Transcutaneous Electrical Nerve Stimulation May Not Effectively Relieve Low Back Pain

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Investigators evaluated 12 randomized controlled trials examining patients with low back pain undergoing transcutaneous electrical nerve stimulation.
Investigators evaluated 12 randomized controlled trials examining patients with low back pain undergoing transcutaneous electrical nerve stimulation.

Transcutaneous electrical nerve stimulation (TENS) may not provide relief from lower back pain, but may be associated with short-term improvement (<6 weeks) in functional disability, according to a literature review published in Regional Anesthesia and Pain Medicine.

Investigators evaluated 12 randomized controlled trials examining patients with low back pain undergoing TENS (n=350), control therapy (n=269; eg, placebo, sham, or medication only), or other nerve stimulation therapies (n=81; eg, electroacupuncture, percutaneous electrical nerve stimulation or percutaneous neuromodulation therapy).

TENS was found to provide pain relief comparable with that of a control therapy (standardized difference in means [SDM], −0.20; 95% CI, −0.58 to 0.18; P =.293).

At follow-up <6 weeks, other nerve stimulation therapies provided greater pain relief than TENS (SDM, 0.86; 95% CI, 0.15-1.57; P =.017), but not at ≥6 weeks follow-up (SDM, 0.54; 95% CI, −0.54 to 1.61; P =.326).

TENS was found to provide greater improvement in functional disability than control therapy at follow-up <6 weeks (SDM, −1.24; 95% CI, −1.83 to −0.65; P <.001), but not at follow-up >6 weeks (SDM, 0.26; 95% CI, −0.08 to 0.59; P =.134). There was noticeable variation in intervention duration across studies, which could have affected the review's findings.

”Examination of more subjective parameters such as satisfaction with TENS treatment and outcome and overall perception of the treatment would add value to determination of the value of TENS treatment in [chronic back pain],” concluded the study authors.

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Reference

Wu LC, Weng PW, Chen CH, et al. Literature review and meta-analysis of transcutaneous electrical nerve stimulation in treating chronic back pain [published online February 1, 2018]. Reg Anesth Pain Med. doi:10.1097/AAP.0000000000000740

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