Brazilian Journal of Pain
Brazilian Journal of Pain
Review Article

Effect of neuromuscular electrical stimulation on muscle function in chronic low back pain patients: systematic review

Efeito da estimulação elétrica neuromuscular na função muscular em pacientes com dor lombar crônica: revisão sistemática

Alessandra Linzmeyer; Camila Amaral Coracini; Gladson Ricardo Flor Bertolini; Alberito Rodrigo Carvalho

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BACKGROUND AND OBJECTIVES: Neuromuscular electrical stimulation (NMES) is one of the resources that can be used in the treatment of patients with chronic low back pain. It is possible that issues related to the stimulation parameters may affect the results obtained with the use of these currents. Therefore, the aim of this review was to investigate the effects of NMES on aspects of lumbopelvic muscle function in individuals with chronic low back pain.

CONTENTS: The study is a systematic review that used 10 databases for the search through a comprehensive combination of descriptors that met the research question. The selection criteria based on the PICOT strategy were population - individuals with chronic low back pain (specific and/or non-specific); intervention - NMES; outcomes - paravertebral and/or abdominal muscle changes (muscle power and endurance). The articles were selected by two independent reviewers, who developed the tools for data extraction. Four articles were included in this review. In three of them, there was a significant increase in muscle strength and endurance, as well as muscle cross-sectional area in the group that received NMES compared to the control group.

CONCLUSION: NMES showed positive effects in optimizing aspects of muscle function in individuals with chronic low back pain. However, the methods employed are very heterogeneous, which made it impossible to perform a quantitative analysis.


Electric stimulation therapy, Low back pain, Skeletal muscle


JUSTIFICATIVA E OBJETIVOS: A estimulação elétrica neuromuscular (EENM) é um dos recursos que podem ser utilizados no tratamento de pacientes com dor lombar crônica. É possível que questões relacionadas aos parâmetros de estimulação possam afetar os resultados obtidos com o uso dessas correntes. Portanto, o objetivo deste estudo foi investigar os efeitos da EENM em aspectos da função muscular da região lombopélvica em indivíduos com dor lombar crônica.

CONTEÚDO: Trata-se de uma revisão sistemática que utilizou 10 bases de dados para a busca por meio da combinação abrangente de descritores que atendessem a pergunta da investigação. Os critérios de seleção com base na estratégia PICOT foram: população - indivíduos com dor lombar crônica (específica e/ ou não específica); intervenção - EENM; desfechos – alterações musculares de paravertebrais e/ou abdominais (potência e resistência muscular). A seleção dos artigos foi feita por dois revisores independentes que elaboraram as ferramentas para extração dos dados. Ao todo, quatro artigos foram incluídos nesta revisão. Em três deles, houve aumento significativo de força e resistência muscular, assim como da área de secção transversa muscular no grupo que recebeu EENM, em relação ao controle.

CONCLUSÃO: A EENM apresentou efeitos positivos na otimização dos aspectos da função muscular em indivíduos com dor lombar crônica. Porém, os métodos empregados são muito heterogêneos, o que impossibilitou a realização da análise quantitativa.


Dor lombar, Musculoesquelético, Terapia por estimulação elétrica


Bahns C, Happe L, Thiel C, Kopkow C. Physical therapy for patients with low back pain in Germany: a survey of current practice. BMC Musculoskelet Disord. 2021;22(1):563.

Batistella CE, Bidin F, Giacomelli I, Nunez MA, Gasoto E, Albuquerque CE. Effects of the Russian current in the treatment of low back pain in women: a randomized clinical trial. J Bodyw Mov Ther. 2020;24(2):118-22.

Gonzalez GZ, Silva T, Avanzi MA, Macedo GT, Alves SS, Indini LS. Low back pain prevalence in Sao Paulo, Brazil: a cross-sectional study. Braz J Phys Ther. 2011;26:837-45.

Aguiar D P, Souza C P, Barbosa WJ, Santos-Júnior F F, Oliveira AS. Prevalence of chronic pain in Brazil: systematic review. BrJP. 2021;4(3):257-67.

Liu M, Shaparin N, Nair S, Kim RS, Hascalovici JR. Chronic low back pain: the therapeutic benefits of diagnostic medial branch nerve blocks. Pain Physician. 2021;24(4):E521-8.

Frizziero A, Pellizzon G, Vittadini F, Bigliardi D, Costantino C. Efficacy of core stability in non-specific chronic low back pain. J Funct Morphol Kinesiol. 2021;6(2):37.

George SZ, Fritz JM, Silfies S P, Schneider MJ, Beneciuk JM, Lentz TA. Interventions for the management of acute and chronic low back pain: Revision 2021. J Orthop Sports Phys Ther. 2021;51(11):CPG1-CPG60.

Bardin LD, King P, Maher CG. Diagnostic triage for low back pain: a practical approach for primary care. Med J Aust. 2017;206(6):268-73.

Russo M, Deckers K, Eldabe S, Kiesel K, Gilligan C, Vieceli J. Muscle control and non-specific chronic low back pain. Neuromodulation. 2018;21(1):1-9.

Songjaroen S, Sungnak P, Piriyaprasarth P, Wang HK, Laskin JJ, Wattananon P. Combined neuromuscular electrical stimulation with motor control exercise can improve lumbar multifidus activation in individuals with recurrent low back pain. Sci Rep. 2021;11(1):14815.

Ferreira PH, Ferreira ML, Maher CG, Herbert RD, Refshauge K. Specific stabilisation exercise for spinal and pelvic pain: a systematic review. Aust J Physiother. 2006;52(2):79-88.

van Tulder M, Malmivaara A, Esmail R, Koes B. Exercise therapy for low-back pain. In: Cochrane Database of Systematic Reviews. 2000.

Ibrahim T, Tleyjeh IM, Gabbar O. Surgical versus non-surgical treatment of chronic low back pain: a meta-analysis of randomised trials. Int Orthop. 2008;32(1):107-13.

Almeida GJ, Khoja SS, Piva SR. Dose-response relationship between neuromuscular electrical stimulation and muscle function in people with rheumatoid arthritis. Phys Ther. 2019;99(9):1167-76.

Impellizzeri FM, Marcora SM, Coutts AJ. Internal and external training load: 15 years on. Int J Sports Physiol Perform. 2018;14(2):270-3.

Dehail P, Duclos C, Barat M. Electrical stimulation and muscle strengthening. Ann Readapt Med Phys. 2008;51(6):441-51.

Bosques G, Martin R, McGee L, Sadowsky C. Does therapeutic electrical stimulation improve function in children with disabilities? A comprehensive literature review. J Pediatr Rehabil Med. 2016;9(2):83-99.

Chughtai M, Elmallah RD, Mistry JB, Bhave A, Cherian JJ, McGinn TL. Non-pharmacologic pain management and muscle strengthening following total knee arthroplasty. J Knee Surg. 2016;29(3):194-200.

Marston KJ, Peiffer JJ, Newton MJ, Scott BR. A comparison of traditional and novel metrics to quantify resistance training. Sci Rep. 2017;7(1):5606.

Alrwaily M, Schneider M, Sowa G, Timko M, Whitney SL, Delitto A. Stabilization exercises combined with neuromuscular electrical stimulation for patients with chronic low back pain: a randomized controlled trial. Braz J Phys Ther. 2019;23(6):506-15.

Dimer da Luz R, Santos MS, Evaldt AS, Matos LS, Daitx RB, Döhnert MB. Neuromuscular electrical stimulation associated with core stability exercises in nonspecific postural low back pain: a randomized clinical trial. Muscle Ligaments Tendons J. 2019;9(03):446-56.

Pelegrini ACA, Gasoto E, Bussolaro JM, Segatti G, Albuquerque CE, Bertolini GRF. The analgesic action of Aussie current in women with non-specific chronic lumbar pain. Int J Ther Rehabil. 2019;26(7):1-10.

Coghlan S, Crowe L, McCarthy Persson U, Minogue C, Caulfield B. Neuromuscular electrical stimulation training results in enhanced activation of spinal stabilizing muscles during spinal loading and improvements in pain ratings. Annu Int Conf IEEE Eng Med Biol Soc. 2011;2011:7622-5.

Sterne JAC, Savović J, Page MJ, Elberts RG, Blencowe NS, Boutron I. RoB 2: A revised tool for assessing risk of bias in randomised trials. BMJ. 2019;366:14898.

Lopes AB, Amboni DE, Schmidel MM, Maciel MJ, de Carvalho AR, Bertolini GRF. Evaluation of the dose-response for electrostimulation with Aussie current in the core strength. Eur J Clin Exp Med. 2020;18(2):81-7.

Camilo IR, Silva P, Mata TB, Peres CPA, Bertolini GRF. Estimulação elétrica neuromuscular na diástase, flacidez e trofismo da musculatura abdominal: uma revisão sistemática. Saúde.Com. 2021;16(3):1894-900.

Sions JM, Crippen DC, Hicks GE, Alroumi AM, Manal TJ, Pohlig RT. Exploring neuromuscular electrical stimulation intensity effects on multifidus muscle activity in adults with chronic low back pain: an ultrasound imaging–informed investigation. Clin Med Insights Arthritis Musculoskelet Disord. 2019;20(12).

Kim SH, Park KN, Kwon OY. Pain intensity and abdominal muscle activation during walking in patients with low back pain. Medicine (Baltimore). 2017;96(42).

Goubert D, Oosterwijck J Van, Meeus M, Danneels L. Structural changes of lumbar muscles in non-specific low back pain. Pain Physician. 2016;19(7):E985-99.

Mukaino M, Ono T, Shindo K. Efficacy of brain-computer interface-driven neuromuscular electrical stimulation for chronic paresis after stroke. J Rehabil Med. 2014;46(4):378-82.

Mettler JA, Bennett SM, Doucet BM, Magee DM. Neuromuscular electrical stimulation and anabolic signaling in patients with stroke. J Stroke Cerebrovasc Dis. 2017;26(12):2954-63.

Fukuda TY, Marcondes FB, Anjos Rabelo N, Vasconcelos RA, Cazarini Junior C. Comparison of peak torque, intensity and discomfort generated by neuromuscular electrical stimulation of low and medium frequency. Isokinets Exerc Sci. 2013;21(2):167-73.

Dantas LO, Vieira A, Siqueira AL, Salvini TF, Durigan JLQ. Comparison between the effects of four different electrical stimulation current waveforms on isometric knee extension torque and perceived discomfort in healthy women. Muscle Nerve. 2015;51(1):76-82.

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