title: The role of the monopolar electromyographic pin in myofascial pain therapy: automated twitch-obtaining intramuscular stimulation (ATOIMS) and electrical twitch-obtaining intramuscular stimulation (ETOIMS).
abstract: OBJECTIVE
  To show that the monopolar pin electrode has a role in the control of radiculopathy related myofascial pain and fibromyalgia using the automated twitch-obtaining intramuscular stimulation (ATOIMS) and electrical twitch-obtaining intramuscular stimulation (ETOIMS) methods.
  
  
  METHODS
  A hand-held ATOIMS device facilitated the insertion, oscillation and retraction of the monopolar pin into motor end-plate regions. The device oscillated the pin at 2 Hz for three times in two seconds. ETOIMS method employed micro-stimulation at 2 Hz for two seconds/point. Obtaining muscle twitches were the goals of both treatments. This is a retrospective study of two patients with fibromyalgia who received these treatments. Patient #1 with chronic low back > neck pain, underwent treatments which included the L2-S1 myotomes and patient #2 with chronic neck pain > low back pain, received treatments to the bilateral C2-T1 myotomes. Both received treatments also to bilateral C3-S1 paraspinal muscles. Treatments to both began with ETOIMS for two months and five months respectively. Following this period, they both received ATOIMS and ETOIMS to the same muscles in the same treatment session. The combined procedure sessions continued for the same treatment duration as for ETOIMS only sessions. Both patients recorded daily visual analog pain levels.
  
  
  RESULTS
  Significant reductions in pain levels occurred with the increase in number of ETOIMS treatment sessions. More significant pain level reductions occurred with combined ATOIMS & ETOIMS treatments than with ETOIMS only treatments. The monopolar pin served both procedures well and there were no complications.
  
  
  CONCLUSIONS
  The monopolar pin has a very promising role in the management of radiculopathy related myofascial pain using the ATOIMS and ETOIMS methods.
authors.affiliation: Department of Rehabilitation Medicine, Hospital of the University of Pennsylvania, Philadelphia, USA.
authors.forename: J
authors.initials: J
authors.lastname: Chu
mesh_terms: D000328:Adult; D016009:Chi-Square Distribution; D002908:Chronic Disease; D004599:Electric Stimulation Therapy / Q000295:instrumentation*; D004567:Electrodes, Implanted; D004576:Electromyography / Q000295:instrumentation*; D004867:Equipment Design; D005260:Female; D005356:Fibromyalgia / Q000628:therapy; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D017116:Low Back Pain / Q000628:therapy; D008297:Male; D008839:Microelectrodes; D009045:Motor Endplate / Q000502:physiology; D009119:Muscle Contraction / Q000502:physiology; D018482:Muscle, Skeletal / Q000294:innervation; D009209:Myofascial Pain Syndromes / Q000503:physiopathology / Q000628:therapy*; D019547:Neck Pain / Q000628:therapy; D010147:Pain Measurement; D012189:Retrospective Studies