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What is Neuromuscular Electrical Stimulation?

J. Beam
J. Beam

Neuromuscular electrical stimulation (NMES) is the application of electrical stimuli to a group of muscles, most often for the purpose of muscle rehabilitation. This technique is primarily used by physical therapists as a form of rehabilitation after injury, stroke, or other incident that results in the loss of muscle function. NMES is achieved by passing an electrical impulse from a device through electrodes placed on the skin over the targeted muscle or muscles.

For the purpose of rehabilitation, neuromuscular electrical stimulation is typically used in conjunction with other methods of physical therapy. The intent of is to stimulate the nerves in the muscle with electrical impulses, since they are a natural part of the normal communication between the brain and the muscular system in an uninjured or unaffected body. With this therapy, these natural impulses are simulated and can help “retrain” the muscles to function again.

Neuromuscular electrical stimulation is done by passing an electrical impulse from a device through electrodes placed on the skin over the targeted muscle or muscles.
Neuromuscular electrical stimulation is done by passing an electrical impulse from a device through electrodes placed on the skin over the targeted muscle or muscles.

Even with the use of NMES, most rehabilitation patients must also undergo physical therapy to prevent muscles from atrophying, or dying. In some cases, depending on the cause and extent of injury, other forms of electrical stimulation therapy may also be used. Similarly, the same electrical technology is used to measure the performance of nerves and muscles for diagnostic purposes and measuring improvement.

While neuromuscular electrical stimulation is most often used in rehabilitation of injured muscles or stroke, it has also been used to improve the health of damaged tissue. This technique is also sometimes used to provide relief for chronic pain.

Neuromuscular electrical stimulation is often used in conjunction with physical therapy.
Neuromuscular electrical stimulation is often used in conjunction with physical therapy.

Not all individuals are candidates for NMES therapy, either for rehabilitation or pain management. Patients who have suffered heart attacks, have a pacemaker, and those with certain other medical conditions should not use it. In the event of muscle failure from injury or stroke, a physical therapist will work in conjunction with the patient’s healthcare team to determine the right therapy, and may adjust it as needed.

Discussion Comments

anon332489

Dr. Terry Wahls has done tests using this on MS patients. I'm hoping this can help my husband!

anon330797

@anon282686: You can use direct current E-stim on denervated muscles - in cases of hemiplegia due to stroke, in order to maintain some muscle tone. However, the caveat to that is that some stimulation is beneficial, and may induce nerve regrowth, but too much may cause the nerve to regress (the body doesn't see a "need" for the nerve due to the outside stimulation from the surface electrodes)

anon330317

@miriam98: You can use e-stim for muscle strengthening, treating muscle spasm, edema, acute and chronic pain and a variety of other issues. It also speeds tissues healing - in cases of tendinitis.

anon330316

@NathanG: Russian protocol is generally more comfortable to the patient than traditional TENS, because it delivers a higher carrier frequency in bursts, so patients can tolerate a greater amplitude of current.

@anon270040: Yes, you can use this type of stimulation for muscle re-education and targeting denervated muscle.

anon282686

NMES seems to me to hold great potential. Much still has to be done so that it can be a more proven line of treatment for certain illnesses. I would personally like to know its effects in stroke patients, hemiplegics and paraplegics, since they need it the most.

anon270040

The above article on Neuromuscular Electrical Stimulation is good but it did not say anything about a patient who is hemiplegic in either the left or right side of the body as a result of stroke. Please will somebody in this category benefit from the stimulation? Give more details.

NathanG

@SkyWhisperer - There are a variety of applications to electrical stimulation of muscles. I’ve heard that the Russians have used it for their Olympic teams, to help them in training for example. Russian electrical stimulation uses a high frequency to produce a deeper massage of the muscles than what is produced by regular muscle treatment.

It makes the muscles much stronger but is more painful to endure, which I suppose Russian athletes have learned is the price they must pay to compete.

SkyWhisperer

I hear that this technology holds a lot of promise for people who suffer from lower back pain. A company recently announced a patent for an implantable nerve stimulator. The device is "installed" in the patient’s back and shoots up electrical impulses from time to time into the back muscles to strengthen them and relieve the pain.

I’m not sure about the cost, but this would be a great help to a lot of people with back pain.

David09

@miriam98 - I don’t think the conditions you listed would qualify for electrical muscle stimulation. The key is the treatment is for muscles that have atrophied. For typical conditions like tendinitis, doctors usually recommend exercises to strengthen the muscles again.

I think you can regain good working condition of your muscles with orthopedic exercises and heat and ice pack treatments. Electrical stimulation physical therapy sounds like it’s for people who have lost all mobility, and need to have their muscles “awakened” in order to be put back to good use.

miriam98

These are interesting insights into electrical muscle stimulation. I am wondering if this has application beyond rehabilitation. For example, can this treatment help people who have suffered from tendinitis, carpal tunnel syndrome or bursitis?

I ask because I’ve heard that sometimes muscles can become “frayed” with some of these conditions, and am wondering if sending little shocks into the muscle system can help retrain the muscles again.

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    • Neuromuscular electrical stimulation is done by passing an electrical impulse from a device through electrodes placed on the skin over the targeted muscle or muscles.
      By: Albert Lozano-Nieto
      Neuromuscular electrical stimulation is done by passing an electrical impulse from a device through electrodes placed on the skin over the targeted muscle or muscles.
    • Neuromuscular electrical stimulation is often used in conjunction with physical therapy.
      Neuromuscular electrical stimulation is often used in conjunction with physical therapy.
    • Neuromuscular electrical stimulation may be used to relieve chronic pain in some people.
      By: praisaeng
      Neuromuscular electrical stimulation may be used to relieve chronic pain in some people.
    • NMES may be used to help patients regain muscle control on the affected side of their bodies after a stroke.
      By: sframe
      NMES may be used to help patients regain muscle control on the affected side of their bodies after a stroke.
    • Neuromuscular electrical stimulation is sometimes used to provide relief from chronic pain.
      By: Monkey Business
      Neuromuscular electrical stimulation is sometimes used to provide relief from chronic pain.