Electric Muscle Stimulation in for Neck or Back Pain

Electrical muscle stimulation, aka e-stim or electrostim, is an adjunct physical therapy modality often used to reignite muscles' ability to contract. Enhancing muscle contraction may help you control pain, get stronger, increase physical functioning, retrain movements you may have lost, and/or manage inflammation.

While it is the most well-known type of electrical stimulation, transcutaneous electrical nerve stimulation (TENS) treatment, is not the only type of e-stim. TENS offers a pain relief strategy you can use at home or take with you on the go, Some types of e-stim provided in physical therapy settings stimulate muscles to contract as an approach to making them stronger and encouraging blood circulation. Blood circulation can directly affect the condition of your muscle tissue.

Electrical stimulation is also used in cases of spinal cord injury and other neuromuscular conditions.

Electro Stimulation In Physical Therapy To A Young Woman
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What Happens During an E-stim Treatment?

During an e-stim treatment, electrodes are hooked up to an electric stimulation machine and placed around the affected area of your back or neck.

According to Michael Crary who wrote the book Dysphagia: Clinical Management in Adults and Children, the electrodes may be placed on the skin, on the muscles, or by implantation.

Here's what you can expect:

  • For most neck or back injuries treated in outpatient physical therapy clinics, the electrodes will be placed on your skin.
  • The exact placement of the electrodes depends on the reason for treatment, as well as how deep or superficial your therapist intends for the current to go. The electrodes are often placed near a motor point of a muscle so that the correct contraction occurs.
  • Your therapist will adjust the controls of the electric stimulation machine with the goal of getting a good muscle contraction with minimal discomfort.

An electric stimulation treatment lasts about 5 or 15 minutes.

Electric Stimulation Therapy for Spinal Joint Stabilization

Because e-stim ignites muscles and calls them into action, it may help increase spinal joint stability, and therefore improve problems with spinal instability.

The home exercise program your therapist teaches you will be instrumental in helping you maintain your joint stability, and it is thought that electrostim can enhance this process.

E-stim may also contribute to your muscle strength and endurance. Muscle endurance is the number of times a muscle can contract before it fatigues.

Electric Stimulation for Healing and Pain Control

By reducing swelling and increasing circulation, electric muscle stimulation therapy may also enhance tissue healing and help control inflammation.

And it may help reduce pain sensations by blocking nerve transmission at the spinal cord.

For treating pain, your healthcare professional may suggest a TENS unit, which is a take-home electric stimulation therapy. While many patients report good pain control results using TENS, not all healthcare providers are on board with it.

Does Electrical Muscle Stimulation Work?

Despite its popularity, muscle stimulation does not top of the list of effective neck or back treatments.

The lineup, according to a 2018 article published in the European Spine Journal, goes more like this:

  • For mild to moderate, non-serious neck or back pain, exercise, yoga, short-term cognitive behavioral therapy, biofeedback, progressive relaxation, massage, manual therapy, and acupuncture are the recommended go-to therapies.
  • Taking non-steroidal anti-inflammatory medication, Tylenol, and/or antidepressants may also help.
  • Spinal manipulation is a type of chiropractic adjustment, and physical therapists are licensed to give this treatment, as well.

The authors of the study also say that interdisciplinary treatment, which essentially means you'll have a variety of therapies tailored to your specific back or neck pain, tends to get good results.

The review found that electrical muscle stimulation is not a particularly effective spine treatment. Muscle relaxers, botox injections, steroid injections, wearing a cervical collar for a neck injury, traction, TENS, and short wave diathermy were also on the no-go list.

You and your healthcare professional should discuss your symptoms and condition to determine which treatment would be best for you.

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5 Sources
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  1. Ho CH, Triolo RJ, Elias AL, et al. Functional electrical stimulation and spinal cord injury. Phys Med Rehabil Clin N Am. 2014;25(3):631-54.  doi:10.1016/j.pmr.2014.05.001

  2. Groher ME, Crary MA. Dysphagia: Clinical Management in Adults and Children (2nd Edition). Mosby. 2015.

  3. Veldman MP, Gondin J, Place N, Maffiuletti NA. Effects of Neuromuscular Electrical Stimulation Training on Endurance Performance. Front Physiol. 2016;7:544.  doi:10.3389/fphys.2016.00544

  4. Johnson MI, Jones G, Paley CA, Wittkopf PG. The clinical efficacy of transcutaneous electrical nerve stimulation (TENS) for acute and chronic pain: a protocol for a meta-analysis of randomised controlled trials (RCTs). BMJ Open. 2019;9(10):e029999.  doi:10.1136/bmjopen-2019-029999

  5. Chou R, Côté P, Randhawa K, et al. The Global Spine Care Initiative: applying evidence-based guidelines on the non-invasive management of back and neck pain to low- and middle-income communities. Eur Spine J. 2018;27(Suppl 6):851-860.  doi:10.1007/s00586-017-5433-8

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