Electrical Stimulation for Knee Osteoarthritis

Electrical Stimulation Is Alternative Treatment Option for Knee Osteoarthritis

Electrical stimulation of the knee
leezsnow/E+/Getty Images

Osteoarthritis, often referred to as "wear-and-tear" arthritis, can be helped by improving the muscle strength around the joint or joints involved. Exercise has been shown to improve the symptoms, severity, and disability associated with osteoarthritis of the knee. However, many people don't exercise. They fear that exercise will worsen their arthritis or they feel they can't do enough to matter.

Electrical stimulation may provide an alternative.

Studies have shown promising results for improving quadricep strength and relieving pain in older adults with knee osteoarthritis. Let's consider the study results.

Electrical Stimulation Study Results

In 2003, neuromuscular electrical stimulation was studied as a treatment option for osteoarthritis by Dr. Laura Talbot from The Johns Hopkins University. NMES is achieved by sending small electrical impulses through the skin to the underlying motor units (nerves and muscles) to create an involuntary muscle contraction. Thirty-four adults with radiographically (x-ray) confirmed symptomatic knee osteoarthritis were involved in the study. The study participants were randomly given standard arthritis education (12-week Arthritis Self-Management Course) with or without NMES. The NMES group used a portable electrical muscle stimulator 3 days a week for quadricep training and strengthening. Over 12 weeks, the intensity of isometric contraction was increased incrementally to 30-40 percent of maximum.

The primary outcome was isometric quadriceps femoris (QF) torque. Secondary outcomes included daily step counts, total activity vector magnitude, 100-foot walk-turn-walk, timed stair climb, chair rise, and pain level.

The results indicated that:

  • The stimulated-knee extensor showed a 9.1 percent increase in 120 degree QF peak torque compared to a 7 percent loss in the education only group.
  • The chair rise time decreased by 11 percent in the NMES group, while the education only group had a 7 percent reduction.
  • Both groups improved their walk time by about 7 percent.
  • Severity of pain reported following intervention (either NMES or education) did not differ between groups.

The research team led by Talbot concluded that a home-based NMES treatment plan is promising for increasing quadriceps femoris strength in adults with knee osteoarthritis without making arthritis symptoms worse.

In 2007, results of a study published in the journal Clinical Rheumatology revealed that a 4 week program involving electrical stimulation was equally effective as a 4 week exercise program for relief of pain and stiffness and for improving physical function

By 2015, there were various kinds of electrical stimulation evaluated for effectiveness in treating pain associated with knee osteoarthritis. There were 27 trials and 6 types of electrical stimulation evaluated in a meta-analysis. The 6 types were h-TENS (high frequency transcutaneous electrical nerve stimulation),  l-TENS (low frequency transcutaneous electrical nerve stimulation), NMES, IFC (interferential current), PES (pulsed electrical stimulation), NIN (noninvasive interactive neurostimulation).

Researchers concluded from the results that, of the 6 types, IFC was most promising as a pain relief treatment for knee osteoarthritis. Although there was uncertainty about recommending h-TENS, the other types (l-TENS, NMES, PES, and NIN) were considered inappropriate for relief of knee osteoarthritis pain. However, it was also concluded that while some types were inappropriate, they likely would not be harmful.    


A Home-Based Protocol of Electrical Muscle Stimulation for Quadriceps Muscle Strength in Older Adults with Osteoarthritis of the Knee. Talbot LA et al. The Journal of Rheumatology. July 2003.

Effects of quadriceps electrical stimulation program on clinical parameters in the patients with knee osteoarthritis. Dilek Durmus et al. Clinical Rheumatology. May 2007.

Electrical stimulation for pain relief in knee osteoarthritis: systematic review and network meta-analysis. Zeng C et al . Osteoarthritis Cartilage. February 2015.

Continue Reading