Does TENS Reduce the Intensity of Acute and Chronic Pain? A Comprehensive Appraisal of the Characteristics and Outcomes of 169 Reviews and 49 Meta-Analyses

Paley, Carole A; Wittkopf, Priscilla Geraldine; Jones, Gareth; Johnson, Mark I.

doi:10.3390/medicina57101060

Cited by 35 publications

(25 citation statements)

References 342 publications

(226 reference statements)

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“…Often trial reports are unclear whether data were collected within an ongoing course of treatment, or after a course of TENS treatment had finished (ie, follow-up), and this would compromise simple pooling of long-term and/or follow-up data. 10 Our analysis of outcomes during or immediately after treatment also reduces the influence of participants who stop using TENS within a prolonged course of treatment. We noted a scarcity of data at 6 weeks, 3 months, 6 months and 12 months after the end of a course of TENS treatment in studies included in our review.…”

Section: Discussionmentioning

confidence: 99%

“…Credence is given to effect size estimates of long-term follow-up, but analysis of such outcomes is complex for TENS. Often trial reports are unclear whether data were collected within an ongoing course of treatment, or after a course of TENS treatment had finished (ie, follow-up), and this would compromise simple pooling of long-term and/or follow-up data 10. Our analysis of outcomes during or immediately after treatment also reduces the influence of participants who stop using TENS within a prolonged course of treatment.…”

Section: Discussionmentioning

confidence: 99%

“… 9 A comprehensive appraisal of literature identified 169 systematic reviews, including Cochrane reviews, and at least 49 meta-analyses of TENS for specific pain conditions. 10 Most reviews are inconclusive due to insufficient pooled data. A recent overview of eight Cochrane reviews on TENS for chronic pain analysed 51 RCTs (2895 participants) and was inconclusive, with reviewers reluctant to pool data for meta-analysis because of clinical heterogeneity.…”

Section: Introductionmentioning

confidence: 99%

“…The debate about the efficacy of TENS has been ongoing since the 1970s, despite the publication of more than 350 RCTs 9. A comprehensive appraisal of literature identified 169 systematic reviews, including Cochrane reviews, and at least 49 meta-analyses of TENS for specific pain conditions 10. Most reviews are inconclusive due to insufficient pooled data.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Efficacy and safety of transcutaneous electrical nerve stimulation (TENS) for acute and chronic pain in adults: a systematic review and meta-analysis of 381 studies (the meta-TENS study)

et al. 2022

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ObjectiveTo investigate the efficacy and safety of transcutaneous electrical nerve stimulation (TENS) for relief of pain in adults.DesignSystematic review and meta-analysis.Data sourcesMedline, Cochrane Central, Embase (and others) from inception to July 2019 and updated on 17 May 2020.Eligibility criteria for study selectionRandomised controlled trials (RCTs) comparing strong non-painful TENS at or close to the site of pain versus placebo or other treatments in adults with pain, irrespective of diagnosis.Data extraction and synthesisReviewers independently screened, extracted data and assessed risk of bias (RoB, Cochrane tool) and certainty of evidence (Grading and Recommendations, Assessment, Development and Evaluation). Mean pain intensity and proportions of participants achieving reductions of pain intensity (≥30% or >50%) during or immediately after TENS. Random effect models were used to calculate standardised mean differences (SMD) and risk ratios. Subgroup analyses were related to trial methodology and characteristics of pain.ResultsThe review included 381 RCTs (24 532 participants). Pain intensity was lower during or immediately after TENS compared with placebo (91 RCTs, 92 samples, n=4841, SMD=−0·96 (95% CI −1·14 to –0·78), moderate-certainty evidence). Methodological (eg, RoB, sample size) and pain characteristics (eg, acute vs chronic, diagnosis) did not modify the effect. Pain intensity was lower during or immediately after TENS compared with pharmacological and non-pharmacological treatments used as part of standard of care (61 RCTs, 61 samples, n=3155, SMD = −0·72 (95% CI −0·95 to –0·50], low-certainty evidence). Levels of evidence were downgraded because of small-sized trials contributing to imprecision in magnitude estimates. Data were limited for other outcomes including adverse events which were poorly reported, generally mild and not different to comparators.ConclusionThere was moderate-certainty evidence that pain intensity is lower during or immediately after TENS compared with placebo and without serious adverse events.PROSPERO registration numberCRD42019125054.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Efficacy and safety of transcutaneous electrical nerve stimulation (TENS) for acute and chronic pain in adults: a systematic review and meta-analysis of 381 studies (the meta-TENS study)

et al. 2022

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“…Transcutaneous electrical nerve stimulation (TENS) is a noninvasive, inexpensive and easy to learn technique that is used to manage acute and chronic pain of nociceptive and neuropathic origin [22,23]. TENS has a low risk of side-effects and the postoperative analgesic benefit from this treatment has been demonstrated in previous studies following various surgeries.…”

Section: Introductionmentioning

confidence: 99%

Transcutaneous Electric Nerve Stimulation Reduces Pathological Sensation of Mesh One Week after Open Inguinal Hernia Surgery: Follow-Up Results from a Randomized, Double Blind and Placebo-Controlled Trial

et al. 2022

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Background and Objectives: Quality of life (QoL) and chronic pain are important outcomes following hernia surgery. The long-term effects of Transcutaneous Electric Nerve Stimulation (TENS) on postoperative recovery are not well known. In this trial we investigated the role of TENS on QoL and on the incidence of chronic pain following inguinal hernia repair with mesh. Materials and Methods: A total of 80 male patients with elective primary unilateral hernia Lichtenstein repair were randomly allocated to receive TENS or a placebo-TENS procedure. The TENS group received conventional TENS twice a day on the first and second postoperative days. The intensity was set at 0–0.5 mA in the placebo-TENS group. General and hernia-specific QoL, as well as the incidence of chronic pain were assessed using SF-36v2 and the Carolinas comfort scale. Results: Less sensation of mesh was reported by the TENS group patients one week after surgery. At this time point, the mean sensation score was 6.07 ± 8.88 in the TENS group and 14.08 ± 16.67 in the placebo-TENS group (p = 0.029). Although at two days and one week postoperatively, TENS group patients tended to have less pain, less movement restrictions and better overall hernia-specific QoL, the differences were not statistically significant. At 6 months postoperatively, no incidence of chronic pain was found in either the placebo-TENS or TENS group. Conclusions: Conventional TENS applied in the early postoperative period following inguinal hernia repair with mesh was found to reduce mesh-related foreign body sensation one week after surgery. Promising results were also found for other QoL domains.

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Emerging Technologies for Improving Musculoskeletal Health: A Systematic Evidence Gap Map

Tanner,

Still,

Ghasri

et al. 2024

Musculoskeletal Care

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IntroductionMusculoskeletal (MSK) conditions are the largest contributor to disability worldwide. The aim of this project was to undertake a horizon scan and generate an evidence gap map (EGM) to highlight technological innovations in development for preventing and managing MSK conditions at early stages of the clinical treatment pathway, and to identify areas of unmet need.MethodsIn February 2024, bibliographic databases, a clinical trial registry, research funding portals, and company websites were searched for relevant records. Identified records were screened for relevance; they had to be a device or digital “innovative” technology for maintaining or recovering positive musculoskeletal health in adults. The characteristics of relevant technologies, delivery setting and outcomes assessed were coded. An EGM was generated to illustrate the results. Methods followed Cochrane Rapid Reviews Guidance to ensure robustness.ResultsOne hundred and nine relevant technologies were identified. Nearly half (49.5%) of these technologies were designed for use at home. Most (50.5%) were digital technologies (e.g., mobile apps) or devices with a digital component (19.3%) (e.g., digital pain reduction kit). The impact of these technologies was most assessed by changes seen in measures of pain and mobility.Discussion and ConclusionThe proportion of technologies used at home compared to other settings indicates a shift in the setting of therapy provision for individuals with MSK conditions. Future evaluative studies should consider measuring a broader set of outcome domains in order to understand the direct and wider impacts of health technologies for those with MSK conditions.

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Does TENS Reduce the Intensity of Acute and Chronic Pain? A Comprehensive Appraisal of the Characteristics and Outcomes of 169 Reviews and 49 Meta-Analyses

Cited by 35 publications

References 342 publications

Efficacy and safety of transcutaneous electrical nerve stimulation (TENS) for acute and chronic pain in adults: a systematic review and meta-analysis of 381 studies (the meta-TENS study)

Efficacy and safety of transcutaneous electrical nerve stimulation (TENS) for acute and chronic pain in adults: a systematic review and meta-analysis of 381 studies (the meta-TENS study)

Transcutaneous Electric Nerve Stimulation Reduces Pathological Sensation of Mesh One Week after Open Inguinal Hernia Surgery: Follow-Up Results from a Randomized, Double Blind and Placebo-Controlled Trial

Emerging Technologies for Improving Musculoskeletal Health: A Systematic Evidence Gap Map

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