Korean J Pain.  2021 Apr;34(2):217-228. 10.3344/kjp.2021.34.2.217.

Does transcutaneous electrical nerve stimulation affect pain, neuropathic pain, and sympathetic skin responses in the treatment of chronic low back pain? A randomized, placebocontrolled study

• Yakşi E
• Ketenci A
• Baslo MB
• Orhan EK

• KMID: 2514421
• DOI: http://doi.org/10.3344/kjp.2021.34.2.217

Abstract

Background
The purpose of this study was to assess the effectiveness of transcutaneous electrical nerve stimulation (TENS) in chronic low back pain and neuropathic pain.
Methods
Seventy-four patients aged 18-65 with chronic low back pain were included in the study. Baseline measurements were performed, and patients were randomized into three groups. The first group received burst TENS (bTENS), the second group conventional TENS (cTENS), and the third group placebo TENS (pTENS), all over 15 sessions. Patients’ visual analogue scale (VAS) scores were evaluated before treatment (preT), immediately after treatment (postT), and in the third month after treatment (postT3). Douleur Neuropathique 4 Questions (DN4), the Modified Oswestry Low Back Pain Disability Questionnaire (MOS), the Beck Depression Inventory (BDI), and sympathetic skin response (SSR) values were also evaluated preT and postT3.
Results
A statistically significant improvement was observed in mean VAS scores postT compared to preT in all three groups. Intergroup comparison revealed a significant difference between preT and postT values, that difference being assessed in favor of bTENS at multiple comparison analysis. Although significant improvement was determined in neuropathic pain DN4 scores measured at postT3 compared to preT in all groups, there was no significant difference between the groups. No statistically significant difference was also observed between the groups in terms of MOS, BDI, or SSR values at postT3 (P > 0.05).
Conclusions
bTENS therapy in patients with low back pain is an effective and safe method that can be employed in short-term pain control.

Keyword

Chronic Pain; Depression; Electromyography; Low Back Pain; Neuralgia; Pain Management; Surveys and Questionnaires; Sympathetic Nervous System; Transcutaneous Electric Nerve Stimulation

Figure

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  Fig. 1 CONSORT (Consolidated Standards of Reporting Trials) flow diagram of the patient inclusion process. TENS: transcutaneous electrical nerve stimulation, bTENS: burst TENS, cTENS: conventional TENS, pTENS: placebo TENS.

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  Fig. 2 Electrodes are placed in the lumbar region.

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  Fig. 3 Intergroup comparisons of mean and night-time visual analogue scale (VAS) scores. Asterisk (*) indicates statistically significant differences between the time points within the group. For the lines in a box and whisker plot: error bars are the 95% confidence interval, the bottom and top of the box are the 25th and 75th percentiles, the line inside the box is the 50th percentile (median), and any outliers are shown as open circles or asteriks. TENS: transcutaneous electrical nerve stimulation, bTENS: burst TENS, cTENS: conventional TENS, pTENS: placebo TENS, preT: before treatment, postT: after treatment, postT3: third month after treatment.

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