You are here

  • Home
  • Archive
  • Volume 3, Issue 2
  • American football and other sports injuries may cause migraine/persistent pain decades later and can be treated successfully with electrical twitch-obtaining intramuscular stimulation (ETOIMS)

Article Text

Article menu

Download PDFPDF

XML
Medical devices
Original article
American football and other sports injuries may cause migraine/persistent pain decades later and can be treated successfully with electrical twitch-obtaining intramuscular stimulation (ETOIMS)
  1. J Chu1,
  2. S McNally2,
  3. F Bruyninckx3,
  4. D Neuhauser4
  1. 1Department of Physical Medicine and Rehabilitation, Perelman School of Medicine, University of Pennsylvania, Ardmore, Pennsylvania, USA
  2. 2Manchester United, Manchester, UK
  3. 3Leuven University Hospitals, Leuven, Belgium
  4. 4Department of Epidemiology and Biostatistics, School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA
  1. Correspondence to Dr J Chu, Department of Physical Medicine and Rehabilitation, Perelman School of Medicine, University of Pennsylvania, Ardmore, PA 19003-2321, USA; jchu{at}etoims.com

Abstract

Introduction Autonomous twitch elicitation at myofascial trigger points from spondylotic radiculopathies-induced denervation supersensitivity can provide favourable pain relief using electrical twitch-obtaining intramuscular stimulation (ETOIMS).

Aim To provide objective evidence that ETOIMS is safe and efficacious in migraine and persistent pain management due to decades-old injuries to head and spine from paediatric American football.

Methods and materials An 83-year-old mildly hypertensive patient with 25-year history of refractory migraine and persistent pain self-selected to regularly receive fee-for-service ETOIMS 2/week over 20 months. He had 180 sessions of ETOIMS. Pain levels, blood pressure (BP) and heart rate/pulse were recorded before and immediately after each treatment alongside highest level of clinically elicitable twitch forces/session, session duration and intervals between treatments. Twitch force grades recorded were from 1 to 5, grade 5 twitch force being strongest.

Results Initially, there was hypersensitivity to electrical stimulation with low stimulus parameters (500 µs pulse-width, 30 mA stimulus intensity, frequency 1.3 Hz). This resolved with gradual stimulus increments as tolerated during successive treatments. By treatment 27, autonomous twitches were noted. Spearman's correlation coefficients showed that pain levels are negatively related to twitch force, number of treatments, treatment session duration and directly related to BP and heart rate/pulse. Treatment numbers and session durations directly influence twitch force. At end of study, headaches and quality of life improved, hypertension resolved and antihypertensive medication had been discontinued.

Conclusions Using statistical process control methodology in an individual patient, we showed long-term safety and effectiveness of ETOIMS in simultaneous diagnosis, treatment, prognosis and prevention of migraine and persistent pain in real time obviating necessity for randomised controlled studies.

  • Global Health
  • Inventions
  • Musculoskeletal
  • Sports Medicine

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/bmjinnov-2016-000151

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    View Full Text

    Footnotes

    • Twitter Follow Jennifer Chu @stopmusclepain

    • Contributors JC  was responsible for planning, conducting, and reporting of the work described in the submitted article. For the sports section and input/feedback for grammar and syntax: SM, Head of Football Medicine & Science, Manchester United, Manchester, UK, email: steve.mcnally@manutd.co.uk. For the neurophysiology section input/feedback: FB, Clinical Professor, Department of Physical Medicine and Rehabilitation, Director, Clinical Electromyography Laboratory, University Hospitals Leuven, Herestraat 49, B—3000 Leuven, Belgium, email: frans. bruyninckx@uzleuven.be. For the statistics section input/ feedback: DN, The Charles Elton Blanchard Emeritus Professor of Health Management and Emeritus Professor, Epidemiology and Biostatistics, Department of Epidemiology and Biostatistics, School of Medicine, Case Western Reserve University, Ohio, USA.

    • Competing interests JC is the sole inventor of ETOIMS and holds patents for the bipolar probe and electrodes. She is Emeritus Associate Professor, Physical Medicine and Rehabilitation, Perelman School of Medicine, University of Pennsylvania, USA, email: jchu@etoims.com.

    • Patient consent Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement Our data sharing is available. We have not mentioned this following manuscript for this submission but the effects of ETOIMS on ability to lower blood pressure and heart rate/pulse has been submitted for publication to BMJ Innovations (2016; JC, FB, DN). The blood pressure and heart rate changes as components of complex regional pain syndrome are improved with electrical twitch-obtaining intramuscular stimulation (ETOIMS) as pain treatment modality. Data are available to BMJ Innovations.