A survey of the attitudes and beliefs about the use of TENS for pain management by physiotherapists working in two cities in Sri Lanka

Abstract

IntroductionTranscutaneous electrical nerve stimulation (TENS) is a noninvasive, inexpensive, self-administered technique used throughout the world to relieve pain. In Sri Lanka, physiotherapists may use TENS for their patients as they receive a small amount of education about the principles and practice of TENS in their undergraduate training. To date, there have been no data gathered about the use of TENS by physiotherapists in Sri Lanka. The aim of this study was to assess attitudes and beliefs of physiotherapists working in Sri Lanka about their use of TENS for pain management.MethodsA postal survey was undertaken using a 12-item questionnaire developed by the investigators to gather information about attitudes, beliefs and use of TENS in clinical practice. The questionnaire was distributed to 100 physiotherapists working in three government hospitals and six private hospitals in the cities of Kandy and Colombo. A descriptive analysis of data was performed.ResultsSixty-seven completed questionnaires were returned (67% response rate). Over half of the respondents (58.2%) reported that they used TENS to treat pain “often” or “very often”, with use for musculoskeletal/orthopedic (61.3%) and neuropathic/neuralgic (79.1%) pain being most common. TENS was used less for postsurgical pain and rarely for cancer pain. Most (95.5%) respondents reported that their patients benefitted “considerably” from TENS. 76.1% of the respondents reported that they did not recommend and/or prescribe TENS for patients to use at home.ConclusionPhysiotherapists value TENS as a treatment option to manage musculoskeletal and neuropathic pain. However, there is a need for systems and resources to enable to patients to self-administer TENS rather than having to visit clinics.

"The Beliefs and Attitudes of Cypriot Physical Therapists Regarding the Use of TENS in Pain Management"

“…As the duration of the pain increases, it appears that Cypriots are reducing the use of TENS. The same was observed in the Indian study [39]. Sri Lankan's research opposed to Cyprus and India as shows that the use of TENS is increasing as the duration of pain increases [43].…”

“…Figure 4 shows that the frequency of its use increases with increasing intensity. In the Indian study, there is no such a significant change, however, no statistical process has been conducted to investigate this [39]. In research in Sri Lanka, therapists use TENS more frequently as the pain of patients increases, while in mild pain 30% of physiotherapists do not use TENS [43].…”

“…In Japan, with the same research protocol, only 8% reported using TENS daily, while 46% responded that they did not use it at all [38]. In Sri Lanka and India, surveys conducted followed the same protocol as the present study [32,39]. A survey in Sri Lanka found that 9.5% managed pain with TENS very often while no one responded that they did not use it at all [39] In the Indian study, the results showed that 80% of physiotherapists use TENS often or very often, however, it is not clear the percentage of very often and often [32].…”

“…In Sri Lanka and India, surveys conducted followed the same protocol as the present study [32,39]. A survey in Sri Lanka found that 9.5% managed pain with TENS very often while no one responded that they did not use it at all [39] In the Indian study, the results showed that 80% of physiotherapists use TENS often or very often, however, it is not clear the percentage of very often and often [32]. In USA 72.4% of physiotherapists reported using the TENS device in their clinical practice, but the study did not investigate the frequency of use of the device [40].…”

National survey of pain clinics in Croatia: Organization and services

“…The results of this study indicate that, in addition to pharmacotherapy, Croatian pain clinics also frequently prescribe TENS, acupuncture and injection of trigger points. Pain clinics in the world are increasingly using TENS for musculoskeletal and neuropathic pain (13). However, evidence supporting the use of TENS for chronic pain is scarce.…”