TWITCHES

The tasks and routines of normal daily living can have an adverse effect on the physical body. The way that we sit, sleep, exercise, and work cause muscles to tire and become susceptible to injury. In the event of an injury that is diagnosed within 24 hours of occurrence with The eToims® Technique, the muscles are still soft and pliable and have not tightened significantly such that the twitches elicited with the bipolar probe with widely spaced electrodes are rapid in frequency and are of large force.

In those with chronic pain, the overlying muscles are so stiff and tight that the twitches are of low force and slow in frequency since the electricity is unable to penetrate through well to reach the deep neuromuscular junctions in muscles apposed to bones and joints.

Twitch force (TWF) grades 1–5 include the following characteristics:

TWF1: superficial trigger point stimulation without joint movement effects produce weak and feeble feedback on the probe.

TWF2: capable of non-antigravity movements such as shaking, rocking and rolling of the joint over which the stimulated muscle crosses over. This indicates that the stimulation reached the trigger points in deep muscles apposed to bone and joints. TWF2 is the minimum force needed to demonstrate that the electricity has penetrated deep to reach the trigger points of those muscles lying on top of bone and joints. In patients with pain, even TWF2 are difficult to find because of overlying muscle hypertonicity and accompanying allodynia (supersensitivity to mechanical or electrical stimuli) which produces difficulty for adequate stimulation).

In normal individuals, the greatest twitch force is TWF2 and It is very easy to elicit such twitches since healthy trigger points are easy to find and to stimulate. Since the widely spaced electrodes allow only one electrode to be on one muscle, 2 muscles can be simultaneously stimulated and the contraction of 2 muscles can cause joint movements to occur without correct placement of the stimulation on the trigger points. The correct force of the evoked twitches is determined by the impact of the twitch force on the palm of the hand holding the bipolar probe. The clinician must always feel this feedback of the twitch force on the hand to determine the correct grading of the TWF which is crucial and not to depend on the presence of joint movements alone.

TWF2 does not undergo pre-fatigue phenomenon and will also not fatigue since there is no denervation supersensitivity. In normal muscles, evoked twitches from trigger points are painless and provide equal force feedback on both electrodes simultaneously. Both electrodes can easily evoke such twitches immediately since no search effort is needed to find the trigger points.

TWF3 produces vigorous antigravity movements of the limb due to spread of stimulation to many MTrPs from presence of denervation supersensitivity which results in full contraction of the entire muscle or many muscles simultaneously. In the presence of denervation supersensitivity, force feedback from the electrode on the muscle which is not on the real trigger point seemed extinguished since the electrode overlying the trigger point with denervation supersensitivity is very forceful and strong.

TWF4 and TWF5: A pre-fatigue phenomenon consisting of sudden rapid-firing twitches occurs that can proceed to autonomous twitching that fatigue slowly (TWF4) or rapidly (TWF5).

TWF4: Chronic pain: Finding Trigger Points with eToims

and TWF5 provide the most effective pain/discomfort relieving results through active exercise derived from many forceful simultaneous contractions associated with local and remote autonomous twitches.

TWF5: Twitches of Choice Rapidly Fatigue

Muscles that allow TWF4 and TWF5 elicitation indicate better prognosis for improvement in function since they are less hypertonic compared with muscles where only TWF1–3 can be elicited. The goal of ETOIMS is to normalise denervation supersensitivity through elicitation of local and remote autonomous twitches that exercise, fatigue irritable trigger points and improve circulation.

Acute Pain: eToims Clinical Effectiveness

To facilitate the elicitation of twitches we use eToims magnesium sulfate spray to immediately relax surface muscles and allow electrical stimulation to penetrate through to reach and stimulate the trigger points.

ETOIMS MGSO4 FOR MUSCLE COMFORT AND SLEEP