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

PainSci » bibliography » Chen et al 2015
Tags: knee, arthritis, TENS, leg, limbs, pain problems, aging, devices, treatment

One article on PainSci cites Chen 2015: Zapped! Does TENS work for pain?

PainSci commentary on Chen 2015: ?This page is one of thousands in the 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 wherever possible.

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, 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.

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