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Chiropractic Research Review

How Effective Is TENS?

Transcutaneous electrical nerve stimulation (TENS) involves stimulation of peripheral nerves through electrodes on the skin surface as a noninvasive therapy to relieve pain. TENS was first used over 30 years ago as an alternative to drugs for managing long-term pain, but despite its use by many chiropractors, its success for treating pain has not been clinically established.

To evaluate the effectiveness of TENS for treating chronic low back pain (LBP), the authors of this report reviewed studies in which TENS had been administered with varying frequency-intensities (high, low, burst, and hyperstimulation); duration periods; treatment techniques; and locations on the torso.

Only randomized, controlled trials with at least five TENS subjects and five controls, examining only adults and those with LBP of at least 12 weeks, were included in the review.

Five eligible studies involved a total of 170 controls and 251 TENS subjects (153 receiving conventional TENS, 98 receiving "acupuncture-like" TENS) who met the review criteria. Treatments varied substantially between these studies, from one treatment/day for two days to three treatments/day for four weeks. No significant differences were observed between TENS and control groups; however, patients in the TENS groups tended to report less pain and better functional abilities than placebo groups. Varying application methods or frequency did not appear to affect treatment outcomes.

The authors conclude that current research does not support either the use or nonuse of TENS for chronic LBP patients. They add that the small number of valid studies and the trend, although not significant, toward positive treatment results in TENS patients warrant more studies on this method. They suggest, "It is clear that more well-controlled studies are necessary before concluding in the inefficacy of TENS in LBP."

Brosseau L, Milne S, Robinson V, et al. Efficacy of the transcutaneous electrical nerve stimulation for the treatment of chronic low back pain: A meta-analysis. Spine 2002:27(6), pp. 596-603.

Chiropractic Research Review

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