Wu LC, Weng PW, Chen CH, et al. Literature Review and Meta-Analysis of Transcutaneous Electrical Nerve Stimulation in Treating Chronic Back Pain. Reg Anesth Pain Med. 2018 May;43(4):425-433. doi: 10.1097/AAP.0000000000000740.
Discipline Area Score
Physician 6 / 7
Rehab Clinician (OT/PT) 5 / 7

BACKGROUND AND OBJECTIVES: This study is a meta-analysis of randomized controlled trials comparing the efficacy of transcutaneous electrical nerve stimulation (TENS) to a control and to other nerve stimulation therapies (NSTs) for the treatment of chronic back pain.

METHODS: Citations were identified in MEDLINE, the Cochrane Library, Google Scholar, and through June 2014 using the following keywords: nerve stimulation therapy, transcutaneous electrical nerve stimulation, back pain, chronic pain. Control treatments included sham, placebo, or medication only. Other NSTs included electroacupuncture, percutaneous electrical nerve stimulation, and percutaneous neuromodulation therapy.

RESULTS: Twelve randomized controlled trials including 700 patients were included in the analysis. The efficacy of TENS was similar to that of control treatment for providing pain relief (standardized difference in means [SDM] = -0.20; 95% confidence interval [CI], -0.58 to 0.18; P = 0.293). Other types of NSTs were more effective than TENS in providing pain relief (SDM = 0.86; 95% CI, 0.15-1.57; P = 0.017). Transcutaneous electrical nerve stimulation was more effective than control treatment in improving functional disability only in patients with follow-up of less than 6 weeks (SDM = -1.24; 95% CI, -1.83 to -0.65; P < 0.001). There was no difference in functional disability outcomes between TENS and other NSTs.

CONCLUSIONS: These results suggest that TENS does not improve symptoms of lower back pain, but may offer short-term improvement of functional disability.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

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Comments from MORE raters

Physician rater

Another study without a definite conclusion: "Additional RCTs comparing the efficacy of TENS and other ap- proved procedures are warranted."

Physician rater

It's interesting to know how TENS rates with other options; we hope to have non pharmacological treatments (with fewer side effects) available.
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