Improve Leg Circulation: Do Electronic Muscle Stimulators Really Work?

Peripheral Artery Disease: A Common Condition

Peripheral artery disease is a surprisingly common condition affecting more than one in ten people aged over 65 in the UK. Caused by narrowings and blockages in the arteries of the legs, it can lead to intermittent claudication – calf pain while walking – what the Dutch call “window-shopping legs.”

Leg Pain and Quality of Life

Leg pain during walking significantly affects the everyday life of those with peripheral artery disease. It limits their ability to take part in social activities, daily tasks such as shopping, and may even impact on a person’s employment. Unsurprisingly, those with shorter pain-free walking distances report worse quality of life and major impacts on their mental wellbeing.

Optimal Medical Treatment

The most important elements of optimal medical treatment are blood-thinning medications such as aspirin, cholesterol-lowering medications such as statins, and stopping smoking. For those with pain when walking, the treatment with one of the biggest effects on walking distance and quality of life is, well, walking. The best results are seen in those who take part in a supervised exercise programme which has consistently been shown to be more cost-effective than surgery for claudication.

Electrical Muscle Stimulation

These devices work by using electronic impulses to cause the muscles of the calf to repeatedly contract. Usually, this is by indirect stimulation through the feet using an electronic footplate, somewhat resembling a foot spa – although no water is needed. These devices appear to be safe and well-tolerated, with no adverse events reported.

Studies on Electrical Muscle Stimulation

Studies have demonstrated they do indeed increase arterial blood flow in the calf, both in healthy people and in those with peripheral artery disease. However, these increases in blood flow are present only while using the device.

A 2023 Trial on Electrical Muscle Stimulation

A 2023 trial of 200 patients with peripheral artery disease assessed the effect of electrical muscle stimulation on walking distance. The study recruited half of the participants from centres with supervised exercise programmes and half from those without. All patients received optimal medical therapy.

Results of the 2023 Trial

After three months, there was no difference in the maximum walking distance between those that did and did not receive electrical muscle stimulation. However, there was an improvement in walking distance in those that received electrical muscle stimulation in addition to supervised exercise therapy compared to those that received supervised exercise alone.

Transcutaneous Nerve Stimulation (Tens)

Tens has also been used in people with peripheral artery disease. This uses weaker electrical impulses to stimulate nerve fibres and block the transmission of pain signals.

Review of Published Studies on Tens

A review of published studies highlighted that Tens may have some benefit in improving walking distance. The included studies were relatively small, though, and not all were randomised trials. This means the findings may not be just due to the effect of Tens or applicable to a wider group of patients.

Conclusion

While these electrical stimulation devices show some promise, it is not clear if they are cost-effective nor are they currently recommended in guidelines for treating peripheral artery disease. Certainly, some people with peripheral artery disease do report benefit from using these devices. But they should only be used in addition to the cornerstones of peripheral artery disease treatment: medication, stopping smoking, and walking as much as possible.

Frequently Asked Questions

Q: Are electronic muscle stimulators safe and well-tolerated?
A: Yes, the devices appear to be safe and well-tolerated, with no adverse events reported.

Q: Do electronic muscle stimulators increase arterial blood flow in the calf?
A: Yes, studies have demonstrated that they do indeed increase arterial blood flow in the calf, both in healthy people and in those with peripheral artery disease.

Q: Are electrical muscle stimulators recommended in guidelines for treating peripheral artery disease?
A: No, they are not currently recommended in guidelines for treating peripheral artery disease.