Efficacy of Transcutaneous Electrical Nerve Stimulation (TENS) for Chronic Low-back Pain in a Multiple Sclerosis Population: A Randomized, Placebo-controlled Clinical Trial

doi:10.1097/01.ajp.0000210935.73686.79

Paper

Efficacy of Transcutaneous Electrical Nerve Stimulation (TENS) for Chronic Low-back Pain in a Multiple Sclerosis Population: A Randomized, Placebo-controlled Clinical Trial

Published Nov 1, 2006 · K. Warke, J. Al-Smadi, D. Baxter

The Clinical Journal of Pain

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Abstract

ObjectiveThis study was designed to investigate the hypoalgesic effects of self-applied transcutaneous electrical nerve stimulation (TENS) on chronic low-back pain (LBP) in a multiple sclerosis (MS) population. MethodsNinety participants with probable or definite MS (aged 21 to 78 y) presenting with chronic LBP were recruited and randomized into 3 groups (n=30 per group): (1) low-frequency TENS group (4 Hz, 200 μs); (2) high-frequency TENS group (110 Hz, 200 μs); and (3) placebo TENS. Participants self-applied TENS for 45 minutes, a minimum of twice daily, for 6 weeks. Outcome measures were recorded at weeks 1, 6, 10, and 32. Primary outcome measures included: Visual Analog Scale for average LBP and the McGill Pain Questionnaire. Secondary outcome measures included: Visual Analog Scale for worst and weekly LBP, back and leg spasm; Roland Morris Disability Questionnaire; Barthel Index; Rivermead Mobility Index; Multiple Sclerosis Quality of Life-54 Instrument, and a daily logbook. Data were analyzed blind using parametric and nonparametric tests, as appropriate. ResultsResults indicated a statistically significant interactive effect between groups for average LBP (P=0.008); 1-way analysis of covariance did not show any significant effects at any time point once a Bonferonni correction was applied (P>0.05). However, clinically important differences were observed in some of the outcome measures in both active treatment groups during the treatment and follow-up periods. DiscussionAlthough not statistically significant, the observed effects may have implications for the clinical prescription and the use of TENS within this population.

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Key takeawayTENS may have clinically important effects on chronic low-back pain in multiple sclerosis patients, but its effectiveness remains unresolved.

PopulationOlder adults (50-71 years)

Sample size24

MethodsObservational

OutcomesBody Mass Index projections

ResultsSocial networks mitigate obesity in older groups.

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Efficacy of Transcutaneous Electrical Nerve Stimulation (TENS) for Chronic Low-back Pain in a Multiple Sclerosis Population: A Randomized, Placebo-controlled Clinical Trial

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Citations

Lumbar Pain in Patients with Multiple Sclerosis and Knowledge about Physiotherapeutic Methods for Combating Pain

Low back pain is common in multiple sclerosis patients, with higher risks in females, those with secondary progressive forms, and those with longer disease durations.

Noninvasive electrical neuromodulation for gastrointestinal motility disorders

Noninvasive electrical neuromodulation is an effective and safe treatment for various gastrointestinal motility disorders, offering a promising alternative to pharmacotherapy when pharmacotherapy fails.

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Clinical studies on TENS are dominated by small parallel group evaluations of high frequency TENS, often contaminated by concurrent treatments, with study reports focusing on physiological and clinical implications rather than methodology and findings.

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TENS may reduce pain and increase function in osteoarthritic knees, but its effectiveness remains inconclusive, with the combination of TENS and acupuncture showing higher benefits than sham-electroacupuncture.

Transcutaneous electrical nerve stimulation effects on pain-intensity and endogenous opioids levels among chronic low-back pain patients: A randomised controlled trial.

TENS significantly reduced pain intensity in chronic low back pain patients up to 24 hours after treatment, but did not significantly affect endogenous opioid levels.

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High-frequency TENS is more effective than low-frequency TENS in treating diabetic neuropathic pain, with significant differences in pain assessment using various scales.

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Non-invasive neurostimulation, acupuncture, TENS, and mirror therapy effectively reduce pain in individuals with central neuropathic pain due to spinal cord injury, phantom limb pain, and multiple sclerosis.