Using muscle stimulation to treat disease symptoms

What is muscle stimulation?

The treatment is applied to the so-called striated (skeletal) muscles. It does not significantly affect the viscera, i.e. smooth muscles.

There are two main forms.

• Treatment of a muscle with an intact motor nerve.
• Treatment of a muscle with an injured motor nerve – the so-called denervated muscle. Hungarian therapists call this type of treatment “denervated current”.

The essence of muscle stimulation treatment is that an electrode placed on the skin (which can be self-adhesive, metal or rubber) delivers an electrical impulse of milliamps (mA) current intensity to the treated muscle. The electrical impulse triggers muscle contraction. By controlling the impulse frequency, intensity and duration, you can define what kind of contraction occurs, how much of the muscle bundle it covers, at what speed and how frequently it happens.

The treatment can be focused on a specific muscle or muscle group, so the effect appears only on the treated muscle (and not throughout the body).

Normally a muscle contraction is produced by an electrical signal coming from your brain. During muscle stimulation the muscle receives similar, artificial impulses.

In both cases the muscle contracts by exactly the same mechanism, the same metabolic processes occur, and it fatigues in the same way.

If the contraction is the same, its effect is also identical. This is the basis for its application.

Relieving muscle stiffness

I think the most common muscle-stiffness problem is the “slept-on” neck. You wake up in the morning unable to turn your head in one direction. The muscles on that side are tight and painful. You can’t look sideways properly for days, and turning your head back is even worse…. If you do a muscle-relaxing stimulation treatment every 4–5 hours, it disappears by the next day, or at most within 2 days.

It is very common that after a fracture is healed and the cast is removed, the muscles and tendons that were immobilized for 2–3 months have stiffened and become contracted. This limits movement. With muscle stimulation you can “work them back into motion” and eliminate it in 8–10 days. Otherwise the stiffness remains or slowly resolves over months. A similar stiffening can be caused by postoperative immobilization or simply by lack of movement.

Muscle-relaxing treatments also help in treating shoulder pain, frozen shoulder, rotator cuff syndrome, epicondylitis, piriformis syndrome, etc.

In peripheral arterial disease (narrowing of vessels) and diabetes-related neuropathy, severe night-time spasms of the leg muscles ruin sleep. The cramp is very hard to relieve. Night cramps can be prevented by a muscle-relaxing treatment performed before going to bed!

In some diseases and conditions — for example ALS (amyotrophic lateral sclerosis), multiple sclerosis, post-stroke paralysis, etc. — certain muscle groups (for example the forearm flexors) become spastic (stiff), causing the hand to remain flexed. Opening the fingers for grasping or straightening the elbow then becomes extremely difficult. The tension becomes increasingly uncomfortable and even painful. Muscle stimulation with properly set frequency and impulse duration can very effectively relieve muscle stiffness, bringing hours-long relief to the spastic patient.

Improving blood circulation

In healthy people, physical exercise ensures that venous blood returns to the heart. While walking, contractions of the leg muscles compress the veins and “pump” the blood upwards toward the heart. If you move little or are bedridden by illness, this beneficial effect of the muscles disappears. Your circulation slows down, varicose veins develop, and you may get a thrombosis, which never heals without sequelae. Exercise — a regular 30–40 minute walk or cycling — would be the best medicine for this.

Muscle stimulation becomes relevant if your condition no longer allows you to exercise. Muscle stimulation “replaces” the pumping action of the muscles and improves your circulation. It also helps prevent thrombosis.

Vascular narrowing can have other causes, but poor circulation is likewise helped by movement (or, if movement is not possible, by muscle stimulation).

Muscle stimulation and joint pain

Joint complaints usually develop slowly and insidiously. Of course, sometimes a crack occurs after an accident or sports injury. But one of the fundamental causes is decreased joint stability. The joint is held together by ligaments and the joint capsule, but its stability is provided by the strength of the muscles surrounding it. If you move little and gain weight, the weakening muscles cannot support your increasing body weight. The bones forming the joint then bang against each other with every step — strong muscles would prevent this!

If your complaints are not yet severe, joint pain could easily be avoided with sport, exercise and movement. Trained muscles maintain joint stability.

This muscle weakness causes most knee pain, hip pain, back and spinal pain, including herniated discs. These could all be avoided with regular exercise — 30–40 minutes of daily exercise.

The problem is that you only realize it when back pain, a herniated disc or knee pain have already developed and your knee hurts with every step. You try to exercise in the hope of improvement, but the painful muscles and joints “don’t understand” this sudden exertion, and your pain rather increases. You soon stop. Then you may think only back or knee surgery can help. But that’s not necessarily true.

Muscle stimulation treatment, however, is. It effectively strengthens your muscles within a few weeks (literally while sitting in an armchair!) and after about 6–8 weeks you can gradually and simultaneously start exercise, movement and resistance training with your own weight. After 3 months your muscles will be so strong that you’ll only use the stimulator because you like the way it massages you.

If you are a visual person, watch my film about this. If you prefer to read, scroll down.

Regaining muscle strength

If your physical activity suddenly decreases for some reason, you quickly lose the strength you previously had and your muscle mass also begins to decline. For example, if a severe illness confines you to bed for 2–3 weeks or you cannot move after surgery, upon first standing you will find that your muscles barely support you. You have difficulty rising from a chair and cannot push yourself up into a sitting position from the bed.

Because many people ask me for advice, I’ve observed that domestic hospitals often do not pay sufficient attention to a patient’s recovery after a severe illness. They perform, say, your knee surgery and a few days later discharge you with instructions not to strain it and to return for a checkup in 3 weeks. You obediently rest, lie down, avoid effort and watch your muscles atrophy.

Three weeks later they tell you to get up and walk! You are surprised to find your knee stiff, your thigh trembling, and your knee joint unstable. You notice in alarm that your knee hurts again before you’ve even walked to the corner shop.

Of course — your rehabilitation was missed!

The stability and support of your knee are provided by the strength of your leg muscles, especially the thigh muscles. These have wasted away during rest! Without rehabilitation you end up in a serious situation.

However, if during forced bedrest you perform muscle-stimulating treatments on the key muscles (after knee surgery primarily the thigh muscles), you can prevent the loss of strength, resulting in a shorter recovery time and faster rehabilitation.

In theory you could exercise your thigh while sitting in an armchair — but after recent joint ligament, cartilage, etc. surgery this is prohibited because moving the joint is not allowed. Muscle stimulation is excellent in such situations. You can start treating the (thigh) muscles as early as the day after surgery because stimulation does not cause displacement in the joint! However, it works the muscle thoroughly, increases its blood circulation, and brings oxygen- and nutrient-rich blood to the injured area — so it not only preserves muscle strength but also accelerates your healing!

Delaying muscle atrophy

Muscle atrophy is not only caused by lack of movement. There are diseases that directly “damage” muscle tissue or the nerves that supply them. Affected muscles slowly lose strength, mass and tone, and after a while become rigid and spastic.

Muscle stimulators are effective in these cases as well, but while muscle weakness from inactivity can be reversed with stimulation, in the diseases mentioned here stimulation can only slow disease progression, prevent and relieve stiffness, pain and muscle cramps, and improve quality of life — it does not cure the muscle disease itself.

Treatment of paralyzed muscle

Muscle paralysis can be divided into two main groups.

• Central paralysis – here the nerve fibers to the muscle and the muscle itself are intact, but due to a brain injury (e.g. cerebral infarct or hemorrhage caused by stroke) the motor areas of the brain do not provide appropriate impulses.
• Peripheral paralysis – here the nerve fiber running to the muscle is injured (for example torn in an accident, a vertebra collapses and injures the nerve exiting the spinal cord, or a spine surgery damages the nerve fiber).

The two types of paralysis require different muscle stimulation impulses!

In central paralysis, the biphasic square wave used for healthy muscles is appropriate.

In peripheral paralysis, however, this is not suitable. In such cases denervated current treatment (or, in international terminology, denervated muscle treatment) must be used. Denervated muscle can be stimulated by long impulses lasting 2–900 milliseconds. The short (microsecond) duration biphasic square wave cannot bring a denervated muscle into adequate contraction.

The only domestic textbook considered a “bible” for physiotherapists (Physical Therapy in Practice) contains incorrect information about muscle stimulation, so many physiotherapists graduate with poor knowledge. For example, stroke-induced paralysis is treated with denervated current and high frequency. This increases muscle spasticity (the increasing stiffness forces the paralyzed limb into a fixed posture). The correct solution would be the biphasic square wave and low frequency.

Importance of muscle stimulation in paralysis

In paralysis the chance of recovery increases manyfold if the patient receives muscle stimulation treatment on a daily basis!

Those who return home after paralysis without receiving treatment improve significantly more slowly or not at all. Muscle stimulation increases the chance of regaining function.

After a stroke or peripheral paralysis, muscle stimulation should be started as soon as possible. Because recovery from paralysis can take months or even years, it is necessary to perform exercises combined with muscle stimulation persistently every day for a long time. Without electrical impulses, the paralyzed muscle slowly wastes away and within about two years degenerates into a gelatinous mass from which there is no return.

Repeating the lost movement (even if no visible movement occurs) and muscle stimulation are crucial so that another area of the brain relearns the motor task and takes over the functions of the destroyed brain area after a stroke.

Muscle stimulation plays a very important role in “retraining” the neuromuscular (nerve–muscle) connection. According to some studies, the brain and the motor neuron running from the brain to the muscle need at least 10,000 repetitions to relearn how to perform a movement. Retraining the brain to move muscles that do not function after paralysis can be accelerated with stimulation.

I’ve already mentioned many conditions. Of course they cannot all be treated the same way. Just as you use different cutlery for soup, the main course or dessert. You can read in this article what determines the effect of muscle stimulation.