A comparative study between transcutaneous electrical nerve stimulation and pulsed electromagnetic field therapy in the management of post-herpetic neuralgia of the sciatic nerve

Abstract

Objectives: To compare the efficacy of pulsed electromagnetic field therapy (PEMFT) versus transcutaneous electrical nerve stimulation (TENS) in the treatment of post-herpetic neuralgia of the sciatic nerve.Methods: A double-blinded randomized clinical study has included 56 patients (18 males and 38 females). Participants were randomly and equally assigned into 2 groups. Both groups received conventional physical therapy treatment. Moreover, group (A) has an additional TENS, and group (B) had PEMFT. Both modalities were applied once daily, 3 times a week for 20 minutes for 8 successive weeks. Visual analog scale (VAS) and carbamazepine intake (CMI) dose have been assessed before and after interventions.Results: There was a significant decrease in VAS and CMI post-treatment in group A and B compared with that pretreatment (P > .001). The percent decrease in VAS and CMI in group A were 72.44% and 69.47% respectively and that for group B was 68.95% and 67.94% respectively. The findings revealed a non-significant difference in VAS and CMI (P > .05) between groups. The Means of VAS and CMI were (2.4 ± 0.78, 204.5 ± 16.76 and 2.67 ± 0.9, 210.57 ± 16.5) in group A and group B respectively. The mean difference for VAS and CMI was (−0.27 and −6.07) between groups post-treatment respectively. Conclusion:Both TENS and PEMFT were effective and nearly equivalent in improving the post-herpetic neuralgia of the sciatic nerve as measured by in VAS and CMI. Clinical recommendations should be highlighted to instigate the using of TENS and PEMFT in the management of post-herpetic neuralgia of the sciatic nerve.Abbreviations: CMI = carbamazepine intake, HZ = herpes zoster, PEMFT = pulsed electromagnetic field therapy, PHN = post herpetic neuralgia, TENS = transcutaneous electrical nerve stimulation, VAS = visual analog scale, VZV = varicella zoster virus.

Peripheral magnetic stimulation for chronic peripheral neuropathic pain: A systematic review and meta‐analysis

“…After reviewing and resolving any conflicts in screening, a total of 23 studies fulfilled the eligibility criteria and were included in the review. Of the included studies, 15 were randomized controlled trials, 14,21–34 5 were case series, 35–37 2 were case reports, 38,39 and 1 was a non‐randomized trial 40 …”

“…Studies were published across several countries (according to location of primary author) including Azerbaijan (n = 1), 37 Canada (n = 2), 35,38 Egypt (n = 4), 21,29,31,32 Germany (n = 1), 22 India (n = 1), 30 Italy (n = 2), 39,41 Japan (n = 1), 42 Poland (n = 2), 26,27 Romania (n = 1), 23 Russia (n = 1), 40 Thailand (n = 1), 33 Turkey (n = 1), 28 and United States (n = 5). 14,24,25,34,36 The total number of patients across all studies was 1123.…”

“…PMS was evaluated across several neuropathic pain disorders: carpal tunnel syndrome (n = 3), 24,27,33 chemotherapy-induced polyneuropathy (n = 1), 22 complex regional pain syndrome (n = 3), 28,35,39 diabetic peripheral neuropathy (n = 5), 25,26,30,34,37 glossopharyngeal neuralgia (n = 1), 38 lumbar radiculopathy (n = 2), 23,32 orofacial pain (n = 1), 41 phantom limb pain (n = 1), 14 post-herpetic neuralgia (n = 1), 29 post-traumatic neuroma/nerve entrapment (n = 1), 36 pudendal neuralgia (n = 1), 42 traumatic brachial plexopathy (n = 1), 31 and trigeminal neuropathy (n = 2). 21,40 Nine studies compared PMS to a sham device, while the other studies compared a number of different controls (physiotherapy, 23 physiotherapy and vitamins, 33 transcutaneous electrical nerve stimulation, 29 laser therapy 21,27 ), or no additional treatment above the standard of care. 30,40 Included studies used varying types of PMS devices including round coils, 21,28,42 figure-of-eight coils, 31,35,36,38 racetrack coils, 23,33 diamagnetic pumps, 39 wearable devices, 24,41 and magnetic mattresses.…”

“…14 In another study, a randomized trial (n = 56) enrolled patients with post-herpetic neuralgia and assessed PMS for 20 min three times a week for 8 weeks to control (TENS and physical therapy) and found nonsignificant differences in pain scores and carbamazepine intake between groups. 29 A case series (n = 5) 36 evaluating PMS for 13 min for three to four sessions on those with post-traumatic neuroma/nerve entrapment and demonstrated an average pain reduction of 84%, and that pretreatment tactile allodynia found in three patients resolved after 2-month treatment sessions. Another case series (n = 5) 42 evaluated PMS for pudendal neuralgia or sciatica during a single session of 1.5 T for 2 min which resulted in immediate elimination of pain with stimulation that lasted between 30 min and 56 days (median 25 h).…”

“…Five trials reported on pain scores from 1 to 3 months, 21,24,26,27,29 with one trial reporting a significant reduction in pain scores that favored PMS. 21 Pooled data for this period did not show a significant reduction in pain scores with PMS use (MD 0.24, 95% CI −0.30 to 0.79, I 2 = 74%, p = 0.38, 256 patients, very low quality of evidence, Figure 3).…”