How Do Physical Therapists Administer Medication With Iontophoresis? (2022)

If you have an injury that causes pain and limited mobility, you may benefit from working with a physical therapist (PT) to help decrease your pain and improve your function. Your PT may use various treatments to augment your rehab program. One such treatment is iontophoresis.

Iontophoresis is a therapeutic modality often used by physical therapists to treat a variety of conditions. It is a type of electrical stimulation that is used to administer medication into your body through your skin.

How Do Physical Therapists Administer Medication With Iontophoresis? (1)

How Iontophoresis Work

To understand the basic principles of iontophoresis, you should remember some basic lessons from physics and chemistry class. In general, ionic charges that are alike will repel one another, while ions that are oppositely charged will be attracted to one another.

So if you have a medicine in a solution that is negatively charged and you apply a negative electrical charge to it, the medicine in solution will be pushed away, or repelled, from the negative electricity. When using iontophoresis, your physical therapist is using electricity to push medicine into your injured tissues.

The medication used in iontophoresis is ionically charged. So if your physical therapist decides to introduce medication into your injured tissues via iontophoresis and that medication is negatively charged, he or she will use a negative current to drive that medication into your body.

Common Uses

There are many different uses for iontophoresis. These include, but are not limited to:

  • Decrease inflammation
  • Decrease pain
  • Decrease muscle spasm
  • Decrease swelling and edema
  • Reduce calcium deposits in the body
  • Manage scar tissue

Your PT will work with you to decide on the treatment goals and the rationale for using iontophoresis.

Procedure

Before applying iontophoresis, your PT must first decide on which type of medication to use. The medication used in iontophoresis depends on the goals of the treatment. Different medications have different effects on the body, and your PT will decide on the best medication for your specific condition.

Iontophoresis can be used in physical therapy for the local delivery of anesthetics (such as lidocaine), cortisteroids, anti-inflammatory drugs. and analgesics to inflamed joints, muscles, and subcutaneous tissues.

Many states require that your PT obtain a prescription from your healthcare provider before administering the medication into your body via iontophoresis. Don't be surprised if your therapist contacts your healthcare provider or asks you to contact your healthcare provider prior to administering iontophoresis medication.

A direct current electrical stimulation unit is used to apply iontophoresis. The unit has two electrodes; one electrode is for the negative current, and one is for the positive current. Your PT will apply medication to either the positive electrode or the negative one, depending on the type of medication that is being used for iontophoresis.

The electrodes are then applied to your body. The electrode with the medication is applied to the area of your body that is being treated. The electrode without the medication is applied to your body nearby. The electrical stimulation unit is then turned on, and the electricity pushes the medication into your injured body part while you relax.

What to Expect

When your physical therapist applies iontophoresis to your body, he or she uses an electrical stimulation device. When the electrical current is turned on, you will likely feel a slight tingling sensation. Sometimes the stimulation feels like a tiny bee sting. If you are uncomfortable during the iontophoresis treatment, notify your physical therapist and adjustments can be made.

A typical iontophoresis treatment takes 10 to 20 minutes, depending on the amount of medication that your PT is administering to you. When your iontophoresis treatment is completed, your PT will remove the electrodes and inspect your skin. Don't be surprised if your skin is red where the medication electrode was placed; this is common after iontophoresis.

Once you receive your iontophoresis treatment, your PT will give you specific instructions. Many times, withholding ice or heat treatments after iontophoresis is recommended since these treatments alter circulation to the injured area. This altered circulation might "wash away" the medication that was just introduced to your body. If you have any questions about what to do after iontophoresis, be sure to ask your physical therapist.

Side Effects

Iontophoresis is a safe procedure, and side effects are minimal. While receiving the stimulation, you may feel a slight pin prick tingling sensation. Redness may also occur underneath the electrodes used for it. Some patients notice some dryness or rough skin in the area where the iontophoresis was administered. This can be mitigated by using skin lotion over the area several hours after receiving the treatment.

In the literature review of 25 iontophoresis studies, including 13 randomized trials, rates of adverse skin reactions varied widely but were mostly mild and did not require treatment.

(Video) Iontophoresis in Physical Therapy

Keep in mind that iontophoresis is a passive treatment, and the most successful physical therapy programs require you to be actively involved in your care. Active exercises are often the most important component of your rehabilitation, so be sure that your PT gives you a strategy to manage your condition when you are not in the physical therapy clinic.

Contraindications

While generally considered safe, the procedure is not without its limitations and safety issues. When used for systemic drug delivery, iontophoresis machines are classified by the U.S. Food and Drug Administration (FDA) as a class 3 device alongside total artificial disc replacements and implanted neurostimulators.

Due to the lack of research into its affect on fetal health, iontophoresis is contraindicated in pregnancy. It is also contraindicated if you have a pacemaker, metal implant, cardiac arrhythmia, a skin rash, or skin disease.

Evidence

If your physical therapist considers using iontophoresis for your treatment, you should know if it is likely to be of benefit for your condition. Studies investigating iontophoresis have been performed, some of which are promising than eithe.

A 2015 study published in the journal Physiotherapy examined the role of lidocaine iontophoresis in the treatment of spasticity in children with cerebral palsy. Thirty children were randomized to one of two groups: those who received PT and iontophoresis, and those who only received PT. The group that received iontophoresis showed greater improvements in certain walking variables compared to the PT-only group.

Another study examined the effect of iontophoresis for shoulder impingement syndrome. Eighty-eight subjects with shoulder impingement were randomized into one of three groups: one with placebo ultrasonophoresis and placebo iontophoresis; another with placebo ultrasonophoresis and real iontophoresis; and a third with a real ultrasonophoresis and placebo iontophoresis. The group that received only iontophoresis (without ultrasonophoresis) showed no significant improvements when added to the standard treatment.

In terms of systemic drug delivery, a 2013 study published in the British Journal of Clinical Pharmacology concluded that iontopheresis is "theoretically promising" and, depending on the aims of treatment, may offer advantages over a transdermal patch.

So, iontophoresis may be helpful for some conditions and not in others. But the most important study participant is you. If your PT suggests iontophoresis for your condition, it may be worth a try, but it should not be considered a panacea by any means.

A Word From Verywell

Iontophoresis, a form of electrical stimulation, can be an important part of your physical therapy treatment. It is used to introduce medication into your body to achieve specific therapeutic goals. Iontophoresis may be one treatment that can help you return to normal activity quickly and safely after injury.

Medications Used in Iontophoresis

Frequently Asked Questions

  • What are the benefits of iontophoresis for sports injuries?

    Iontophoresis treatments used with anti-inflammatory medicines can help relieve soft-tissue injuries, joint swelling, and pain related to sprains or bursitis. The advantage of using iontophoresis instead of some other treatments is that it’s non-invasive; it's also faster to administer and it's easy to control the dosage.

    (Video) How to set up Iontophoresis?

    Learn More:Common Ways Physical Therapists Treat Sports Injuries

  • What does iontophoresis feel like?

    Iontophoresisinvolves electrical currents going through an area of your body. This can cause a tingling sensation while the machine is on. You shouldn’t feel pain or a serious electrical shock, though.

    Learn More:Types of Electrical Stimulations Used in PT

  • How long does iontophoresis take to heal a knee injury?

    The number of sessions of iontophoresis you need to help with an injury depends on the injury and your overall health. Research has shown that six sessions of iontophoresis can result in improvement.

    Learn More:What You Should Know About Knee Pain

9 Sources

(Video) Iontophoresis demonstration

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

  1. Batheja P, Priya B, Thakur R, Rashmi T, Michniak B, Bozena M. Transdermal iontophoresis. Expert Opin Drug Deliv. 2006;3(1):127-38. doi:10.1517/17425247.3.1.127

  2. Khan AP, Yasir MP, Asif MP, et al. Iontophoretic drug delivery: History and applications.Journal of Applied Pharmaceutical Science.

  3. Hölzle E, Alberti N. Long-term efficacy and side effects of tap water iontophoresis of palmoplantar hyperhidrosis--the usefulness of home therapy. Dermatologica. 1987;175(3):126-35. doi:10.1159/000248810

  4. Federal Registrar by the Food and Drug Administration. Physical Medicine Devices; Reclassification of Iontophoresis Device Intended for Any Other Purposes.

  5. Hegazy F, Salem Y, Aboelnasr E. Lidocaine iontophoresis combined with physical therapy interventions for children with spastic hemiplegic cerebral palsy.Physiotherapy. 2015;101. doi:10.1016/j.physio.2015.03.3369.

  6. García I, Lobo C, López E, Serván JL, Tenías JM. Comparative effectiveness of ultrasonophoresis and iontophoresis in impingement syndrome: a double-blind, randomized, placebo controlled trial. Clin Rehabil. 2016;30(4):347-58. doi:10.1177/0269215515578293

  7. Roustit M, Blaise S, Cracowski JL. Trials and tribulations of skin iontophoresis in therapeutics: Skin iontophoresis in therapeutics. Br J Clin Pharmacol. 2014;77(1):63-71. doi:10.1111%2Fbcp.12128

  8. International Hyperhidrosis Society. Iontophoresis.

  9. Rigby JH, Mortensen BB, Draper DO. Wireless versus wired iontophoresis for treating patellar tendinopathy: a randomized clinical trial. Journal of Athletic Training. 2015;50(11):1165-1173. doi:10.4085/1062-6050-50.11.04

Additional Reading

  • Clijsen, R.; Taeymans, J.; Baeyens, J. et al. The Effects of Iontophoresis in the Treatment of Musculoskeletal Disorders: A Systematic Review and Meta-Analysis. Drug Delivery. 2012:2(3). DOI: 10.2174/2210303111202030180.

  • García, I., Lobo, C., López, E., Serván, J. L., & Tenías, J. M. Comparative effectiveness of ultrasonophoresis and iontophoresis in impingement syndrome: a double-blind, randomized, placebo controlled trial.Clinical rehabilitation,30(4), 347-358.

  • Hegazy, F., Salem, Y., & Aboelnasr, E. Lidocaine iontophoresis combined with physical therapy interventions for children with spastic hemiplegic cerebral palsy.Physiotherapy,101, e554-e555.

  • Huisstede, B. M., Hoogvliet, P., Franke, T. P., Randsdorp, M. S., & Koes, B. W. Carpal Tunnel Syndrome: Effectiveness of Physical Therapy and Electrophysical Modalities. An Updated Systematic Review of Randomized Controlled Trials.Archives of physical medicine and rehabilitation.

    (Video) IONTOPHORESIS - How Does It Work?? - We Break It Down HERE

  • Rousit, M.; Blaise, S.; Cracowski, J. et al. Trials and tribulations of skin iontophoresis in therapeutics. Brit J Clin Pharmacol. 2014;77(1):63-71. DOI: 10.1111/bcp.12128.

How Do Physical Therapists Administer Medication With Iontophoresis? (2)

By Brett Sears, PT
Brett Sears, PT, MDT, is a physical therapist with over 20 years of experience in orthopedic and hospital-based therapy.

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FAQs

How are drugs administered in iontophoresis? ›

Iontophoresis is a method of transdermal drug delivery wherein a clinician uses an electric current to promote localized, superficial permeation of a therapeutic agent through the skin. Among the earliest applications of electrical current for medical therapy was by Pivati in 1740 to treat arthritis.

What is iontophoresis medication? ›

Iontophoresis is a treatment that allows medication to be delivered across your skin to the painful area without having to have an injection into your muscle or soft tissue, through a vein in your arm, or taking a pill.

What is the process of iontophoresis? ›

Iontophoresis is one of the physical methods. In iontophoresis, cationic or neutral therapeutic agents are placed under an anode or anionic therapeutic agents under a cathode. When a low voltage and low current density is applied, according to simple electrorepulsion, ions are repelled into and through the skin.

Which route of administration does iontophoresis and Phonophoresis utilize? ›

Transdermal drug delivery using iontophoresis and phonophoresis.

What are the disadvantages of iontophoresis? ›

The disadvantages of iontophoresis are the complexity of the drug release system and prolonged exposure of the skin to an electrical current.

How quickly does iontophoresis work? ›

In most cases, iontophoresis takes at least two weeks of consistent use to show results. Sometimes it can take even longer. [2] For a patient dealing with burdensome symptoms, that is a long time, and it can lead some to change their treatment plan prematurely.

How long is iontophoresis treatment? ›

The treatment is administered clinically for 15-20 minutes per session. In a physical therapy setting, iontophoresis is typically one of several treatment interventions applied, so the addition of another 15-20 minutes to a pre-existing 60 minute program is a time burden for some patients.

Do you need a prescription for iontophoresis? ›

Note that a prescription from a medical professional is often required in the US. For mild to moderate hyperhidrosis, a battery-operated, non-prescription iontophoresis device may suffice, but note that their reported sweat reduction rates are often less than that those of plug-in devices.

What is the frequency for iontophoresis? ›

Iontophoresis was applied for 60 min at a 0.4 mA/sq·cm current density, while low-frequency sonophoresis was applied at a 20 kHz frequency (2 min application, and 6.9 W/sq·cm intensity).

What water is best for iontophoresis? ›

Tap water serves as electrically conductive medium between the electrodes and the skin. Its use avoids direct skin contact with the electrodes and thus achieves a greatly homogenous current flow through the skin. Treatment of hands and feet is facilitated in two basins filled with tap water.

Which of the following are contraindications for iontophoresis? ›

Contraindications
  • Epilepsy, Seizures.
  • Pacemakers.
  • Heart diseases.
  • Metal implant.
  • Pregnancy.
  • Recent wounds, skin grafting or scar.

What is the difference between iontophoresis and Phonophoresis? ›

Definition: Phonophoresis is a physical agent, which utilizes ultrasound with a topical drug to facilitate transdermal drug delivery. Iontophoresis is the transcutaneous delivery of ions into the body for therapeutic purposes using a DC electrical current.

Can iontophoresis damage nerves? ›

Ions produced by iontophoresis may physically block the sweat ducts in the stratum corneum. The external electrical current may disrupt normal sympathetic nerve transmission.

Does iontophoresis affect the heart? ›

Blood Pressure and heart rate did not change significantly from the baseline during the histamine iontophoresis and direct currents treatments (P > 0.05). The findings suggest that the subjects' BP and HR were not affected by histamine iontophoresis during the twenty minutes treatment.

Can iontophoresis cause heart problems? ›

The findings of no statistically significant changes in cardiovascular functioning following both histamine iontophoresis and . electrical stimulation treatments should be interpreted with caution.

What is one of the most serious adverse reactions during iontophoresis treatment? ›

Erythema is the most frequently described adverse effect, with a variable frequency according to the iontophoresis protocols [44, 64].

How much is iontophoresis treatment? ›

Iontophoresis treatments in a doctor's office will set you back about $150 to $200 per session. Costs can vary significantly depending on the selected practitioner and location.

At what depth in the body does iontophoresis deliver medication? ›

Iontophoresis is now commonly used by caregivers to deliver water soluble anti-inflammatory medications locally into sub-acute or acute inflammations, as an alternative to syringe-and-needle injection (ref. 1). Studies have shown iontophoresis has penetrated medication to depths of at least 1 cm (ref. 1).

Is iontophoresis machine covered by insurance? ›

Since iontophoresis is recognized as medical therapy for the treatment and control of hyperhidrosis, some health insurance companies may cover a portion of the costs. Patients typically purchase an iontophoresis device and then obtain a reimbursement directly from the insurance company.

How do you prepare for iontophoresis? ›

Take off any jewelry you're wearing before you start treatments. Cover any sore spots with petroleum jelly before you start treatment. Remember that petroleum jelly blocks the iontophoresis, so don't use more than you need. If treatments dry out your skin, use a moisturizer afterward.

Can you do iontophoresis twice a day? ›

The process of iontophoresis must be performed twice daily for 3-4 weeks. The results will last for several weeks before the procedure needs to be repeated. With the proper device, you can complete the treatment at home.

Can you feel iontophoresis? ›

You'll feel a tingling sensation from the electrical current, but it shouldn't be painful. Most iontophoresis sessions for sports injuries last 10 to 15 minutes. Your doctor may order several sessions per week until your injury begins to heal. Iontophoresis is a safe and painless procedure.

How much baking soda do you put in iontophoresis? ›

In some areas tap water can be too soft for Iontophoresis to be effective. If you live in a very soft water area and find Iontophoresis doesn't work for you, then try adding 2 teaspoons of bicarbonate of soda (baking soda). Using bottled Badoit water (available in most supermarkets) can also have the same effect.

Is iontophoresis a steroid? ›

Iontophoresis is a method for getting a corticosteroid drug down to an inflamed area without the need for an injection. The machine uses a small electrical current applied to an electrode. The electrode is soaked in Dexamethasone (a soluble steroid), and is placed over the inflamed area.

What are the benefits of iontophoresis? ›

Some of the Common Uses for Iontophoresis
  • Decrease inflammation.
  • Decrease pain.
  • Decrease muscle spasm.
  • Decrease swelling and edema.
  • Reduce calcium deposits in the body.
  • Manage scar tissue.

› topics › neuroscience › i... ›


Iontophoresis - an overview

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Grant C. Fowler MD, in Pfenninger and Fowler's Procedures for Primary Care, 2020. Transcutaneous Electrical Nerve Stimulation. TENS therapy uses low-voltage...

Iontophoresis

https://www.physio-pedia.com › Iontophoresis
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Iontophoresis is a procedure in which an electric current will be passed through the skin which will be soaked in tap water allowing ionized or charged particle...

Iontophoresis - an overview

https://www.sciencedirect.com › medicine-and-dentistry
https://www.sciencedirect.com › medicine-and-dentistry
Grant C. Fowler MD, in Pfenninger and Fowler's Procedures for Primary Care, 2020. Transcutaneous Electrical Nerve Stimulation. TENS therapy uses low-voltage...

How are drugs delivered transdermally? ›

Transdermal Drug Delivery (TDD)

TDD is a painless method of delivering drugs systemically by applying a drug formulation onto intact and healthy skin [2,5]. The drug initially penetrates through the stratum corneum and then passes through the deeper epidermis and dermis without drug accumulation in the dermal layer.

How is dexamethasone used in iontophoresis? ›

Dexamethasone is the most commonly used medication with iontophoresis to treat a variety of connective tissue disorders. Hypothesis: Iontophoresis will facilitate the absorption of dexamethasone into connective tissue compared with diffusion.

How does iontophoresis work with dexamethasone? ›

How does it work? Iontophoresis delivers medication based on the principle that like charges repel each other – like magnets pushing away from each other. This means that when a negatively charged medication, like dexamethasone, is applied to the negative drug pad, the medication will be forced away from the pad.

Does iontophoresis require a prescription? ›

The most common medication utilized with these two procedures is dexamethasone. Dexamethasone is used for pain relief and inflammation. What do you need to do to order Phonophoresis and Iontophoresis? A prescription is needed for both iontophoresis and phonophoresis to comply with legal guidelines.

How is a transdermal medication given to a patient? ›

What is it? Transdermal means the application of a medicine or drug through the skin. In the simplest terms, a drug is placed on top of the skin, where it is absorbed into the bloodstream. Transdermal medications have many advantages, the main one being ease of application.

What are the disadvantages of transdermal drug delivery system? ›

Common disadvantages of TDDS: 1,3-5

Many drugs especially drugs with hydrophilic structures permeate the skin too slowly may not achieve therapeutic level. 2. The drug, the adhesive or other excipients in the patch formulation can cause erythema, itching, and local edema.

Is transdermal better than oral? ›

Although comparable to oral-dosage forms in efficacy, transdermal patches have numerous advantages over oral forms. First, transdermal administration avoids the first-pass effect of metabolism associated with the oral route. Therefore, transdermal administration allows for improved bioavailability.

At what depth in the body does iontophoresis deliver medication? ›

Iontophoresis is now commonly used by caregivers to deliver water soluble anti-inflammatory medications locally into sub-acute or acute inflammations, as an alternative to syringe-and-needle injection (ref. 1). Studies have shown iontophoresis has penetrated medication to depths of at least 1 cm (ref. 1).

How long does iontophoresis with dexamethasone last? ›

But it also helps distribute the dexamethasone, lidocane, etc to a larger surface area. Ionto treatment lasts between 10 and 15 minutes and may be given either before or after the exercise portion of your session.

How long is iontophoresis treatment? ›

The treatment is administered clinically for 15-20 minutes per session. In a physical therapy setting, iontophoresis is typically one of several treatment interventions applied, so the addition of another 15-20 minutes to a pre-existing 60 minute program is a time burden for some patients.

What does dexamethasone do to muscles? ›

The synthetic glucocorticoid dexamethasone (Dex) has been used therapeutically to treat muscular dystrophy by an inhibition of inflammation, followed by slowing muscle degeneration and stabilizing muscle strength.

What water is best for iontophoresis? ›

Tap water serves as electrically conductive medium between the electrodes and the skin. Its use avoids direct skin contact with the electrodes and thus achieves a greatly homogenous current flow through the skin. Treatment of hands and feet is facilitated in two basins filled with tap water.

Is iontophoresis machine covered by insurance? ›

Since iontophoresis is recognized as medical therapy for the treatment and control of hyperhidrosis, some health insurance companies may cover a portion of the costs. Patients typically purchase an iontophoresis device and then obtain a reimbursement directly from the insurance company.

Can iontophoresis cause heart problems? ›

The findings of no statistically significant changes in cardiovascular functioning following both histamine iontophoresis and . electrical stimulation treatments should be interpreted with caution.

How often should you do iontophoresis? ›

How often should I have treatments? Always consult with your doctor before beginning a regimen of iontophoresis treatments. Usually, the process is repeated 3 times a week in the beginning, and until sweating is reduced to the desired degree. Then patients are switched to a schedule of one treatment each week.

Videos

1. Iontophoresis for Inflammation with @Ortho EVAL Pal With Paul Marquis
(Ortho EVAL Pal With Paul Marquis PT)
2. Iontophoresis | electrotherapy | physiotherapy | must watch
(Physio's Healing Touch)
3. IONTOPHORESIS | V.V.I TOPIC | FREE 💥 HANDWRITTEN NOTES | ELECTROTHERAPY | PHYSIOTHERAPY| (PART 1/2)
(MEDICAL ONESHOT)
4. Plantar Fasciitis: Treatment by a Physical Therapist
(ChoosePT)
5. Basics of Iontophoresis [+ Example Calculations]
(Catalyst University)
6. How Iontophoresis is applied
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