Abstract
Introduction: Noninvasive Electrical Twitch-Obtaining Intramuscular Stimulation (eToims) is safe and efficacious in long-term management of chronic refractory myofascial pain (CRMP). Objective: To evaluate factors influencing patient self-selection for long-term eToims management of CRMP. Methods and materials: Included were 133 consecutive CRMP patients (65 males, 68 females) who opted to pay for eToims treatments between 12/1/09 and 12/31/11. Each session involved treatment to large muscles of C3-C7 and L3-S1 myotomes. Outcome measures include immediate prep Group1: ≤ 10 treatments and immediate reduction of VAS ≥ 2; Group2: >10 treatments and immediate reduction of VAS 10 treatments and immediate reduction of VAS ≥ 2. Safety precautions include interval history and vital signs before and after treatment. Results: Groups 0 & 1 comparison showed no measured ROM difference. Group 3 & Group 2 comparison demonstrated shorter interval between treatments (15+47 vs. 138+167 days respectively, p<0.001), longer treatment duration/session (52.0+26.0 vs. 49.0+22.0 minutes, respectively), and immediate improvement in all ROM measured. Group pain relief appears influenced by age, symptom duration, treatment duration/session, pulse reduction and improvement in ROM. No eToims-associated safety issues noted. Conclusions: Safe and efficacious pain relief with concomitant immediate improvement in ROM and pulse rate reduction correlates with patient satisfaction and self-selection to return for multiple eToims treatments over time.
Highlights
Noninvasive Electrical Twitch-Obtaining Intramuscular Stimulation is safe and efficacious in long-term management of chronic refractory myofascial pain (CRMP)
Safe and efficacious pain relief with concomitant immediate improvement in ROM and pulse rate reduction correlates with patient satisfaction and self-selection to return for multiple Electrical Twitch-Obtaining Intramuscular Stimulation (eToims) treatments over time
We aim to demonstrate that patients, who self-select repeat eToims treatment sessions over prolonged periods of time, do so because of receiving pain-relieving results, indicating patient satisfaction
Summary
Noninvasive Electrical Twitch-Obtaining Intramuscular Stimulation (eToims) is safe and efficacious in long-term management of chronic refractory myofascial pain (CRMP). Patients with myofascial pain syndrome present with painful muscles, which tend to restrict the range of motion of the joint upon which they act. Tender points on palpable taut muscle bands, that when compressed produce stereotypical referred pain patterns, are named myofascial trigger points (MTrPs). On physical examination MTrPs are the main and pathognomonic finding of myofascial pain syndrome. Snapping palpation of the myofascial band produces a local twitch response [1]. MTrPs merit special attention because eliciting local twitch response and referred pain requires skill and experience, with difficulty in reproducibility. Meta analysis suggests that physical examination cannot be recommended as a reliable test for the diagnosis of trigger points, based on limited number of available studies, along with concurrent problems in their design, reporting, statistical integrity, and clinical applicability [2]. Deeper MTrPs appear beyond the reach of manual palpation, especially those involving huge muscles of the pelvic girdle, such as gluteus maximus and adductor magnus, or in other similar deeply situated and/or large muscles
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