Electrical muscle stimulation towards self-physiotherapy on myofascial pain syndrome.

There was no active-stretching-only or sham-stimulation control, so the separate effect of electrical stimulation cannot be separated from stretching. The pain difference was statistically significant but modest: mean reduction was 1.15 points on an 11-point scale, below the usual minimal clinically important difference of 1.3 to 1.5 points. The ultrasound study was a pilot with 8 people, and the authors describe it as exploratory, not confirmatory. Upper and middle trapezius trigger points were analyzed together, not separately. The treatment was very short, and the authors note a one-minute intervention is unlikely to produce structural changes in trigger points. Ultrasound thickness was measured by a single rater, and the authors note future studies need multiple clinicians.

Do not conclude that electrical muscle stimulation alone reduced pain. The stimulation was given together with active stretching, and the study had no active-stretching-only or sham-stimulation control, so the contribution of each component cannot be separated.