Article Text

Download PDFPDF
Literature Review and Meta-Analysis of Transcutaneous Electrical Nerve Stimulation in Treating Chronic Back Pain
  1. Lien-Chen Wu, MD, PhD*,,,
  2. Pei-Wei Weng, MD, PhD,,
  3. Chia-Hsien Chen, MD, PhD,,
  4. Yi-You Huang, PhD*,
  5. Yang-Hwei Tsuang, MD, PhD, and
  6. Chang-Jung Chiang, MD, PhD,
  1. *Institute of Biomedical Engineering, College of Engineering, College of Medicine, National Taiwan University, Taipei, Taiwan
  2. Department of Orthopaedics, Shuang Ho Hospital, Taipei, Taiwan
  3. Department of Orthopaedics, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
  1. Address correspondence to: Chang-Jung Chiang, MD, PhD, Department of Orthopaedics, Shuang Ho Hospital, Taipei Medical University, Taiwan No. 291, Zhongzheng Rd, Zhonghe District, New Taipei City 23561, Taiwan (e-mail: cjchiang{at}


Background and Objectives This study is a meta-analysis of randomized controlled trials comparing the efficacy of transcutaneous electrical nerve stimulation (TENS) to a control and to other nerve stimulation therapies (NSTs) for the treatment of chronic back pain.

Methods Citations were identified in MEDLINE, the Cochrane Library, Google Scholar, and through June 2014 using the following keywords: nerve stimulation therapy, transcutaneous electrical nerve stimulation, back pain, chronic pain. Control treatments included sham, placebo, or medication only. Other NSTs included electroacupuncture, percutaneous electrical nerve stimulation, and percutaneous neuromodulation therapy.

Results Twelve randomized controlled trials including 700 patients were included in the analysis. The efficacy of TENS was similar to that of control treatment for providing pain relief (standardized difference in means [SDM] = −0.20; 95% confidence interval [CI], −0.58 to 0.18; P = 0.293). Other types of NSTs were more effective than TENS in providing pain relief (SDM = 0.86; 95% CI, 0.15–1.57; P = 0.017). Transcutaneous electrical nerve stimulation was more effective than control treatment in improving functional disability only in patients with follow-up of less than 6 weeks (SDM = −1.24; 95% CI, −1.83 to −0.65; P < 0.001). There was no difference in functional disability outcomes between TENS and other NSTs.

Conclusions These results suggest that TENS does not improve symptoms of lower back pain, but may offer short-term improvement of functional disability.

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • This research did not receive any funding from agencies in the public, commercial, or not-for-profit sectors.

    The authors declare no conflict of interest.

    Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (

    This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.