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Dear Dr. Roach: I'm a 77-year-old woman with degenerative disc disease. I had an L4 microdiscectomy surgery in 2020, but I still have chronic pain in my lower back. Although I do core strengthening exercises with physical therapy (which helps), I'm still in daily pain. I've been seeing advertisements for multifidus muscle-strengthening devices, such as NeuroMD and ReliveX. What's your opinion on this type of exercise device? -- C.K.
Answer: I think that better non-pharmacologic therapies are needed for back pain, and the theory of electrical stimulation to strengthen the back muscles makes sense. (The multifidus muscles run on either side of the spine, stabilizing the joints between the vertebral bodies. Weakness and atrophy of these muscles are strongly associated with back pain.) The devices that you mentioned are called neuromuscular electrical stimulation devices, and they have a complementary action with exercise.
Unfortunately, the published data supporting their use aren't strong. Some studies do show an improvement in muscle strength, and one study did show a reduction in back pain. But other studies didn't show a benefit when compared to a control group. Some of the expert groups issued guidelines that haven't yet recommended the treatment for chronic back pain, citing a lack of proof. A well-designed study is apparently underway.
I did read a handful of reports of adverse events (mostly around unpleasant electric shock sensations), but the studies found a low incidence of side effects. I can't recommend it based on the lack of strong evidence of its effectiveness at this time, but this may change with further studies.
Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu.