Position Statement of the Israeli Society for Musculoskeletal Medicine on Intramuscular Stimulation for Myofascial Pain Syndrome-A Delphi Process

Pain Pract. 2017 Apr;17(4):438-446. doi: 10.1111/papr.12491. Epub 2016 Oct 14.


Objective: To develop consensus on a position paper on the use of intramuscular stimulation (IMS) for the treatment of myofascial pain syndrome (MPS) by physicians in Israel.

Methods: The Israeli Society of Musculoskeletal Medicine ran a modified Delphi process to gather opinions from a multidisciplinary expert panel. Eight experts in the treatment of MPS were chosen and asked to participate, and six participated. The position paper was iterated three times.

Results: After three iterations, general consensus was reached by all six experts. The general statement that was agreed on was: "IMS is one of the preferred treatments for myofascial pain syndrome. The treatment is evidence-based, effective, safe, and inexpensive. The position of the Israeli Society of Musculoskeletal Medicine is that the treatment should be taught and used by all primary care physicians and those physicians in other areas of medicine who deal with pain in their work."

Conclusions: The position paper is a basis for clinical work and education programs for physicians interested in a better understanding and ability to treat patients with a musculoskeletal complaint or manifestation of disease.

Keywords: Delphi process; clinical guidelines; dry needling; intramuscular stimulation; myofascial; myofascial pain syndromes; trigger points.

MeSH terms

  • Acupuncture Therapy / methods*
  • Adult
  • Consensus*
  • Delphi Technique*
  • Humans
  • Israel
  • Musculoskeletal Pain / diagnosis
  • Musculoskeletal Pain / epidemiology
  • Musculoskeletal Pain / therapy
  • Myofascial Pain Syndromes / diagnosis
  • Myofascial Pain Syndromes / epidemiology
  • Myofascial Pain Syndromes / therapy*
  • Pain Management / methods*
  • Physicians
  • Societies, Medical*