Abstract
This article was not intended to be a complete review of the electromyography of pathological muscle states, but it was written to illustrate how the “Coletti Method of EMG ChemoDenervation” (CMECD©) protocol for the treatment of chronic pain resulting from chronic muscle spasm was developed and established. That process led to an unexpected understanding of the underlying pathophysiology of chronic muscle spasm, which represents a paradigm shift in our understanding and ultimately in our treatment of muscle spasm-induced chronic pain. Other investigators had brought to light the presence of spontaneous electrical activity (SEA) in states of muscle spasm. Those findings were all but ignored by standard EMG/Nerve conduction studies in clinical practice. Starting with a simple EMG device I experimented with various medications to treat patients with chronic pain associated with chronic muscle spasm. Suppression of SEA with long-acting medications resolved both the chronic spasm and chronic pain. A successful protocol using phenoxybenzamine was established and clinical outcomes were followed. More than 200 patients were successfully treated during last 12 years. Correlating known exercise muscle physiology with the development of the pathological state of chronic muscle spasm as seen by electromyography led to the postulation of the ischemic model of chronic muscle spasm. Light microscopy pathophysiologic supportive findings are presented and discussed. Predictions from this model to various aspects of treatment were supportive. Implications regarding treatment by the CMECD© procedure, as well as other standard therapies, are discussed. Application of the ischemic model to other pain conditions was explored with implications of therapeutic modification. Recommendations for changes in rehabilitation therapy are discussed.
Highlights
This article was not intended to be a complete review of the electromyography of pathological muscle states, but it was written to illustrate how the “Coletti Method of EM G ChemoDenervation” (CMECD ) protocol for the treatment of chronic pain resulting fro m chronic muscle spasm was developed and established
This article was not intended to be a complete review of the electromyography of pathological muscle states, nor to present the findings of a clinical trial, but it was written to present new concepts and models of skeletal muscle pathophysiology that were realized in the development of the CMECD protocol for the treatment of chronic pain resulting from chronic muscle spasm
That process led to an unexpected understanding of the underlying pathophysiology of chronic muscle spasm, which may represents a paradigm shift in our understanding and in our treatment of muscle spas m induced chronic pain
Summary
Interventional Health, PA, Lewes, DE, USA. This article is distributed under the terms of the Creative Commons Attribution Commercial License ( CC BY 4.0), which permits any commercial use, distribution, and reproduction in any medium, provided the original author( s) and source are credited.
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