Short-term effect of multifidus muscle intramuscular electrical stimulation in chronic low back pain

Abstract

Interventions for mechanical low back pain (LBP) include physical therapy and pharmaceutical management, as well as surgical intervention. Although the paraspinal muscles have been identified as important spinal stabilizers and are targeted during physical therapy, diminished activation of this muscle can lead to biomechanical dysfunction and lead to mechanical LBP. Intramuscular electrical stimulation (IMES) with low-frequency (2 Hz) current facilitates release of endogenous opioids which promotes analgesia and causes activation of multifidus muscle and improves the changes produced by muscular dysfunction. After single session of intervention, the patient reported that her pain levels were 0 and 1 on a numeric pain scale of 0-10 during rest and walking, respectively. The average score on the Oswestry LBP Disability Questionnaire was reduced from 43/50 to 11/50. Thus, IMES can be used as an effective therapeutic strategy to directly target the deep multifidus muscle and to treat mechanical LBP produced due to multifidus dysfunction.

Keywords

• back pain
• endogenous opioids
• intramuscular electrical stimulation
• muscle recruitment