November 9, 2021
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Who among us hasn’t been sitting on the couch at 2pm (or am) with the TV droning on in the background only to get sucked into a 5 minute infomercial about a cure for all medical device that is sure to change your life? Now I won’t name any names in this post, but there’s no shortage of quick fix devices that promise to immediately cure whatever ailment you have. So I figured it’s a good time to sit down and actually discuss what these devices do, and what benefit they may have (if any) before you go spend your hard earned money on them.
Without further ado let’s dive in.
Device One: The Buzz Buzz Machine
You may be asking yourself what is a buzz buzz machine? Well it’s a machine that sends out electrical current, is usually run by batteries, and comes with some sticky silicone pads to adhere to your skin through which the buzz buzz flows.
The claims:
The Evidence:
Verdict: Meh
It’s an ambitious claim and definitely tempting in a society where conditions that may compromise circulation, such as stroke and diabetes, are prevalent. That said there is no compelling evidence that a Transcutaneous Electrical Nerve Stimulation (TENS) machine (aka buzz buzz machine), that simply delivers electrical current to the skin, can alter blood flow in vasculature that is found deeper in the body. There is some evidence showing that there is increased blood flow to the skin under where the pads are applied. However; other research has shown that it cannot alter blood flow over deeper vasculature in the calves regardless of the settings on the TENS unit.
2. Targets pain at its source
Verdict: Nope
To understand why this claim is false requires some understanding of pain and human physiology. We have specialized nerve endings in our skin and body called nociceptors. When they are stimulated by a painful stimulus they are activated and send a signal to your spinal cord, which is then relayed to your brain that a certain area of your body hurts. However, our bodies have many types of nerve endings, and the nociceptors that detect pain happen to be the slowest. That’s where the buzz buzz machine comes in. The electrical current stimulates the other nerve endings we have in our bodies, and the messages from those reach our brain first and in essence distract us from the area that is in pain. Similar to when you bang your knee on the edge of a table and your instinct is to rub it to help with the pain, it is simply a physiological trick to mask some of the pain you are in. So yes, the TENS machine helps your body with pain (I like to call it electrical tylenol), but no it does not target pain at its source or stimulate healing of whatever is hurting you.
3. Provides instant relief
Verdict: Correct
As we mentioned above the TENS machine makes use of a neat trick we can play on our brains to distract from our pain, and the frequency of the electrical current it delivers is much faster than the frequency at which we can rub our knee (or other painful area), so it is much more effective. Usually pain can be masked right away especially if it is not as severe, but again it is important to note that it is merely managing symptoms, and not addressing the underlying cause of your pain.
Take home message: If you want to spend your money on a buzz buzz machine then there is some reasoning behind it. So long as you are aware that all you are getting out of it is pain relief then there is very little potential harm that they can cause (but little to no long term benefit as well).
Device Two: The Back Cracker
Alright so what am I referring to with the back cracker? Without naming company names, it’s a curved piece of plastic that is supposed to mimic the “ideal” curvature of a back/spine. You then put it on the floor, lie down, and it adjusts your back for you to be perfectly in line. Supposedly.
The claims:
The Evidence:
Verdict: Please leave
Alright I’m not even sure where to start with this one. To make the claim that a product improves posture implies that there is a posture that needs fixing in the first place. All the newest evidence shows that there’s no such thing as “good” or “bad” posture. People who have ‘perfect’ military posture can have pain in their neck and back, and people who look like the hunchback of Notre Dame can be walking around pain free. That said, what the research is clear on is that there is only one good posture, and that is a posture that is constantly changing. Sitting in your office chair while at work completely slumped down the chair is fine, so long as it’s only for a brief time. Sitting upright with “perfect” posture is also fine, so long as it’s only for a brief time. Both of those are also bad and going to cause you some degree of pain if you maintain them for 10 hours straight.
To get back to the device, I guess the implication is that if you lie down on this piece of plastic it will push your spine back into ideal alignment with the help of gravity. I’m calling nonsense on that one too. Your spine’s alignment is at the mercy of many things, some being: Muscular tension, genetics and how it grew, the daily forces they encounter, time of day, trauma, and others.
2. Relieves Back Pain
Verdict: I mean maybe? But please you should still leave
Ask any clinician, doctor, physiotherapist, chiropractor, radiologist, and they will all tell you the same thing (assuming they are ethical and up to date on research): Back pain is unbelievably complex, multi-factorial, difficult to diagnose, and unique to each person’s individual experiences.
So can arching your back, with or without the aid of a backcracker (™), help with pain? Yes of course. In fact it’s a common technique used by clinicians for certain types of back pain, especially back pain believed to be predominantly caused by herniated or aggravated discs (sciatica). This approach is commonly referred to as the McKenzie approach. Even then those who practice the McKenzie approach to back pain don’t just automatically assume spinal extension (i.e. arching your back) is the go to movement for pain relief. Rather, they conduct an assessment to establish your directional preference (which way you move alleviates your pain, and which way makes it worse). Directions can be arching (spinal extension), curving (spinal flexion), bending (reaching to one side), twisting, or a combination of any of those. Is extension the most commonly relieving direction for disc type back pain? Yes. Should you assume it will automatically cure your type of back pain? Absolutely not.
Furthermore, this backcracker seems to make the assumption that everyone’s back pain is due to disc issues (or sciatica) which is extremely far from the case. You can have a sprain or strain of the back, irritated joints, narrowing of the spinal canal, or any number of other issues, and guess what? Arching your back in these other conditions often makes the pain worse.
3. Decompresses the Discs of Your Spine
Verdict: Why are you still here? I already told you to leave
Again, this claim makes no sense, and is in fact purposely misleading. When you look at the makeup of your spinal column, you have vertebrae, which are bone stacked on top of each other. Between each level or vertebrae you have an intervertebral disc, which more closely resembles cartilage. The alignment of the vertebrae both above and below each disc will determine how the disc is loaded (or compressed).
We’ll take the fourth and fifth lumbar vertebrae for example, since they are the most commonly painful or rather blamed segment in your back (and probably body). When you flex your spine (think bending over to pick something up), the front of the disc gets compressed as the two front portions of the vertebrae come closer together. When you extend the spine the exact opposite happens and the back part of the disc is relatively more compressed. Furthermore, this only applies to the portions of the spine that are actually moving, so to make the claim that this decompresses the whole spine is nonsensical. The only way to actually do that would be to ask one of your friends to yank on your head as hard as they can while another does the same to your feet (please for the love of god do not try this at home).
Take home message: Save your $40 and go for a walk. It’s free and chances are it’ll do way more for your back than lying on the floor will.
Device Three: The Massage Gun
Say hello to my little friend! (**pulls out a handheld vibrating gun and jackhammers your lower back**). Alright so it’s a little more anti-climactic than Pacino, but massage guns have soared in popularity. In fact I have one and I use them on patients sometimes.
The Claims:
The Evidence:
Verdict: True, but who cares
It’s not surprising that a vibrating gun with a massage head forcefully pushed against your skin is going to generate heat. So does rubbing my hands together. While this claim is objectively true, I’m not exactly sure how this is supposedly helpful. It’s true that heat can be useful for pain relief at times, but as was the case with the BuzzBuzz machines, pain relief is just that: relief, and does not target the source of pain.
2. Stimulates circulation
Verdict: Again True, but also I still don’t know why we care
Just as is the case with the first claim, this is technically true, but maybe a little misleading in terms of if that is actually desirable. Again we can go back to the example of the TENS/BuzzBuzz machine, where this will cause increased blood flow to the skin, but this is rarely if ever of any clinical use or benefit. In fact it’s essentially the same claim as the first (that it generates heat). Friction from the vibrating massage head creates heat, heat causes the small arteries of your skin to dilate and let in more blood, more blood goes to the skin. Whoopdedoo, you make your skin splotchy, we still haven’t cured anything.
3. Releases Muscular Tension
Verdict: Yes (BUT)
Listen, I’m not going to be the guy that sits here and tells you using a massage gun doesn’t work at all. Like I said, I have and use one myself, and they feel amazing (and at the right setting and spot they can even stimulate something the scientific community has dubbed “the giggles”). There’s tons of tools rehab clinicians may use during treatment to relieve muscular tension, they can use hands on massage, a scraping/blading tool, cupping, stretching, even *gasp* exercise. A massage gun is just one of many tools that helps us relax, and yes it feels really good, much like going to see a registered massage therapist would. The science is unclear on if it truly relieves muscular tension, mainly because it’s hard to actually nail down what tension really means. Will it transiently make you feel really nice? In my experience, yep. Again, will it cure whatever is ailing you in the first place? Almost definitely not.
Take home message: You may be sensing a trend here, but as long as you know that the tool you are using, in this case a massage gun, is for symptom management and not a cure all tool, then I have no issues with it. Fire away.
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FAQ:
So Which products DO you recommend?
None. I recommend consulting a health professional if you are in pain, especially if it is a new onset of pain, and making a plan to best address it. That plan may include medications, exercise, lifestyle modification, or yes even some pain relief tools, but there are never blanket recommendations that can be given to everyone. It’s always best to have a plan tailored to you.
Are Any of These Products Dangerous?
Short answer is usually no, the longer answer is maybe. In rare cases a certain pain relief tool may not be recommended for you, for example a TENS machine is not recommended over the chest for people who have pacemakers installed, over areas with cancerous tumors, or over areas with metal in the body such as joint replacements. Something like a massage gun may be best to avoid in people with severe osteoporosis as it may be able to cause fractures. Again, it’s always best to consult a health professional if you ever have any doubts.
Sounds like I have one of the products you mentioned, and it helps me, should I stop using it?
No! Be happy you found something that provides you with pain relief, it’s not always the case for everyone that they’re able to. That said, it may be time to take stock of how long you’ve been in pain, and what your goals are. Maybe you have some soreness from time to time and busting out the massage gun takes care of it. However; if you are constantly in pain and you need to use one of these devices just to make it through the day, then maybe it’s time to consult a health professional and start taking steps to actually remedy the situation.
