for increasing healing, 3 Hz for stimulation of acupuncture points, 30 Hz for pain control, and 300 Hz for reducing edema and stimulating lymphatic flow.5

The third coincidence occurred when two chiropractors and one orthopedic surgeon began referring their intractable cases of myofascial pain for treatment providing a large, challenging and varied patient base.  We treated 350 new patients between February, 1996 and June, 1997 and learned something with each success and each frustration.  Treatment techniques and frequencies were refined and improved thanks to these physicians and their patients.

Characteristics of the New Method

Unlike traditional trigger point therapy which requires injections, or firm and often painful pressure1, application of microcurrent to the tissue causes the tissue to soften with minimal to no pressure.  When the frequency is "correct", the tissue relaxes under the therapist's fingers until that frequency has finished its portion of the work.  When the changes stop, further use of that frequency during that session is usually not productive and different frequencies must be used to produce results.  After thousands of patient visits, treating more than three hundred patients, we have established a sequence of frequencies that produce fairly consistent results.  Each time the correct frequency is chosen and applied there is a feeling of the tissue going "smoosh" under the operator's fingers.   The patient generally feels a sensation of warmth, tissue softening and pain reduction.

The sequence of frequencies used is individualized somewhat depending on the condition of the muscles and the operator's perception.  Generally we start with a series for "fibrosis", followed by frequencies used for "mineral deposits", followed by four frequencies for "fibrotic debris". It is interesting that the frequencies we find to be most effective were described as treating conditions such as fibrosis and calcium deposits, which coordinate with the mechanisms for myofascial dysfunction proposed by Selye and Travell. 

There are frequencies thought to be specific for conditions such as fibrosis, scar tissue, mineral deposits, allergy reaction, inflammation, viral infection, and spasm to be combined with frequencies for specific tissues such as veins, muscles, connective tissue, arteries, and nerves.10 There are frequencies used to stimulate healing and remove tenderness. We have available about twenty combinations of frequencies we use on a regular basis.  Some frequencies were derived by trial and error and some were borrowed directly from electromagnetic therapies used by medical physicians in the 1920's to 1940's. 9 We have observed, measured and palpated the effects of the frequencies, but short of dissection or biopsy, there is no way to know with certainty exactly what they are doing to any specific tissue.  

The response is clearly frequency specific.  Time spent using an "inappropriate" or ineffective frequency produces no change in tissue no matter how long the frequency is used.  Changing to a "correct" frequency produces the characteristic softening of the tissue in seconds.  This response occurs even when the operator is unaware of the frequency being used.  We performed trials with the operator blinded to the frequencies and the tissue response was consistent, independent of the operator's expectation or knowledge.  
Theoretical model to explain the effects of specific frequencies 

We hypothesize that specific microcurrent frequencies could cause such dramatic and apparently permanent changes in myofascial tissue in several ways. Microcurrent frequencies may interact or resonate with biochemicals based on the thermodynamic and electromagnetic conditions created by the order of the molecules and their configuration.  A resonance state between a specific frequency and a molecule/configuration combination could cause a shift specific to that combination up to the limit of its ability to change within the surrounding matrix.  This process would happen instantaneously. 

A second feature involves the thermodynamics of organic tissue.  Physical tissue is a collection of biochemicals, molecules arranged in a certain order, formed and folded in a specific thermodynamically stable configuration.  These biochemicals are stable in an "energy well" and would require an energy "boost" to move from one energy well to another.   It is possible that current applied to one stable configuration provides the energy needed to shift the tissue to another stable configuration in a different energy well.   The biochemicals would be in the same order but the tissue would be folded in a different way.  If this hypothesis is correct, the shift would happen instantaneously and would be permanent unless energy, in the form of trauma or overuse, or resonance were applied to move the system back to the prior configuration.  

When these hypothesized mechanisms are added to the known mechanisms of microcurrent to increase ATP production, protein synthesis and membrane transport it is possible to see why the clinical results are so rapid, consistent and lasting.

Results in clinical practice - 1996

We treated 250 new patients in 1996 and examined the results in 137 cases of "simple" chronic myofascial pain in various body regions uncomplicated by disc injury, neuropathy, or severe arthridities, most due to prior trauma or chronic overuse. Symptom duration ranged from 8 months to twenty-two years.  The majority of patients had been treated by one or more prior therapies including prescription drugs, physical therapy, surgery, chiropractic, acupuncture, trigger point therapy and massage. Of those 137 patients, 128 completed treatment.  Pain was reduced in 126 of those 128 from an average 5-8/10 to a 0-2/10.  Two patients had pain reduced from the 5-8/10 range to 3-4/10 range.   Treatment duration varied between 6 and 60 visits depending on the severity, complexity and chronicity of the case.   Patients were told to return if the pain reoccurred or motion became limited.  Only six patients have returned for occasional follow-up treatments.  The results seem to be long lasting and possibly permanent.  No follow-up questionnaires were sent. 

Results in Clinical Practice - 1997

Further refinements in treatment techniques and frequencies resulted in improved patient response and reduced the number of treatments required.  Data was retrieved from the charts of 100 new patients seen between January and June of 1997 and the results are quite encouraging.   There were 50 patients with head, neck or face pain resulting from chronic myofascial complaints.  There were five acute cervical and 21 with chronic low back complaints.  The rest were shoulder, other extremity or thoracic pain. Most of the patients were referred to the clinic by a medical physician, chiropractor, naturopathic physician or another patient. We defined chronic as pain lasting longer than 90 days after the precipitating trauma.

Outcomes in head neck and face pain
Patient
Chronicity Years
Other Tx
# treatments
# weeks
Pain in 
0-10 VAS
Pain out
0-10 VAS

RB
.5
MD,PT
15
12*
9.5
4-5 *

DB
1
MD,PT,ND, BOWEN
10
7
7
2

SC
5
MD,ND
12
8
5
2

MC
2
MD,DC,PT
7
8
6
1

SC

DC,PT
3
2
8
2

AC
ACUTE
DC,MD
14
12
5
0

RD
.25
DC,MD,PT, LAc
11
8
8
3

KD
.75

3
1
3
0

CD
2.5
MD,DC,PT,ND,LAc
14
7
8
0

LD
4
MD,PT,DC, LAc
25
12
8.5
1-3

FE
10
MD,PT,LAc
11
8
8
0-3

MF
7
MD,PT
5
8
8
1

FG
28
DC,LAc
10
10
7
2-3

SH
1
DC
5
3
5-7
3-4

RH
10
MD
5
3
3-8
1-2

KL
8
MD,PT,DC
3
4
6
0

JL
6
DC,LMT
8
8
7
4

LL
.75
DC
15
10
7
0-3

SL
new
DO
20
12
7
1-2

RL
10
DO, ND
7
8
5-7
0

LL
1
DC
9
8
9
3-4

DMC
20
LMT,DC,MD
12
8
5
0

MM
NEW
MD
15
8
5
0

RM
NEW
MD
7
8
7
2

FN
.25
DC
6
6
5
0

VN
2
MD,DC
8
8
4-9
0-2

JP
2
MD
24
20
8
0

DP
2

2
8
7
3

MP
2
DDS,DC,MD
28
20
10
3

CP
.6
DC
8
6
6-10
0-4

AP
.5
MD, PT
13
8
4-5
1-2

CP
4
MD,PT
11
6
7
2

GP
20
MD,PT
12
8
4-8
0-2

KR
2
MD,DC
34
20
6
1-3

KR
N/A

1
1 DAY
3-5
0-1

LS
10
MD,PT,DC
5
8
8
0-2

SS
6
MD,PT,DC
16
12
6-7
0-2

BJS
NEW

11
10
7
0

RS
1
MD,DC
14
3
6
0

LS
.5
ND,DC
10
12
7
0-3

CS
4
MD,DC
10
5
5
0

LT
4
MD,DC,PT
33
12
8
5

MT
.5
MD
3
1
7
2

TT
3
MD,DO
1
1 DAY
5
0

KT
5
MD
8
4
5-7
0-2

LT
2
MD
4
6
8
2

LW
3

6
3
8
0-4

CW
5
MD,PT
10
12
9
4

SW
5
MD,PT,DC,
DDS
31
24
8
0-2

DW
3
MD,DC
5
6
7
0-1

Averages
4.7 years

11.2
7.9 weeks
6.8/10
1.5/10

* Injuries were severe following MVA. Patient discontinued treatment due to cost. 

All but two of the patients with chronic cervical pain experienced significant and lasting pain reduction.  Six of them return for occasional maintenance two to three times a year.  The chronic cervical patients required an average of 11.2 treatments, minimum of 1 and maximum of 34.  The average duration of treatment was 7.9 weeks, minimum of one day, maximum of five months. The pain was reduced from an average of 6.8 to an average of 1.5.   The average length of chronicity was 4.7 years, minimum of 1 year and a maximum of 28 years.  A large number of these patients had pain chronicity of 2 to 5 years. The one patient who didn't benefit significantly had her pain reduced from an 8 to a 5/10 during treatment but the improvement wouldn't hold.  After 33 treatments in twelve weeks, treatment was abandoned. Her injury was four years old and she had been refractory to all other methods of treatment including injections and other mechanical and electro-therapies.

Range of motion was increased in all of these patients but we didn't pull this information from the charts. Increases in flexion/extension of 20§ to 30§ after the first twenty-minute session were and are common.  Approximately 80% of this increase persists until the patient is seen again four days later and eventually becomes permanent.

88% (44/50) of these patients had failed with some other therapy.  75% (33/44) of them had failed with Medical care, 54% (24/44) had failed with Chiropractic, 38% (17/44) had failed with Physical Therapy, 11%(5/44) with Naturopathic, and 6% (3/44) with acupuncture.  Many patients had used two or more of these therapies with minimal to no permanent effect. 

 Outcomes in low back pain
Patient
Chronicity- Years
Diagnosis
Prior Treatment
# Visits
# Weeks
Pain in
Pain out

DB
17
Facet
MD, PT
10
8
7-8
5

KC
10 
729.1
MD,DC,
6
5
7-8
1-2

MF
10
729.1
DC
4
2
9
2

EH
12
729.1
MD
6
5
4-8
0-2

KL
8
729.1
MD,PT,DC
5
6 
4-6
0-2

RL
1.5
729.1
MD,DC
4
6
4-8
2

MMT
2 months
729.1

3
4
6-8
2-3

KM
15
729.1
MD
3
1
7
0-4

JM
NEW
846.3

6
8
7
1

DM
3
729.1

3
4
6-7
1-2

MJM   ***
5
729.1 - 729.0
MD
5  **
4
6
4**

BN
2
FACET-729.1
MD,PT,DC
21
24
4-8
2-3

DP
5
729.1

2
4
4
0

JP
2
729.1 ("Sciatica")
MD
6
8
7
0

GP
20
729.1
MD
4
4
8-9
0-2

LS
11
729.1 729.0
MD,PT
5
5
6-8
0-3

SS
10
729.1
MD, PT
10
10
6-7
2

AS
5
729.1
MD, LAc
6
8
7
0

AS
10
729.1
MD
4
2
6
0-2

LT
7
729.1
MD
6
4
6-8
0

DW
2-3
729.1
MD
2
4
4-9
0-1

TZ
7
729.1
MD,DC
3
3
5-7
0-2

HB
20
729.1
MD,PT
3
3
3-5
1

SA
10
729.1
DC,MD,LMT
8
4
6
2



Averages 23 Chronic
193/23= 8.4yrs
**1
20/23 =87% had seen at least one other practitioner
135/23= 5.87 visits
138/23 = 6 weeks
156.5/23 = 6.8
36/23=1.57= 1.6

1  acute


19/23 - MD
7/23 - DC
6/23 - PT
4/23 - other
114/22 = 5.1 visits
**2
114/22 = 5.1 weeks  **2 



*** Couldn't follow treatment protocol and discontinued care
**1 - Most patients came in with another diagnosis, most often "Chronic low back pain", sciatica, facet syndrome, and degenerative joint disease.  729.1 diagnosis is mine.  When we treated the myofascial trigger points, the pain went away. Therefore, I assume it was a correct diagnosis, or at least it was the diagnosis that was responsible for the pain.
**2 - Removing the one chronic facet patient changed the averages somewhat.

 Treatment Protocol 

Treatments included massage, specific microcurrent frequencies administered with graphite/vinyl gloves and or pads (unattended) and manipulation as needed.   Treatments were twenty to forty minutes long, no more than twice a week.  Treatment frequency reduced to once a week when the patient was pain free for two consecutive visits and reduced to once every two weeks until the patient was functional between visits.  Treatment was discontinued when the patient was still pain free after four weeks without a treatment. 

Microcurrent was the only electrical modality used to treat the myofascial tissue. The microcurrent instrument used was a two channel, "Precision", Monad brand, microcurrent with two-digit frequency specificity and three-place capacity.  For example the numerals 7 and 6 can be modified with a .1, 1, or 10 multiplier to form the numbers 7.6, 76, or 760.  The machine can be used with cotton tipped probes for stimulation of acupuncture points or four leads that attach to either pads or gloves. 

Patients were usually given home stretches and exercises within the first two weeks. Conditioning was gradual and gentle and designed to increase muscle oxygenation and mobility before increasing strength.  Supplements were used to provide the nutrients for proper muscle metabolism and enhance liver detoxification pathway function.  

Treatment advantage in neck and back pain 

The treatment technique made possible by use of the graphite/vinyl gloves is a real advantage in treating the sensitive musculature of the head, jaw and neck.  In order to be effective the current must simply pass through the dysfunctional tissue.  Compression is not essential to the process. This makes it possible, for example, to treat the sub-occipital muscles by inserting one glove into the buccal area at the back of the mouth and placing the other on the suboccipital area.  This intra-oral technique can also be used to treat the pterygoids, digastric, omohyoid, scalenius muscles, cervical paraspinals, levator and trapezius.  The current must travel from the intra-oral glove through the muscles to the external glove wherever it is placed. 

When treating the Psoas, iliacus, quadratus lumborum, and lumbar paraspinals the same principles apply.  The patient is treated while supine with the knees and hips flexed. The gloves are positioned with one hand just inside the iliac crest anteriorly and the other hand under the patient's back.  This requires the current to pass through the psoas and posterior muscles simultaneously.  If there is referred pain down the thigh from the psoas, the current can be polarized with the positively charged glove used on the active trigger point in the psoas and the negatively charged glove placed on the referral area. 

The second low back treatment is done with the patient prone.  The gloves are placed on the lumbar paraspinals bilaterally and the current flows from one side through to the other.  If necessary the "indifferent" hand can be placed under the abdomen if the muscle needs to be treated A to P.   The patient is usually much improved after the first treatment.  The second treatment takes care of the remaining posterior pain.  The subsequent treatments usually address trigger points in the gluteals, TFL, pectineus, or piriformis and maintain the tissue while the patient begins reconditioning.

Unlike injections, which can only treat small areas, this method allows treatment of entire muscles and synergist / antagonistic muscle groups at the same time during the same visit allowing a smooth return of normal biomechanical function to the painful dysfunctional region.  Unlike spray and stretch, which can be awkward to use in certain areas, microcurrent is simple and direct and allows easy access to complex muscle couples.  And, there are no negative environmental hazards associated with the use of microcurrent as far as we know.

Side effects and contraindications

Side effects include a post treatment detoxification reaction starting approximately 90 minutes after treatment and lasting six to twenty-four hours.  Symptoms include slight to moderate nausea, flu-like aching and sometimes a slight increase in pain.  This reaction can usually be avoided by consumption of two quarts of water in the first three hours after treatment and use of a supplement which provides phase one and phase two liver detoxification pathway substrates.  The reaction was less pronounced after the fifth or sixth visit, presumably because liver detoxification pathway enzymes increased with the increased demand.  

Five patients didn't tolerate microcurrent.  One had had her first rib removed, a cervical fusion performed and a spinal stimulator installed. She experienced muscle spasm when microcurrent was applied, even when the stimulator was turned off.   One had confirmed Agent Orange exposure and experienced muscle spasms when microcurrent treatment was attempted.  One was a three pack a day smoker who didn't tolerate any electrical modality including TENS. Two were patients with spinal cord injuries who progressed from numbness to hyperesthesia after brief exposure to microcurrent.  The usual cautions and contraindications for microcurrent were otherwise observed.  It is not to be used through the eye or through a pregnant uterus or on patients with demand type pacemakers.
  
Caveat

There are several caveats that must be stated when assessing these results. First, this sample was definitely not average or random.  The patient sample was refractory to other treatment techniques but they had been led to expect a positive outcome by their referring physicians.  Second, there was no systematic control group or sham treatment.  This is a working clinical practice and our patients, their referring doctors and their third party payers expect results and positive outcomes.  And thirdly, microcurrent was not the only thing we did to treat these patients.  The microcurrent treatment made the most obvious, immediate and dramatic differences in muscle tissue and range of motion, but nutritional support, exercise and manipulation most likely contributed to the speed of recovery and permanence of the results.

We began teaching this treatment method in January, 1997. Chiropractors, physical therapists and naturopathic physicians are using this treatment method in clinical practice and the results look promising.  Early reports indicate that our results are reproducible.

Conclusion

Low back, head, neck and face pain caused by myofascial trigger points has been difficult to treat with traditional trigger point therapy. Microcurrent treatment delivered using graphite/vinyl gloves and specific microcurrent frequencies has produced significant improvements in a refractory group of patients.  The treatment method has been used in other clinics by other practitioners and appears to be reproducible. 

This presentation is meant to introduce the concepts and results of trials using specific microcurrent frequencies applied to chronic fibrotic myofascial tissue.  The preliminary results are most encouraging, consistent in thousands of patient visits, and warrant further study and patient trials.  

Inappropriate use of frequencies has produced some side effects that were temporary.  Frequencies used for "fibrosis" were used on freshly healed tissue and caused an increase in pain and delayed final healing.  Achieving optimum positive results requires a good understanding of both the frequencies and the conceptual basis for their use.  For these reasons the frequencies are not included in this presentation but are taught in two six hour seminars open to any professional licensed to use microcurrent as part of their practice.


Frequency Specific Microcurrent( training and additional information is available through the Fibromyalgia and Myofascial Pain Clinic of Portland, 17214 SE Division, Portland, Oregon, 97236,  (503) 762-0805.



References

Travell, JG, Simons DG, Myofascial Pain and Dysfunction: The Trigger Point Manual, Vol.1: The Upper Body. Baltimore, MD: Williams and Wilkins; 1983

Starlanyl, D, Fibromyalgia & Chronic Myofascial Pain Syndrome, A survival Manual. Oakland, CA: New Harbinger Publications, Inc.; 1996

Cheng, N, The effect of Electric Currents on ATP Generation, Protein Synthesis, And Membrane Transport in Rat Skin.  Clin. Orthopedics 1982;171:264-272

Selye, H, Hans Selye, The Stress of My life. NY: Van Nostrand-Reinhold; 1975

Manley Tehan, L, Microcurrent Therapy, Universal Treatment Techniques and Applications. Corona, CA: Manley and Associates;1994

Rowley, BA, McKenna, JM, Wolcott, LE, The use of Low Level Electric Current for the Enhancement of Tissue Healing. ISA BM. 1974; 74322: 111-114

Morgareidge, KR. Chipman,MR, Microcurrent Therapy, Physical Therapy Today, 1990, Spring: 50 -53

Mercola, JM, Kirsch, D. The Basis for Microcurrent Electrical Therapy in Conventional Medical Practice, Journal  of Advancement in Medicine, 1995, Vol.8, Num. 2, 1995

Electronic Medical Digest: Electronic Medical Foundation, San Francisco, CA 1944-1955



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