Alternative Solutions: Neuromuscular Electrical Stimulation for Endometriosis Pain

Neuromuscular Electrical Stimulation has proven to be an effective long-term treatment option for patients suffering from endometriosis-associated pain.

Key Points

)Highlights:

• This study focused on the effects of and safety associated with the use of neuromuscular electrical stimulation (NMES) for patients with endometriosis-associated pain (EAP).  

Importance:

• There are several treatments on the market that attempt to address endometriosis-associated pain, but all the therapies are inadequate. Thus, there is a need for a safe and effective treatment option.
• There are not many studies that focus on the effects of NMES on EAP.

What’s done here?

• Participants:
  • 154 females who have endometriosis and pelvic pain.
  • 83 of them were considered the experimental group (subjected to NMES) and the remaining 71 patients were considered the control group.
• Treatment:
  • All the participants in the treatment group were subject to NMES, The participants in the control group did not receive the NMES therapy
• Outcome measurements:
  • Pain as measured by the numerical rating scale (NRS), which ranges from 1-10, and the Endometriosis Symptom Severity Score (ESSS).
  • The secondary outcome of quality of life was measured using the 36-Item Short Form Health Survey (SF-36). This form also had two subscales.
  • Outcomes were measured before and after 5 and 10-week treatments. 
  • The researchers made notes of all adverse events
• The data was subject to statistical analysis.

Key results:

• After 5 weeks of treatment or the lack thereof for the control group, the researchers found no difference in pain or quality of life between the experimental and control group.
• After 10 weeks of treatment, the experimental group had better results according to the NRS, ESSS, and SF-36. Moreover, there were some mild and acceptable adverse events that occurred within the experimental group, but there was no significant difference in the adverse events that occurred within the two groups.

Limitations of the study:

• The authors listed the following as limitations of the study:
  • There was no placebo control group.
  • The study did not assess the effects of NMES after 10 weeks. This means that the authors cannot ascertain the long-term effects of this treatment.

Lay Summary

Bi and Xie, researchers from The Yan’an People’s Hospital, recently published the results of their retrospective study titled “Effect of neuromuscular electrical stimulation for endometriosis-associated pain” in Medicine. The study hoped to elucidate the effects of using a complementary and alternative medicine, namely neuromuscular electrical stimulation (NMES), for the treatment of endometriosis-associated pain (EAP).

There were 83 patients with EAP in the treatment group and these participants underwent NMES therapy. There were 71 patients with EAP in the control group and they did not undergo NMES therapy. The researchers used a numerical rating scale (NRS) and the Endometriosis Symptom Severity scale (ESSS) to judge the primary objective, which was pain. They also used the 36-Item Short Form Health Survey (SF-36) to judge the quality of life, which was the secondary objective. The aforementioned outcomes and any extraneous adverse events were measured for each patient before and after 5 weeks and 10 weeks of treatment. 

The researchers saw no difference in the primary or secondary outcomes between the two groups at the 5-week time point; however, the experimental group had better NRS, ESSS, and SF-36 scores after the 10-week time point. There were no significant differences in adverse events between the control and experimental group. The NMES group did experience some mild to acceptable adverse events. Overall, the researchers concluded that the NMES therapy is an effective treatment option for patients suffering from EAP.

Research Source: https://www.ncbi.nlm.nih.gov/pubmed/29953000