Effectiveness of neuromuscular electrical stimulation and ibuprofen for pain caused by necrosis of the femoral head

Abstract

This retrospective study analyzed the effectiveness of neuromuscular electrical stimulation (NMES) for pain relief caused by necrosis of femoral head (NFH).Totally, 80 cases of patients with NFH were analyzed and then were assigned to a treatment group or a control group in this study. Of these, 40 cases in the treatment group received ibuprofen and NMES therapy. The other 40 cases in the control group received ibuprofen alone. Cases in both groups were treated for a total of 6 weeks. The primary outcome of pain intensity was measured by a visual analog scale (VAS). The secondary outcome was assessed by Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). In addition, adverse events (AEs) were also recorded in each case. All outcomes were evaluated before and after the treatment.After treatment, patients in the treatment group showed more effectiveness in pain relief, as measured by VAS (P < .01) and WOMAC sub-pain scale (P < .01), except stiffness, as evaluated by WOMAC sub-stiffness scale (P = .07), and function, as assessed by WOMAC sub-function scale (P = .09), than patients in the control group. Additionally, no significant differences in AEs were detected between 2 groups.This study found that NMES may be helpful for pain relief in patients with NFH.

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“…Moreover, PEMFs may promote bone formation, antioxidant and adenosine receptors synthesis reducing pro-inflammatory cytokines in CRPS I [ 49 ]. Concerning NMES, encouraging results were also reported in reducing pain after 6 weeks in patients with osteonecrosis of the femoral head [ 13 ].…”

“…every other day for 20 days) [ 9 ], oral calcium citrate (1 stick of 500 mg per day for 1 month), and cholecalciferol (1 oral solution of 25,000 IU weekly for 1 month). Pharmacological approach was associated with instrumental physical therapy, including Pulsed Electromagnetic Fields (PEMFs) stimulation [8 h per day (night use) for 6 weeks; the device generated single-voltage pulses of 1.3 milliseconds in duration, with a frequency of 75 Hz, and was positioned on the lateral thigh] [ 10 – 12 ], and Neuromuscular Electrical Stimulation (NMES) [ 13 ] of the left quadriceps (1 session per day for 3 weeks; electrodes were placed around the thigh for 30 min each session, generating a frequency of 50 Hz, pulse duration of 250 ms, and 10 s on and 30 s off). Moreover, protected weight bearing for 3 weeks was advised.…”