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Transcutaneous electrical nerve stimulation (TENS) for chronic pain
D Carroll1, R A Moore, H J McQuay
1IPC 814, Pfizer Ltd, Sandwich, Kent, UK, CT13 9NJ. dawn.carroll@pfizer.com
The Cochrane Database of Systematic Reviews
|November 1, 2001
Summary
Transcutaneous electrical nerve stimulation (TENS) shows some positive analgesic outcomes in chronic pain, but evidence on optimal parameters and long-term effectiveness is inconclusive. Large trials are needed to clarify TENS efficacy.
Area of Science:
- Pain Management
- Neurology
- Rehabilitation
Background:
- Transcutaneous electrical nerve stimulation (TENS) is widely used for acute and chronic pain.
- Its effectiveness for chronic pain conditions requires further investigation.
Purpose of the Study:
- To evaluate the effectiveness of TENS in managing chronic pain.
Main Methods:
- Systematic review of randomized controlled trials (RCTs) identified through comprehensive database searches (Cochrane Library, Embase, Medline, CINAHL, Oxford Pain Database).
- Included RCTs compared active TENS to sham TENS, no treatment, or different TENS parameters (e.g., High Frequency TENS vs. Low Frequency TENS).
- Studies focused on chronic pain (≥3 months) with subjective pain intensity or relief measures; meta-analysis was not feasible due to study heterogeneity.
Main Results:
- Nineteen RCTs were evaluated, exhibiting variability in design, outcomes, pain conditions, and TENS parameters.
- Reporting of methods and results was often poor, with poorly defined TENS treatments and controls.
- While 10 of 15 inactive control studies favored active TENS, only 3 of 7 multiple-dose studies showed benefit. Comparisons between High Frequency TENS and Low Frequency TENS found no significant difference in analgesic efficacy in most studies.
Conclusions:
- The current evidence on TENS for chronic pain is inconclusive.
- Published trials do not specify optimal stimulation parameters for pain relief or long-term effectiveness.
- There is an urgent need for large, multi-center randomized controlled trials to establish the efficacy of TENS in chronic pain management.