Neuropathy, Neuralgia and Myalgia are a set of painful conditions that manifest themselves as pain, weakness, and numbness. Neuropathy manifests as pain, weakness, and numbness, Neuralgia is where the patient feels burning, tingling, pins and needles, and electric shock sensation with the lightest form of stimuli. Myalgia is usually localized to one area of the body, or groups of muscles. 

Neuropathy is quite common in older patients, especially among individuals suffering from chronic diseases like high blood pressure, high cholesterol, or diabetes. It can also affect any age of patients who suffer from alcohol or other substance abuse. Neuralgia is more due to inflammation and viral infections, and Myalgia occurs due to chronic fatigue syndrome, post viral infections, fibromyalgia, Myofascial pain syndrome and Rheumatoid arthritis

Traditional Allopathic treatment for Peripheral neuropathy focuses on managing symptoms of pain and numbness, & addressing the underlying cause, through lifestyle changes, medication, & physical therapy or Physiotherapy. Regular exercise, like walking lower neuropathy pain, improving muscle strength and helping control blood sugar levels, BP and dyslipidemia. Mindful routines like yoga, meditation and tai chi also help. Painful neuropathy is addressed by pool-based exercise such as swimming. Myalgia, caused by overuse or fibromyalgia is treated by massage or gentle stretching exercises. A pulled” or strained muscle is treated by rest, use of ice on the affected area, a compression bandage to reduce swelling and elevating the affected area can help reduce swelling pain. Neuromuscular Electrical Stimulation (NMES) is a type of physical therapy modality, using electrical currents to mimic the action potentials of the human central nervous system causing muscle contractions leading to muscle strengthening, or relaxing, increasing local blood circulation, and to relieve fatigue. It has become popular as an adjunctive therapy in recent decades.

Materials and Methods: This article is original research of trying a brand of Electrical Muscle Stimulation Massager (EMSFM) on a small sample of diabetic Peripheral Neuritis (DPN) and post viral infection myalgia supported by request literature search.

Outcomes: Four out of 5 DPN & both Myalgia case satisfied with the outcomes.

electrical muscle stimulation (EMS); Electrical Muscle Stimulation Foot Massager (EMSFM); diabetic peripheral neuritis (DPN)

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While neuropathy can manifest itself as pain, weakness, and numbness, neuralgia is just nerve pain where the patient feels burning, tingling, pins and needles, and electric shock sensation that can occur with the lightest form of stimuli. Neuralgia is a type of neuropathy that tends to affect the motor components, causing slow digestion, nausea, or light-headedness etc. 

Neuropathy is quite common in older patients, especially among individuals suffering from chronic diseases like high blood pressure, high cholesterol, or diabetes. In fact, 60%-70% of diabetic patients will be diagnosed with neuropathy and up to 50% of diabetic peripheral neuropathies are asymptomatic.  It can also affect any age of patients who suffer from alcohol or other substance abuse. 

Traditional Allopathic treatment for Peripheral neuropathy focuses on managing symptoms of pain and numbness, & addressing the underlying cause, through lifestyle changes, medication, & physical therapy or Physiotherapy. Regular exercise, like walking lower neuropathy pain, improving muscle strength and helping control blood sugar levels. Gentle routines like yoga and tai chi also help. Painful neuropathy is addressed by pool-based exercise such as swimming. 

Neuromuscular Electrical Stimulation (NMES) is a type of physical therapy modality. It uses electrical currents to mimic the action potentials of the human central nervous system causing muscle contractions leading to muscle strengthening, relaxing the muscles, increase local blood circulation, and Relieve fatigue. NMES is one such procedure being tried in recent times for Diabetic neuropathy and with reasonable claims of success. Neuromuscular Electrical Stimulation (NMES) can be a beneficial adjunctive therapy for both peripheral neuropathy and myalgia, addressing muscle weakness, pain, and improving function. 

This article is small original research of one such equipment called Electrical Muscle Stimulation Foot Massager (EMSFM) among 5 DPN and two Myalgia cases with satisfactory outcomes in both conditions.

Equipment and Case Report

EMS technology products are designed with a foot mat as electrodes to stimulate feet, ankles, Achilles Tendon & calf muscles to induce contractions & relaxations & boost blood circulation. Manufacturers claim that it may help to improve nerve function in conditions like diabetic peripheral neuropathy, potentially simulating exercise and increasing blood flow. Electrical stimulation can help manage the symptoms of painful neuropathy, offering an alternative or adjunct to other treatments. NMES can strengthen 

weakened muscles, which can be a result of nerve damage in peripheral neuropathy. NMES can be used to restore muscle mass and function in patients with peripheral nerve injury. It improves muscle strength and range of motion, which is important for managing myalgia & improving overall function. 

Technical Specifications

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Among the five cases of DPN this author tried since April 2025 four of them benefited and one did not. Of Myalgia following Dengue improved but one 

after Covid 19 responded poorly. Case of Diabetic Neuropathy: Kusuma aged 74 yrs, a diabetic for 25 years, suffering from diabetic neuropathy for the last 10 years. Her neuropathy pain was typical and used to be relieved by walking and reappearing on sitting for long.  For the last 2 years she has been complaining of Myalgia of calf muscles, and mid-night sleep disruption due to cramps or pain. and had exhausted all standard management practices of better blood sugar control (which of course was not ideal as Hb% still hovers around 8g/dl), walking, diet control etc.  Starting early April she is trained to use the EMS foot massager mat. Initially mode 1 and speed one and scaled upwards over 2 weeks to use mode 6 and speed 8 10 minutes 2-3 times a day. The first sign of benefit was noted on day 4, which is progressively improving and in the last 6 weeks she reports i) No more midnight cramps ii) an improvement in pain while sitting by 60%. She continues to use it regularly. 

A case of Myalgia following Dengue Infection: A 54-year-old male, a shopkeeper by occupation, presented with high-grade fever and myalgia of 3-day duration. He was also having conjunctival congestion and diffuse muscle tenderness. During lower limb movements, he felt pain, but power and tone were normal. Based on a total serum creatine kinase (CPK) of 619 U/L (normal <149>

Peripheral Neuropathy is a condition where nerves outside the brain & spinal cord are damaged, from various causes including diabetes, infections, metabolic problems, and toxins. 

Peripheral neuropathy is a general term referring to nerve damage in the peripheral nervous system, while peripheral neuritis specifically refers to inflammation of those nerves, which can be a cause of neuropathy. In essence, neuritis is a type of neuropathy where inflammation is the primary cause which damages nerve fibers & causes symptoms like pain, numbness, & tingling. It is attributed to various causes like diabetes, autoimmune diseases, infections, or injuries, metabolic problems, and toxins. Neuralgia is described as sharp, shooting, or burning pain that follows the path of the affected nerve & is a specific pain that is caused by nerve damage or dysfunction, due either as a symptom of neuropathy or pressure on a nerve or injury to a nerve.

</>< style="text-align:justify;">Traditional Allopathic treatment for Peripheral neuropathy focuses on managing symptoms of pain and numbness, & addressing the underlying cause, through lifestyle changes, medication, & physical therapy or Physiotherapy. Regular exercise, like walking lower neuropathy pain, improving muscle strength and helping control blood sugar levels. Gentle routines like yoga and tai chi also help. Painful neuropathy is addressed by pool-based exercise such as swimming.

Both physical therapy and physiotherapy aim to improve physical function, reduce pain, & enhance overall well-being through various methods like exercises, manual techniques, & other therapies like electromagnetic procedures in recent times. They address a wide range of musculoskeletal, cardio-respiratory & neurological conditions [4].

Ems foot massager-a messaih for myalgia & periepral neuritis?

Traditional medicine, particularly Ayurveda, offers several approaches like turmeric and ginger, oil massage therapy, and lifestyle modifications. Herbal remedies like ashwagandha, Vidari, and Triphala may also be used to nourish nervous tissue and alleviate symptoms. Practices of Yoga and meditation help manage stress and anxiety associated with neuropathy. However, conditions like pain over the carotid sinus, when the patient has a pacemaker, areas of active tissue infection & devitalized skin, pregnant women and when the patient is unable to comprehend instructions and provide feedback are contraindications.

There are 463 million diabetics worldwide, according to estimates. Southeast Asia is home to 88 million diabetics, 77 million of whom reside in India.[1] A major consequence that affects almost 50% of diabetes individuals is diabetic neuropathy (DN).[2] DN includes autonomic neuropathy, distal symmetric polyneuropathy (DSPN), radiculopathy or polyradiculopathy.[2] Among them, DSPN is responsible for 75% of the diabetic neuropathies. The early detection of DPN using an objective screening test followed by its appropriate management is important

Pathophysiology of Peripheral Neuropathy: Damage to the peripheral nervous system often leads to chronic neuropathic pain characterized by spontaneous pain & an exaggerated response to painful and/or innocuous stimuli. This pain condition is extremely debilitating and usually difficult to treat. Inflammation is a well-characterized phenomenon, involving a cascade of different immune cells like mast cells, neutrophils, macrophages, and T lymphocytes. Recent evidence suggests that immune cells play a role in neuropathic pain in the periphery [3]. 

Causes of Peripheral Neuropathy in Inda: Neuropathy is quite common in older patients, especially among individuals suffering from chronic diseases like high blood pressure, high cholesterol, or diabetes. In fact, 60%-70% of diabetic patients will be diagnosed with neuropathy and up to 50% of diabetic peripheral neuropathies are asymptomatic. It can also affect any age of patients who suffer from alcohol or other substance abuse.

Diabetic Peripheral Neuropathy (DPN) in India: A study among 206 diabetic patients attending a Rural Health and Training Centre assessed using the Michigan Neuropathy Screening Instrument (MNSI), which involves using a questionnaire followed by a physical examination. The results indicated that of the 206 patients, 61.2% were male, and 38.8% were female. The mean age was 50.86 years (standard deviation [SD] = 12.26 years). The mean duration of diabetes was 8.3 years (SD = 5.5 years). The proportion of diabetics who were screened positive for peripheral neuropathy was 16.5% and 21.8% using the MNSI questionnaire and examination, respectively. The age of 60 years and above was significantly associated with DPN. (OR = 3.982, P value = 0.0001). Duration of more than 5 years of diabetes was also significantly associated with DPN. (OR = 6.01, P value = 0.003). 

Management of DPN: Managing peripheral neuropathy involves treating the underlying cause if possible, addressing symptoms like pain and numbness, and preventing further nerve damage. This can include medications, physical therapy, lifestyle changes, and, in some cases, surgery. 

Pathophysiology of Myalgia: Musculoskeletal pain affects more than 30% of the global population and imposes an enormous burden on patients, families, and caregivers related to functional limitation, emotional distress, effects on mood, independence, and reduced quality of life. The pathogenic mechanisms of musculoskeletal pain relate to the differential sensory innervation of bones, joints, and muscles as opposed to skin and involve several peripheral and central nervous system cells and mediators. Pathophysiologically, of myalgia or muscle pain involves a complex interplay of mechanical, metabolic, and inflammatory processes. In order of priority i) excessive or sudden exertion, trauma, and repetitive strain injuries cause microtears in muscle fibers, leading to pain and inflammation ii) Prolonged or intense muscle activity leads to decreased blood flow, hypoxia, and metabolic changes like lactic acid buildup, which activate pain receptors iii) The inflammatory response, triggered by muscle damage or infection, release of inflammatory mediators -prostaglandins and cytokines, that contribute to pain and tenderness iv) Persistent muscle pain leads to changes in the central nervous system, making individuals more sensitive to pain stimuli and potentially leading to chronic pain v) Nerve damage or irritation in or around the affected muscle can also cause myalgia, either directly or through the release of inflammatory mediators [8]. Management of Myalgia include; i) Rest by taking a break from regular, daily activities, ii) use ice on the affected area for 20-minute intervals throughout the day iii) A compression bandage is used to reduce swelling and iv) Elevating affected area to help reduce swelling v) Immobilizing a joint above and a joint below the affected muscle to restrict movements vi) use EMSFM is helpful in lower limb muscles pain.

Electrical Muscle Stimulation Foot Massagers (EMSFM): The EMS foot massager combines 3 advanced clinical technologies - EMS, TENS and EPT, which promote blood circulation and enhance muscle performance through electrical stimulation therapy, improving foot neuropathy, arthritis pain, muscle spasms, swelling, RLS, etc. There are multiple foot massagers in the market and some of the best brand foot massagers include: i) Phixnozar Massage Mat ii) Theraflow Dual Foot Roller. Niksa Foot Spa Bath Massager, Cloud Massage Shiatsu Foot Massager and cost-wise the EMS Foot Massager made in China serves the purpose for common DPN & Myalgia cases. 

EMS (Electro-myo-stimulation) foot massagers, while offering potential benefits like pain relief and muscle relaxation, have some disadvantages of adverse effects like skin irritation, potential muscle damage, and contraindications for certain individuals with medical conditions.

Neuropathy and Myalgias are common symptoms in older patients, especially among individuals suffering from chronic diseases like high blood pressure, high cholesterol, or diabetes and post viral infections like Covid 19, Dengue, Shingles etc.

In fact, 60%-70% of diabetic patients will be diagnosed with neuropathy. While in initial 5-6 years after diagnosis of diabetes 50% of diabetic peripheral neuropathies are asymptomatic.

Myalgia is usually localized to one area of the body, or groups of muscles. The most common causes of muscle pain are stress, overuse, injuries, and tension. Systemic muscle pain is caused by an illness, infection, or a side effect of certain medications.

Allopathic treatment for Peripheral neuropathy and Myalgia focuses on managing symptoms of pain and numbness, & addressing the underlying cause, through lifestyle changes, medication, & physical therapy or Physiotherapy. 

Regular exercise, like walking lower neuropathy pain, improving muscle strength and helping control blood sugar levels, blood pressure and dyslipidemia. Yoga and tai chi and swimming are also advised. In the last decade, the use of electromagnetic therapy, a form of physiotherapy is increasingly being tried with mixed success.

EMS (Electro-myo-stimulation) foot massagers, while offering potential benefits like pain relief and muscle relaxation, have some disadvantages of adverse effects like skin irritation, potential muscle damage, and contraindications for certain individuals with medical conditions.