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Electrical twitch obtaining intramuscular stimulation (ETOIMS) for myofascial pain syndrome in a football player
  1. J Chu,
  2. I Takehara,
  3. T-C Li,
  4. I Schwartz
  1. Rehabilitation Medicine, Hospital of the University of Pennsylvania, Spruce Street, Philadelphia, Pennsylvania, USA
  1. Correspondence to:
 Dr J Chu
 University of Pennsylvania Medical Center, Rehabilitation Medicine, Ground Floor White Building, 3400 Spruce Street, Philadelphia, PA 19104, USA; jechu{at}


Background: Flare up of acute lower back pain associated with myofascial pain syndrome (MPS) may require various forms of treatment including activity restriction and bracing. Electrical twitch obtaining intramuscular stimulation (ETOIMS) is a promising new treatment. It involves the use of a strong monopolar electromyographic needle electrode for electrical stimulation of deep motor end plate zones in multiple muscles in order to elicit twitches.

Case report: An elite American football player with MPS symptoms failed to respond to standard treatments. He then received ETOIMS which completely alleviated the pain. After establishing pain control, the athlete continued with a further series of treatments to control symptoms of muscle tightness.

Conclusions: ETOIMS has a promising role in pain alleviation, increasing and maintaining range of motion, and in providing satisfactory athletic performance during long term follow up.

  • ETOIMS, electrical twitch obtaining intramuscular stimulation
  • FABERE, flexion, abduction, and external rotation of the hip
  • MPS, myofascial pain syndrome
  • VAS, visual analogue scale
  • myofascial pain
  • electrical twitch
  • pain treatment

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