Development History

Discovery of Non-invasive eToims®

Refer to this video for the History of eToims®

https://www.youtube.com/watch?v=qd11g5mtxQA&t=16s

1988: Jennifer Chu, M.D., Associate Professor and Director of Electrodiagnostic Medicine of the Department of Physical Medicine and Rehabilitation at the University of Pennsylvania Perelman School of Medicine received a phone call from a patient claiming pain relief after electromyographic (EMG) testing and wanted the EMG test to be repeated. Thinking the pain relief from the EMG testing was an acupuncture effect, Dr. Chu became certified in acupuncture, but soon found that acupuncture was not sufficient to help patients with neuromuscular pain on a consistent basis.

1990: Dr. Chu began using Intramuscular stimulation (IMS) technique for myofascial pain relief using manual oscillation of an acupuncture needle at neuromuscular junctions (motor points or trigger points). This method was first described by C.C. Gunn, M.D., Clinical Professor of Anesthesia at the University of Washington in Seattle. In the IMS method, motor points are treated by oscillating an acupuncture needle through a plunger. Since the acupuncture needle was not firm enough to penetrate through thick overlying tissues to adequately reach the deeper layers of muscle, Dr. Chu substituted a monopolar EMG needle electrode. This firmer needle was able to stimulate neuromuscular junctions to elicit twitches. Dr. Chu realized the therapeutic significance of the twitch with its pain relieving effects only after she obtained twitches from a tender area in her own forearm. Dr. Chu taped a monopolar EMG needle electrode to the tip of a syringe to enhance leverage in stimulating neuromuscular junctions (motor points) with manually controlled repetitive oscillatory movements to obtain twitches which relieve myofascial pain due to spondylotic radiculopathy. This technique was termed Twitch Obtaining Intramuscular Stimulation (TOIMS). After treating many complicated cases of chronic pain using manual oscillation of the monopolar EMG needle electrode to elicit twitches, she sustained repetitive stress injury in her right upper limb. To preclude development of repetitive stress injury in caregivers who treat with TOIMS, Dr. Chu decided to automate the method.

1996: Dr. Chu invented Automated Twitch Obtaining Intramuscular Stimulation (ATOIMS®). In this method, muscle twitches were obtained by a hand-held device that mechanically stimulated the neuromuscular junction by automatically: (1) inserting a monopolar needle into it, (2) oscillating it three times in two seconds, and (3) then retracting the needle. Dr. Chu soon discovered that mechanical stimulation was not a fast or efficient method to evoke twitches.

1998: To increase the yield of twitches for more effective pain relief, Dr. Chu invented the electrical method called NEEDLE ETOIMS®. In this method, a monopolar EMG needle electrode was manually inserted into the motor point of the muscle with electrical stimulation obtained via the EMG machine. Although twitch elicitation became easier, manually inserting the monopolar needle electrode still aggravated Dr. Chu’s repetitive stress injury. This led to her inventing an automated needling device for ETOIMS® in which the monopolar needle electrode was automatically inserted and retracted from muscle after 0.5 seconds of electrical stimulation. Although automated needle ETOIMS® was more efficient than mechanical stimulation with ATOIMS®, a more user-friendly, noninvasive method to evoke twitches was sought. The noninvasive method would make ETOIMS® safer through use of a needle-free technique, alleviating the potential for any rare complication from use of a needle.

2005: eToims® starts a revolution as a novel, proprietary therapeutic-diagnostic test for detection of acute and chronic denervation. This noninvasive surface electrical testing procedure detects hyper-excitable motor points and these points elicit large force twitches. The detection of these hyper-excitable motor points is essential for diagnosis of presence of nerve irritation. At the hyper- excitable motor points, the twitch forces are strong enough to either shake or move the joint. This is common in pain/discomfort with acute partial denervation as the muscles overlying such trigger points have not tightened or stiffened excessively. With chronic muscle tightness due to chronic denervation, the evoked twitches tend to have low forces. Although such irritable trigger points that can elicit forceful twitches are present in chronic nerve irritation, the trigger points are difficult to locate for stimulation. This difficulty is secondary to tightness and stiffness of overlying painful muscles which become shortened when they are chronically unable to move joints through full range.

2006: The eToims® Technique for eliciting twitches is facilitated by new developments that have allowed the procedure to become
non-invasive, removing the use of the needle electrode. The new non-invasive eToims® retained the acronym eToims®, capitalizing the “T” to signify the importance of the twitch in the diagnosis of irritable trigger points as well as in pain relief. Dr. Chu also founded eToims® Medical Technology, LLC to research, develop, design, and produce eToims® technology for health care practitioners around the world, and the Soft Tissue Comfort Center® in Philadelphia region for the management of patients with nerve related muscle pain and as center of excellence for training eToims® Specialists.

2009: eToims® device (ET127) receives the CE mark for sales in the European Union and Canada. eToims® Medical Technology, LLC develops proprietary noninvasive electrodes for use with The eToims® Technique for painless and efficacious stimulation of deep muscle tissue.

2018: Dr. Chu researched and enhanced eToims magnesium sulfate products that relax muscles by transdermal absorption essential for trigger point localization and stimulation. We are the first to demonstrate that eToims pharmaceutical grade magnesium sulfate products which are non-allergenic and non- sensitizing products can facilitate muscle relaxation providing pain relief. It is also a sleep-aid when used daily and regularly with generous application to the muscles along the entire spinal axis and the muscles surrounding painful joints and limbs.