Meta‐analysis of transcutaneous electrical nerve stimulation for relief of spinal pain

Meta‐analysis of transcutaneous electrical nerve stimulation for relief of spinal pain IntroductionTranscutaneous electrical nerve stimulation (TENS) is an electrotherapeutic procedure used for pain control that was first introduced to the medical community by Wall and Sweet in 1967 (Wall and Sweet, ). In 2012, the Center for Medicare Services rendered a decision stating as follows: ‘TENS is not reasonable and necessary for the treatment of CLBP [chronic low back pain]’ (cms.gov). Systematic reviews similarly conclude that TENS is ineffective or inconclusive for a variety of painful conditions (Khadilkar et al., ; Nnoaham and Kumbang, ; Dowswell et al., ; Kroeling et al., ; Rutjes et al., ; Walsh et al., ; Hurlow et al., ). On the other hand, Jauregui et al. () concluded in their systematic review that the treatment of chronic low back pain with TENS demonstrated significant pain reduction in patients who were treated for less than 5 weeks. Prior studies, however, have not considered important aspects of TENS treatment, namely intensity of stimulation and timing of assessment. We have previously suggested several factors may contribute to the equivocal findings in the literature on TENS effectiveness. These factors include dosing of TENS, timing of assessment, the population assessed and type of outcome (Sluka et al., ). Similarly, Bennett and colleagues describe significant biases in study design http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png European Journal of Pain Wiley

Meta‐analysis of transcutaneous electrical nerve stimulation for relief of spinal pain

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Publisher
Wiley
Copyright
Copyright © 2018 European Pain Federation ‐ EFIC®
ISSN
1090-3801
eISSN
1532-2149
D.O.I.
10.1002/ejp.1168
Publisher site
See Article on Publisher Site

Abstract

IntroductionTranscutaneous electrical nerve stimulation (TENS) is an electrotherapeutic procedure used for pain control that was first introduced to the medical community by Wall and Sweet in 1967 (Wall and Sweet, ). In 2012, the Center for Medicare Services rendered a decision stating as follows: ‘TENS is not reasonable and necessary for the treatment of CLBP [chronic low back pain]’ (cms.gov). Systematic reviews similarly conclude that TENS is ineffective or inconclusive for a variety of painful conditions (Khadilkar et al., ; Nnoaham and Kumbang, ; Dowswell et al., ; Kroeling et al., ; Rutjes et al., ; Walsh et al., ; Hurlow et al., ). On the other hand, Jauregui et al. () concluded in their systematic review that the treatment of chronic low back pain with TENS demonstrated significant pain reduction in patients who were treated for less than 5 weeks. Prior studies, however, have not considered important aspects of TENS treatment, namely intensity of stimulation and timing of assessment. We have previously suggested several factors may contribute to the equivocal findings in the literature on TENS effectiveness. These factors include dosing of TENS, timing of assessment, the population assessed and type of outcome (Sluka et al., ). Similarly, Bennett and colleagues describe significant biases in study design

Journal

European Journal of PainWiley

Published: Jan 1, 2018

References

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