BlueCross BlueShield of Tennessee Medical Policy Manual

Interferential Current Stimulation

DESCRIPTION

Interferential current stimulation (IFCS) is a type of electrical stimulation that uses paired electrodes of 2 independent circuits carrying high-frequency (4,000 Hz) and medium-frequency (150 Hz) alternating currents.  The superficial electrodes are aligned on the skin around the affected area.  There are no standardized protocols for the use of interferential current therapy.  The therapy may vary according to the frequency of stimulation, the pulse duration, treatment time, and electrode-placement technique.

IFCS has been investigated primarily as a technique to reduce pain.  IFCS has also been proposed to increase function of individuals with osteoarthritis and to treat other conditions such as dyspepsia, irritable bowel syndrome, and constipation.

Examples of interferential current stimulation devices include the: Medstar™ 100 (MedNet Services), SporTX Stimulator and the RS-4i® (RS Medical).

POLICY

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IMPORTANT REMINDERS

ADDITIONAL INFORMATION

There is insufficient evidence from well-designed trials that interferential current stimulation (IFCS) improves health outcomes for individuals diagnosed with painful musculoskeletal conditions. The limited amount of evidence from a few small trials comparing IFCS alone to a placebo or sham intervention does not consistently show benefit. Some trials do not adequately evaluate the incremental effects of IFCS beyond that of a co-intervention and/or do not adequately evaluate the equivalence of IFCS and an alternative intervention.  There is also insufficient evidence from well-designed trials that IFCS improves health outcomes for individuals diagnosed with conditions such as dyspepsia, irritable bowel syndrome, and constipation.  Therefore, interferential stimulation is considered investigational.

SOURCES 

Almeida, C.C., Silva, V.Z.M.D., Júnior, G.C., Liebano, R.E., & Durigan, J.L.Q. (2018). Transcutaneous electrical nerve stimulation and interferential current demonstrate similar effects in relieving acute and chronic pain: a systematic review with meta-analysis. Brazilian Journal of Physical Therapy, doi:10.1016/j.bjpt.2017.12.005. [Epub ahead of print]. Abstract retrieved March 12, 2018 from PubMed database.

American College of Physicians, American Pain Society. (2007). Diagnosis and treatment of low back pain: a joint clinical practice guideline from the American College of Physicians and the American Pain Society. Retrieved March 12, 2018 from http://annals.org/aim/fullarticle/736814/diagnosis-treatment-low-back-pain-joint-clinical-practice-guideline.

BlueCross BlueShield Association. Medical Policy Reference Manual. (9:2017). Interferential Current Stimulation (1.01.24). Retrieved March 12, 2018 from BlueWeb. (20 articles and/or guidelines reviewed)

Elnaggar, R. K., & Elshafey, M. A. (2016). Effects of combined resistive underwater exercises and interferential current therapy in patients with juvenile idiopathic arthritis: a randomized controlled trial. American Journal of Physical Medicine and Rehabilitation, 95 (2), 96-102. Abstract retrieved March 3, 2017 from PubMed database.

Gomes, C.A.F.P., Dibai-Filho, A.V., Moreira, W.A., Rivas, S.Q., Silva, E.D.S., & Garrido, A.C.B. (2018). Effect of adding interferential current in an exercise and manual therapy program for patients with unilateral shoulder impingement syndrome: a randomized clinical trial. Journal of Manipulative and Physiological Therapeutics, DOI. 10.1016/j.jmpt.2017.09.009. [Epub ahead of print]. Abstract retrieved March 12, 2018 from PubMed database.

Grabiańska, E., Leśniewicz, J., Pieszyński, & Kostka, J. (2015). Comparison of the analgesic effect of interferential current (IFC) and TENS in patients with low back pain. Wiad Lek, 68 (1), 13-9. Abstract retrieved March 3, 2017 from PubMed database.

Rajfur, J., Pasternok, M., Rajfur, K., Walewicz, K., Fras, B., Bolach, B., et al. (2017). Efficacy of selected electrical therapies on chronic low back pain: a comparative clinical pilot study. Medical Science Monitor, January, (23), 85-100. Abstract retrieved March 3, 2017 from PubMed database.

Samuel, S. R., & Maiya, G. A. (2015). Application of low frequency and medium frequency currents in the management of acute and chronic pain - a narrative review. Indian Journal of Palliative Care, 21 (1), 116-120. (Level 5 evidence)

Suriya-amarit, D., Gaogasigam, C., Siriphorn, A., & Boonyong, S. (2014). Effect of interferential current stimulation in management of hemiplegic shoulder pain. Archives of Physical Medicine Rehabilitation, 95 (8), 1441–1446. Abstract retrieved April 13, 2015 from Pub Med database.

Zeng, C., Li, H., Yang, T., Deng, Z. H., Yang, Y., Zhang, Y., et al. (2015). Electrical stimulation for pain relief in knee osteoarthritis: systematic review and network meta-analysis. Osteoarthritis and Cartilage, 23 (2), 189-202. Abstract retrieved April 13, 2015 from PubMed database.

ORIGINAL EFFECTIVE DATE:  3/1/2000   

MOST RECENT REVIEW DATE:  4/12/2018

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Policies included in the Medical Policy Manual are not intended to certify coverage availability. They are medical determinations about a particular technology, service, drug, etc. While a policy or technology may be medically necessary, it could be excluded in a member's benefit plan. Please check with the appropriate claims department to determine if the service in question is a covered service under a particular benefit plan. Use of the Medical Policy Manual is not intended to replace independent medical judgment for treatment of individuals. The content on this Web site is not intended to be a substitute for professional medical advice in any way. Always seek the advice of your physician or other qualified health care provider if you have questions regarding a medical condition or treatment.

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