title: Electrical twitch-obtaining intramuscular stimulation in lower back pain: a pilot study.
abstract: OBJECTIVE
  To determine if electrical twitch-obtaining intramuscular stimulation (ETOIMS) provides greater myofascial lower back pain relief than muscle stimulation or skin stimulation.
  
  
  METHODS
  In this single-blinded, crossover, pilot trial performed at a university-affiliated outpatient rehabilitation medicine department in Taiwan, 12 acupuncture-naive patients with lower back pain of 3-60 mos duration received one crossover treatment every 2 wks by monopolar needle electrode insertion at bilateral T10-S1 levels to: (1) paraspinal muscles, (2) overlying skin, and (3) paraspinal muscles with ETOIMS applied via the needle electrode at individual treatment sites. A total of 30 manual insertions per side per treatment were performed, with withdrawal after 2 secs. Beginning 1 wk before each trial and continuing until 2 wks after, patients completed a visual analog scale twice daily. In addition, on the day of treatment, patients received a physical examination and completed a visual analog scale both before and after treatment.
  
  
  RESULTS
  Significant and immediate reduction in the visual analog scale levels was noted only with ETOIMS. Immediate improvement occurred in one of nine physical tests with muscle stimulation and ETOIMS only. In the 2 wks after treatment, absolute visual analog scale levels for ETOIMS were significantly lower than muscle stimulation and skin stimulation. ETOIMS resulted in a greater percentage of pain relief in the first week after treatment, although it was not statistically significant from muscle stimulation and skin stimulation.
  
  
  CONCLUSIONS
  ETOIMS provided significantly greater immediate and sustained myofascial lower back pain relief than muscle stimulation and skin stimulation. Although a greater percentage of pain reduction occurred with ETOIMS, it was not statistically significant.
authors.affiliation: Department of Rehabilitation Medicine, Hospital of the University of Pennsylvania, Philadelphia 19104-4283, USA.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Chu
authors.forename: Ka-fai
authors.initials: KF
authors.lastname: Yuen
authors.forename: Bo-han
authors.initials: BH
authors.lastname: Wang
authors.forename: Rai-chi
authors.initials: RC
authors.lastname: Chan
authors.forename: Ira
authors.initials: I
authors.lastname: Schwartz
authors.forename: Duncan
authors.initials: D
authors.lastname: Neuhauser
mesh_terms: D015670:Acupuncture Therapy / Q000379:methods*; D000328:Adult; D000368:Aged; D018592:Cross-Over Studies; D004599:Electric Stimulation Therapy / Q000379:methods*; D004576:Electromyography; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009068:Movement / Q000502:physiology; D018485:Muscle Fibers, Skeletal / Q000502:physiology; D018482:Muscle, Skeletal / Q000294:innervation* / Q000503:physiopathology; D009339:Needles; D010147:Pain Measurement; D010865:Pilot Projects; D012867:Skin / Q000294:innervation; D016896:Treatment Outcome