To systematically summarize the effects of NMES on LM muscle function recovery and pain relief in person with CLBP, and to explore its potential mechanisms in improving chronic low back pain.
A comprehensive search was conducted in databases including Web of Science, MEDLINE, PubMed, Embase, CINAHL, PsycINFO, the Cochrane Central Register of Controlled Trials, ClinicalTrials.gov, and CNKI up to September 1, 2024. Keywords used were related to "neuromuscular electrical stimulation," "chronic low back pain," and "lumbar multifidus muscle." Randomized controlled trials employing any NMES protocol for treating CLBP were included. Two researchers independently screened the trials and extracted data on study populations, interventions, and outcomes. A qualitative analysis was performed to evaluate the effects of NMES on LM morphology and function, as well as pain relief in person with CLBP.
Ten randomized controlled trials were included. Moderate evidence suggests that medium-frequency NMES can effectively stimulate the LM, improving its morphology—such as increasing muscle thickness and reducing fat infiltration—and enhancing muscle function. These effects may be linked to the stimulation of alpha motor neurons, inducing involuntary muscle contractions. Limited evidence also indicates that medium-frequency NMES can significantly reduce pain intensity in person with CLBP. However, discrepancies among study results exist; person with CLBP tolerance and variability in treatment response are key factors influencing therapeutic outcomes.
Medium-frequency NMES appears to be a promising adjunctive treatment for CLBP, potentially improving LM morphology and function and contributing to pain reduction.
Further large-scale studies are needed to optimize NMES treatment protocols, assess long-term effects, and explore its combination with other rehabilitation methods to enhance therapeutic outcomes in CLBP management.
Chronic low back pain
Lumbar multifidus muscle
