TRANSCUTANEOUS ELECTRICAL NERVE STIMULATION IS NOT EFFECTIVE FOR LOW BACK PAIN

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TRANSCUTANEOUS ELECTRICAL NERVE STIMULATION IS NOT EFFECTIVE FOR LOW BACK PAIN.

Patients with chronic low back pain undergo a variety of therapeutic interventions, many of which have not been rigorously studied. This randomized, controlled trial examined the benefits of two popular treatments, transcutaneous electrical nerve stimulation (TENS) and an exercise program.

Investigators randomized 145 patients with low back pain of at least three months' duration to four groups: TENS plus a set of 12 exercises, TENS alone, sham TENS plus exercises, and sham TENS alone. The sham TENS unit appeared identical to the active device but did not deliver stimulation; to maintain blinding, all patients were told that stimulation from TENS can occur without being perceived.

After one month of treatment, TENS was no better than sham TENS in improving functional status, relieving pain, or increasing back flexibility. On the other hand, subjects who exercised had significant improvements in several measures of functional status and pain. TENS did not add to the benefit of exercise. Two months after completion of the trial, the benefits of exercise were not sustained, probably because compliance with the program had diminished.

The authors conclude that patients with low back pain can benefit from exercise but not from TENS. Long-term improvement is unlikely, however, unless patients continue to exercise.

— ASB

Published in Journal Watch General Medicine June 15, 1990

Citation(s):

Deyo RA et al. A controlled trial of transcutaneous electrical nerve stimulation (TENS) and exercise for chronic low back pain. N Engl J Med 1990 Jun 7 322 1627-1634.