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Assessment: efficacy of transcutaneous electric nerve stimulation in the treatment of pain in neurologic disorders (an evidence-based review)

PainSci » bibliography » Dubinsky et al 2010
updated
Tags: back pain, TENS, chronic pain, neurology, pain problems, spine, devices, treatment

PainSci commentary on Dubinsky 2010: ?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 wherever possible.

This review of transcutaneous electric nerve stimulation (TENS) for neurologic disorders found that it showed benefit only in lower quality (class II) studies, and not even in all of those. When tested proper-like in better quality (class I) studies … nada. Thus TENS “is not recommended for the treatment of chronic low back pain.” I’m shocked.

~ 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.

OBJECTIVE: To determine if transcutaneous electric nerve stimulation (TENS) is efficacious in the treatment of pain in neurologic disorders.

METHODS: We performed a systematic literature search of Medline and the Cochrane Library from inception to April 2009.

RESULTS: There are conflicting reports of TENS compared to sham TENS in the treatment of chronic low back pain, with 2 Class II studies showing benefit, but 2 Class I studies and another Class II study not showing benefit. Because the Class I studies are stronger evidence, TENS is established as ineffective for the treatment of chronic low back pain (2 Class I studies). TENS is probably effective in treating painful diabetic neuropathy (2 Class II studies).

RECOMMENDATIONS: Transcutaneous electric nerve stimulation (TENS) is not recommended for the treatment of chronic low back pain (Level A). TENS should be considered in the treatment of painful diabetic neuropathy (Level B). Further research into the mechanism of action of TENS is needed, as well as more rigorous studies for determination of efficacy.

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