Electrical Muscle Stimulation (EMS)
Injury type: Acute/ Chronic
Category: Allied Health Options
Rating: No research
What is it?
Similar to electrical nerve stimulation, in which an alternating electrical current (AC) or modulated direct current (DC) is passed through the tissues for pain relief. However, in this approach the intensity is higher, leading to additional muscle contractions. EMS is applied using an electrical device and should only be provided by qualified practitioners. The current stimulates muscles to contract through electrodes placed on the skin. It can be used to prevent muscle wasting when muscles are not able to work by themselves, especially when it is expected that the muscles will begin working at a later stage.
How does it work?
The current may inhibit pain in the tissues surrounding the electrodes by inhibiting pain impulses (the so-called ‘pain gate theory’). The higher intensity can also stimulate rhythmic muscle contractions which may improve joint range of movement, re-educate muscles, retard muscle atrophy, and increase muscle strength. Circulation can be increased and muscle tension decreased, which may lead to secondary pain relief.
Is it effective?
A clinical practice guideline1, which was underpinned by systematic reviews of high-quality studies, suggested that clinicians should not offer EMS as a treatment option for acute and persistent grades I-II neck pain and associated disorders (including whiplash). However, this recommendation was based on a single randomised controlled trial, albeit with low risk of bias. There is no research specifically examining the effectiveness of EMS on people with whiplash.
Are there any disadvantages?
There has been no research on the disadvantages associated with EMS. The treatment is only available through a qualified health professional, and it may not be suitable for everyone.
Where do you get it?
Electrical muscle stimulation may be provided by therapists involved in facilitating recovery from whiplash.
Recommendations
The use of EMS for whiplash is not recommended because of limited current research evidence. More research is required.