TRANSDERMAL MAGNESIUM SPRAYS FOR MYOFASCIAL PAIN RELIEF AND FACILITATION OF AUTONOMOUS TWITCH ELICITATION WITH ELECTRICAL TWITCH-OBTAINING INTRAMUSCULAR STIMULATION (ETOIMS)
Chu J., Bruyninckx F. and Neuhauser D. V.
Introduction: ETOIMS optimally relieves denervation supersensitivity related myofascial pain when autonomous muscle twitches can be elicited focally or remotely at involved trigger points. Aim: To provide objective evidence that autonomous twitch elicitation with ETOIMS is best facilitated with concomitant transdermal magnesium sulfate (MgSO4) spray rather than magnesium chloride (MgCl) or using only faucet-water. Methods and materials: An 83 year old mildly hypertensive patient with refractory migraine and persistent pain had 3 consecutive ETOIMS therapy trials (N=40/trial) with faucet-water wetted electrodes only or with trans-dermal spray supplementation using MgCl or MgSO4. Pain scores, blood pressure (BP) and pulse/heart-rate were recorded before and immediately after each treatment alongside highest level of clinically elicitable twitch-forces/session and number of muscles with autonomous twitches. For MgSO4 sessions (N=30), the patient also measured onset BP and heart-rate/pulse immediately on sitting down, as well as after sitting for 10 minutes without spray and 10 more minutes with MgSO4 spray applied once to paraspinal and limb muscles. Results: ETOIMS results for eliciting autonomous twitches with MgCl spray were equivalent to using faucet-water. One way ANOVA comparisons showed that using MgSO4 significantly increased number of muscles with autonomous twitches and reduced pain and heart-rate/pulse. Twitch-forces (TWF) between the three groups did not differ. MgSO4 spray alone was also able to reduce the systolic BP within 10 minutes. Conclusions: MgSO4 showed the best capacity to potentiate ETOIMS pain relief effects probably through better skin absorption and vasodilation made possible through skin hydration and iontophoresis effects that enabled autonomous twitching.
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