Age Group Comparisons of TENS Response Among Individuals With Chronic Axial Low Back Pain

Abstract

Chronic low back pain (CLBP) is a highly prevalent and disabling musculoskeletal pain condition among older adults. Transcutaneous electrical nerve stimulation (TENS) is commonly used to treat CLBP, however, TENS response for older adults compared to younger adults is untested. In a dose-response study stratified by age, sixty participants with axial CLBP (20 young, 20 middle-aged, 20 older) received four 20-minute sessions of high frequency, high intensity TENS over a two to three-week period in a laboratory-controlled setting. Experimental measures of pain sensitivity (mechanical pressure pain detection threshold, PPT) and central pain excitability (phasic heat temporal summation, TS; heat aftersensations, AS) were assessed before and after TENS. Episodic or immediate axial CLBP relief was assessed after TENS via measures of resting pain, movement-evoked-pain, and self-reported disability. Cumulative or prolonged axial CLBP relief was assessed by comparing daily pain report across sessions. Independent of age, individuals experienced episodic increase in PPT and reduction in AS following TENS application. Similarly, all groups, on average, experienced episodic axial CLBP relief via improved resting pain, movement-evoked pain, and disability report. Under this design, no cumulative effect was observed as daily pain did not improve for any age group across the four sessions. However, older adults received higher TENS amplitude across all sessions in achieving similar TENS responses to younger adults. These findings suggest that older adults experience similar episodic axial CLBP relief as younger individuals following high frequency, high intensity TENS when higher dosage parameters are used.

Prolonged Reduction in Shoulder Strength after Transcutaneous Electrical Nerve Stimulation Treatment of Exercise‐Induced Acute Muscle Pain

“…Second, measures were collected following TENS or TENS placebo application. Evidence suggests that pain reduction from TENS is episodic and may be better detected during delivery of the electric current or immediately after . However, the pain assessment technique that we utilized is ecologically valid from the participant's perspective, in that the overall success of a treatment is determined after the treatment is administered, not during.…”

“…Evidence suggests that pain reduction from TENS is episodic and may be better detected during delivery of the electric current or immediately after. [84][85][86] However, the pain assessment technique that we utilized is ecologically valid from the participant's perspective, in that the overall success of a treatment is determined after the treatment is administered, not during. Third, because there are no universally accepted dosing parameters and studies often use a range of dosing applications, our findings can only be compared to prior studies using similar conventional TENS parameters (ie, short pulse width and strong, but comfortable, intensities).…”

Randomized study of the impact of a therapeutic education program on patients suffering from chronic low-back pain who are treated with transcutaneous electrical nerve stimulation

“…This could have influenced TENS efficacy since it was shown that the intensity of an efficacious stimulation differed according to patient's age, namely 25.3 mA in the elderly patients vs 7.9 mA and 9.6 mA in the younger and middle-aged patients, respectively. [33] Intensity modifications were not performed in our study.…”

Efeito agudo da estimulação elétrica nervosa transcutânea (TENS) na lombalgia

“…3 Várias estratégias de tratamento vem sendo utilizadas como programas de exercícios com controle motor dos músculos do tronco através de exercícios de estabilização do Core, exercícios de fortalecimento e alongamentos. 4 Na prática fisioterapêutica, diferentes agentes eletrofísicos são utilizados para obter alívio da dor relacionado aos problemas musculoesqueléticos, a fim de complementar outras intervenções terapêuticas, particularmente a realização de exercícios corretivos. 5 Em indivíduos com dor lombar, deuma forma geral, o alívio imediato da dor aguda durante as primeiras sessões de fisioterapia fornece o terreno adequado para o início dos exercícios.…”

“…5 A TENS é uma técnica amplamente utilizada dentro da eletroterapia, sendo considerada um tratamento coadjuvante simples e seguro, podendo ser efetiva para manejo da dor lombar de diversas causas, mecânicas ou radiculares. 4 A estimulação elétrica nervosa transcutânea (TENS) é uma das modalidades mais comumente usadas, com evidência moderada a forte de sua capacidade de modular a dor em diferentes condições de dor. 5 Foi demonstrado que a TENS pode diminuir a dor durante, logo após e por um intervalo de tempo determinado após aplicação nos tecidos moles lesionados 5 .…”