Efficacy of transcutaneous electrical nerve stimulation in the treatment of chronic pelvic pain

Abstract

Background:Chronic pelvic pain is prevalent in 2% of women population globally. The etiology is multifactorial. Even in the absence of pelvic pathology, there is a subgroup of women who do not respond to analgesic and anti-inflammatory therapy. Chronic pelvic pain can be inhibited by direct inhibition of impulses in the preganglionic afferent neuron by closing the hypothetical gate in the dorsal horn of the spinal cord. Transcutaneous electrical nerve stimulation (TENS) is based on the gate control theory of abolishing the painful stimuli by providing simultaneous inputs in larger myelinated nerve fibers.Aims and Objectives:This study was designed to assess the effectiveness and safety of TENS in idiopathic chronic pelvic pain.Methods:It is a prospective, experimental study to evaluate the effectiveness of TENS versus placebo in reducing pain severity in chronic pelvic pain (G1 = 30, G2 = 32, G3 = 30, and G0 = 30). Patients with chronic pelvic pain due to benign lesions of genital tract, gastrointestinal, and renal disorders were excluded from the study after performing an ultrasound study of abdomen and pelvis. Ten treatment sessions (5 sessions/week) of 30 min were conducted.Observations and Results:There was a significant improvement in pain scores in TENS group as compared with control group, and two patients were completely pain free following TENS therapy.Conclusion:In women patients with idiopathic chronic pelvic pain, TENS can be a useful intervention. TENS units are safe, economical, and easily commercially available.

Does transcutaneous electrical nerve stimulation reduce pain and improve quality of life in patients with idiopathic chronic orchialgia? A randomized controlled trial

“… 8 , 29 Also, a similar pain reduction effect of TENS was noted for chronic prostatitis and chronic pelvic pain. 12 , 30 …”

Opioids and Alternatives in Female Chronic Pelvic Pain

“…34,35 A prospective study utilizing TENS for the treatment of pelvic pain showed reduced visual analog scale (VAS) pain scores compared to placebo group after 2 weeks of use. 36 Additionally, a Cochrane review evaluating efficacy of TENS for primary dysmenorrhea found highfrequency TENS more effective than placebo for pain relief. 37…”

Effects of Transcutaneous Electrical Nerve Stimulation on Proinflammatory Cytokines: Systematic Review and Meta-Analysis

“…Pharmacological therapies for pain and inflammation are recognized and accepted by international medical guidelines as the first line of treatment. However, due to intolerable side effects (e.g., gastritis, nausea, and vomiting) [ 1 ] or the ineffectiveness of these interventions in some individuals, analgesic and nonpharmacological treatments with minimal side effects are necessary [ 2 ]. In this case, transcutaneous electrical nerve stimulation (TENS) is a physiotherapeutic resource that has been increasingly studied as an alternative therapy.…”

“…TENS has been used since 1970 as adjunctive therapy for acute and chronic pain management in various medical and surgical conditions [ 3 ]. Currently, evidence on the efficacy of TENS in clinical practice has not yet provided a definitive conclusion as to the clinical effects TENS is capable of generating, whether analgesic or nonanalgesic [ 1 , 4 ].…”

“…Regarding analgesia, studies [ 1 – 5 ] show a reduction in pain intensity when compared to control groups in a variety of diseases. However, the evidence on the best parameters for application and their dose-response relationships in disease-related outcomes (e.g., in low back pain, osteoarthritis, and cancer) are not yet definitive, mainly due to the different clinical protocols performed.…”