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Chiropractic Research Review

PENS for Low Back Pain

Low back pain (LBP) is one of the most common and costly health problems in Western society. Conservative treatment with anti-inflammatory drugs and exercise is effective for many patients with acute LBP, but chronic LBP can burden patients with long-lasting physical and psychological problems.

Current analgesic therapies do have side effects and some non-pharmaceutical means also remain unsatisfactory.

This study compared the effectiveness of a novel non-pharmacologic pain therapy, percutaneous electrical nerve stimulation (PENS), a sham PENS, transcutaneous electrical nerve stimulation (TENS), and flexion-extension exercise therapies. In the authors' use of PENS, ten 32-guage stainless steel acupuncturelike needles were placed into paraspinal soft tissues according to the dermatomal distribution of the pain. An experimental generator passed a very small amount of current (4 Hz) through the needles to probefore repeating the regimen with a different modality. The investigators measured the patients for improvements in pain severity, physical activity, and quality of sleep.

PENS was the most beneficial modality in the study, lessening pain and physical limitations and diminishing sleep loss and psychological distress. The conclusions of this study are of consequential clinical interest: "PENS is more effective in improving short-term outcomes than TENS and exercise therapies in patients with long-term LBP. The use of PENS therapy significantly decreased the need for oral nonopiod analgesic medications in this patient population."

Ghoname EA, Craig WF, White PF, et al. Percutaneous electrical nerve stimulation for low back pain: A randomized crossover study. Journal of the American Medical Association, Mar. 3, 1999;281(9), pp818-23.

Chiropractic Research Review

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