Microcurrent Transcutaneous Electric Nerve Stimulation in Painful Diabetic Neuropathy: A Randomized Placebo-Controlled Study

Abstract

The pain reduction with the applied transcutaneous electrotherapy regimen is not superior to a placebo treatment.

Electrical stimulation and electromagnetic field use in patients with diabetic neuropathy: systematic review and meta-analysis

“…Five trials [11][12][13][14][15] compared TENS to placebo (total n=132, of which 75 were on TENS), one trial 22 compared TENS to HF (total n=41, of which 21 were on TENS), one trial 23 compared FREMS to placebo (total n=62, of which 31 were on FREMS), one trial 24 compared PENS to placebo (total n=50, of which 25 were on PENS), and four trials 18-21 compared electromagnetic field to placebo (total n=532, of which 268 were on electromagnetic field).…”

“…There was pain improvement in the articles that compared TENS versus placebo [11][12][13][14][15] [-0.44 (95% CI: -0.79 to -0.09; I2: 0%, p=0.01)] (Figure 2A). …”

“…In a sub-analysis of studies on TENS in patients with PND at different treatment durations, four studies 11,[13][14][15] involved treatment for two, four and six weeks, which resulted in improvement in pain relief compared to placebo [-0.54 (95% CI: -1.02 to -0.06; I2: 26%, p = 0.03)] (Figure 2A).…”

“…As several studies have suggested, nonpharmacological options, such as electrical stimulation, which represents one of the more benign therapies for this condition 9 , may contribute to a better quality of life and fewer complaints of pain 10 . In randomized trials, various types of electrotherapy, such as transcutaneous electric nerve stimulation (TENS) [11][12][13][14][15] , pulsed electromagnetic fields [16][17][18][19] , static magnetic field therapy 20 , low-frequency pulsed magnetic field 21 , high-frequency external muscle stimulation (HF) 22 , frequency-modulated electromagnetic neural stimulation (FREMS) 23 and percutaneous electrical nerve stimulation (PENS) 24 , have been reported to show beneficial effects, such as decreased pain and improved sensitivity, due to electric stimulation in the treatment of patients with PDN.…”

“…However, studies comparing these benefits with those obtained from placebo had small sample sizes and showed conflicting results [11][12][13][14][15][18][19][20][21][22][23][24] . A systematic review of the evidence would allow for a more precise evaluation of its effectiveness and, if the benefits are proven, aid in disseminating the use of electrical stimulation.…”