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Chronic and Interventional Pain: Original Articles
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}s.tmu.edu.tw).

Abstract

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 ClinicalTrials.gov 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.

https://doi.org/10.1097/AAP.0000000000000740

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    Footnotes

    • 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.

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