Transcutaneous Electrical Nerve Stimulation in Patients with Knee Osteoarthritis: Evidence from Randomized Controlled Trials

updated Feb 18, 2016

Tags: knee, TENS, arthritis, leg, limbs, pain problems, devices, treatment, aging

PainSci summary of Chen 2015?This page is one of thousands in the PainScience.com bibliography. It is not a general article: it is focused on a single scientific paper, and it may provide only just enough context for the summary to make sense. Links to other papers and more general information are provided at the bottom of the page, as often as possible. ★★★★☆?4-star ratings are for bigger/better studies and reviews published in more prestigious journals, with only quibbles. Ratings are a highly subjective opinion, and subject to revision at any time. If you think this paper has been incorrectly rated, please let me know.

A review of 18 trials concluded that TENS “might” relieve knee pain caused by osteoarthritis, but this is a rather optimistic word choice that the data doesn’t actually support: it’s based on just a small reduction in pain … so small that it wasn’t evidence when patients were assessed using another scoring system for arthritis disability (WOMAC). These people didn’t get better, or too little to care about.

~ Paul Ingraham

original abstract†Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.

OBJECTIVES: Transcutaneous electrical nerve stimulation (TENS) has been reported to relieve pain and improve function in patients with knee osteoarthritis. The purpose of this systematic review and meta-analysis was to evaluate the efficacy of TENS for the management of knee osteoarthritis.

METHODS: We searched Embase, PubMed, CENTRAL, SIGLE, PEDro and clinicaltrials.gov, up to June 2014 for literature related to TENS used for the treatment of knee osteoarthritis. Two authors independently screened the searched records based on the title and abstract. Information including the authors, study design, mean age, sex, study population, stimulation frequency (of TENS), outcome measures and follow-up periods were extracted by the two authors.

RESULTS: Eighteen trials were included in the qualitative systematic review, and 14 were included in the meta-analysis. TENS significantly decreased pain (SMD -0.79, 95%CI -1.31 to -0.27, P value<0.00001) compared with control groups. There was no significant difference in the Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index (SMD -0.13, 95%CI -0.35 to 0.1, P value=0.09) or the rate of all-cause discontinuation (RR 0.77, 95%CI 0.48 to 1.22, P value=0.94) between the TENS and control groups.

DISCUSSION: TENS might relieve pain due to knee osteoarthritis. Further randomized controlled trials should focus on large-scale studies and a longer duration of follow-up.

original abstract†Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.

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