BMJ Case Reports 2012; doi:10.1136/bcr-2012-007648
  • Unexpected outcome (positive or negative) including adverse drug reactions

An unusual effect of interferential therapy

  1. Aisling Gaughran
  1. Department of Physiotherapy, St. Patrick's Hospital, Carrick on Shannnon, Ireland
  1. Correspondence to Dr Keramat Ullah Keramat, Karamatjee{at}


In this report, a patient with severe shoulder pain was treated with interferential currents, a commonly used modality in physiotherapy for the management of pain. He reported loss of concentration, drowsiness, decreased alertness and gait disturbance, along with analgaesia, for 4–5 h after each treatment. He was regularly taking tramadol HCl for pain relief. Endogenous opioids produced in response to interferential therapy may be excessive or may interact with the tramadol HCl and potentiate its effect. There is no published report of interferential-induced symptoms, as described above, in the authors’ knowledge. The clinician using interferential currents should be aware of this possible effect.

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