The efficacy of intramuscular electrical stimulation in the management of patients with myofascial pain syndrome: a systematic review

Abstract

Introduction Myofascial pain syndrome (MPS) is one of the most common disorders causing chronic muscle pain. Almost one-third of patients with musculoskeletal complaints meet the MPS criteria. The aim of this study is to evaluate the effectiveness of intramuscular electrical stimulation (IMES) in patients with MPS through a systematic review method. Methods PubMed, Scopus, Embase, ProQuest, PEDro, Web of Science, and CINAHL were systematically searched to find out the eligible articles without language limitations from 1990 to December 30, 2020. All relevant randomized controlled trials that compared the effectiveness of IMES with sham-IMES, dry needling, or exercise therapy in patients with MPS were included. Full texts of the selected studies were critically appraised using Revised Cochrane risk-of-bias tool for randomized trials (RoB2). Results Six studies (out of 397) had met our inclusion criteria (involving 158 patients) and were entered to the systematic review. Outcome measures examined in these studies included pain, range of motion, pressure pain threshold, biochemical factors, disability, and amount of analgesic use. In the most studies, it has been shown that IMES is more effective than the control group in improving some outcome measurements such as pain. Conclusion There is preliminary evidence from a few small trials suggesting the efficacy of IMES for the care of myofascial pain syndrome. The data support the conduct of larger trials investigating the efficacy of IMES.

Intramuscular Electrical Stimulation to Trigger Points: Insights into Mechanisms and Clinical Applications—A Scoping Review

“…To our knowledge, our scoping review using the PRISMA-ScR methodological framework is the first to investigate the mechanisms of IMES to the TrP location, and therefore is an important contribution to the literature. According to the results of our scoping review, and previous reviews [ 32 , 47 ], few studies investigating the mechanisms of IMES to the TrP are available. Clinical studies suggest the addition of electrical current to dry needling or acupuncture is an effective treatment option for MPS, but few have also specifically targeted the TrP.…”

“…Evidence is gradually accumulating to support the use of IMES in patients with MPS [ 39 , 42 , 44 , 45 , 46 ]. However, a recent systemic review on IMES reported that among the six included studies, only three directly targeted TrPs [ 47 ]. Furthermore, objective variables related to the effects of IMES to the TrP region were lacking in all studies, limiting insight into the potential mechanisms of IMES.…”

“…Systematic reviews usually address clinical effectiveness of a therapeutic intervention to better guide clinical practice decisions based on randomized clinical trials. As it has been previously presented, there is a small number of clinical trials using IMES targeting TrPs [ 47 ]. In such a scenario, scoping reviews are used to identify, report, and discuss the available evidence on a specific topic/concept; an appraisal procedure usually referred to as “evidence mapping”.…”

Effect of ischemic compression on myofascial pain syndrome: a systematic review and meta-analysis

“…The present systematic review included articles that met the following PICOS criteria: (1) patients: confirmed diagnosis of MPS according to the established criteria by Simon et al [ 25 , 26 ]; (2) intervention: Ischemic compression therapy should be administered alone or as the primary intervention combined with the usual intervention; (3) comparison or control: inactive comparison of sham or placebo, or active comparison using other usual intervention; (4) outcomes: pain is the primary outcome, and other indices that reflect the quality of life or other MPS-related symptoms are secondary outcomes; and (5) study: only RCTs.…”

“…The present systematic review included articles that met the following PICOS criteria: (1) patients: confirmed diagnosis of MPS according to the established criteria by Simon et al [25,26]; (2) intervention: Ischemic compression therapy should be administered alone or as the primary intervention combined with the usual intervention;…”