Electric Muscle Stimulation in for Neck or Back Pain

Electric 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.

Contrary to popular opinion, TENS treatment, or transcutaneous electrical nerve stimulation, 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, while e-stim provided in orthopedic physical therapy settings stimulates muscles to contract as a way of making them stronger and encouraging blood circulation. The latter is said to 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.

But 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 which the treatment is given, as well as how deep or superficial your therapist intends for the current to go. The way the muscle changes shape once it’s exposed to the current is another factor in determining placement of the electrodes.

Your therapist will adjust the controls of the electric stimulation machine up to the point where you feel a prickly sensation. This sensation should be noticeable, but not overly intense. An electric stimulation treatment lasts about 10 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 overall spinal stability.

Of course, the home exercise program your therapist teaches you will likely be instrumental in your success maintaining joint stability, but 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 inflammation control.

And it may help reduce pain sensations by blocking nerve transmission at the spinal cord. For this, your healthcare provider 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.

The authors 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.

But if your spinal problem is more serious, for example, symptoms include pain, weakness, numbness and/or electrical sensations that travel down one arm or leg, the researchers recommend that your care provider consider spinal manipulation and non-steroidal anti-inflammatory medication. Spinal manipulation is usually in the form of a chiropractic adjustment, although physical therapists are licensed to give this treatment, as well

The researchers say that some of the treatments listed above for non-serious back or neck pain may be of value as well. Determining which ones may be right for you is a conversation best had with your healthcare provider.

Sadly, 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 neck injury, traction, TENS, which is a home muscle stimulation treatment, and short wave diathermy were also on the no-go list.

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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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