Using TENS for Pain Control: Update on the State of the Evidence

Abstract

Transcutaneous electrical nerve stimulation (TENS) is a non-pharmacological intervention used in the treatment of acute and chronic pain conditions. The first clinical studies on TENS were published over 50 years ago, when effective parameters of stimulation were unclear and clinical trial design was in its infancy. Over the last two decades, a better understanding of the mechanisms underlying TENS efficacy has led to the development of an adequate dose and has improved outcome measure utilization. The continued uncertainty about the clinical efficacy of TENS to alleviate pain, despite years of research, is related to the quality of the clinical trials included in systematic reviews. This summary of the evidence includes only trials with pain as the primary outcome. The outcomes will be rated as positive (+), negative (−), undecided (U), or equivalent to other effective interventions (=). In comparison with our 2014 review, there appears to be improvement in adverse events and parameter reporting. Importantly, stimulation intensity has been documented as critical to therapeutic success. Examinations of the outcomes beyond resting pain, analgesic tolerance, and identification of TENS responders remain less studied areas of research. This literature review supports the conclusion that TENS may have efficacy for a variety of acute and chronic pain conditions, although the magnitude of the effect remains uncertain due to the low quality of existing literature. In order to provide information to individuals with pain and to clinicians treating those with pain, we suggest that resources for research should target larger, high-quality clinical trials including an adequate TENS dose and adequate timing of the outcome and should monitor risks of bias. Systematic reviews and meta-analyses should focus only on areas with sufficiently strong clinical trials that will result in adequate sample size.

TENS (Transcutaneous Electrical Nerve Stimulation) for Pain Control in Multiple Rib Fractures After Blunt Thoracic Trauma

“…2022 yılında yayınlanan Meta-TENS çalışmasında, tanıdan bağımsız olarak ağrının hafiflediğine dair orta düzeyde kanıt bulunmuştur (31,32). Sistematik derlemelerin çoğu, TENS'in çeşitli akut ve kronik ağrı durumları için etkili olabileceği sonucunu desteklemektedir, ancak mevcut literatürün düşük kalitesi nedeniyle etkinin büyüklüğü belirsizliğini korumaktadır (33).…”

“…Ağrı sorgulamaları 0.-2.-6.-12.-24.-48.-72. saatlerde Vizüel Analog Skala (VAS) ile yapıldı. VAS 0-ağrı olmaması ve VAS 10-en dayanılmaz ağrı olacak şekilde, 10 birime ayrıldı ve hastanın bu skalada ağrısını işaretlemesi istendi (5,32,33) (Resim 2). Grup I'deki hastalara yatıştan hemen sonra, kot fraktürlerinin olduğu bölgeye, bu bölgenin üst ve alt interkostal aralığını içerecek şekilde, elektropedler yerleştirildi.…”

Evaluating the readability, quality and reliability of online patient education materials on transcutaneuous electrical nerve stimulation (TENS)

“…[ 28 ] As TENS is available without a prescription, it is easily accessible and allows patients to use it without the guidance of a health professional. [ 29 ] However, patients lack sufficient knowledge regarding the use of health products and use internet as a source to obtain information. [ 30 ] Information obtained from internet also has several disadvantages in terms of reliability and quality, and the text usually written in a language that is difficult to understand by the readers.…”

Rehabilitation Phases, Precautions, and Mobility Goals Following Total Hip Arthroplasty

“…Limited evidence exists to support the use of modalities following THA, and much of the existing evidence is of low quality [49], although interventions such as TENS and manual therapy have substantial support for use in populations with chronic pain [12,47]. Considering that many patients experience persistent pain prior to THA, it is reasonable to consider interventions that address chronic pain and thus enable improved participation in functional activities and exercise.…”