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Do Electrical Stimulation Devices Reduce Pain and Improve Function?-A Comparative Review.

Christian B Allen1, Tyler K Williamson2, Stephen M Norwood3

  • 1University of the Incarnate Word School of Osteopathic Medicine, San Antonio, TX, 78235, USA.

Pain and Therapy
|September 26, 2023
PubMed
Summary

Electrical stimulation (ES) offers varied benefits for pain and function. While some forms like NMES and FES show promise in rehabilitation, others, including TENS, have limited evidence. HWDS demonstrates significant outcomes for pain and function.

Keywords:
Chronic painEffectivenessElectrical stimulationFunctionFunctional electrical stimulationH-Wave device stimulationH-Wave®Neuromuscular electrical stimulationTranscutaneous electrical nerve stimulation

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Area of Science:

  • Physical Medicine and Rehabilitation
  • Pain Management
  • Neurology

Background:

  • Electrical stimulation (ES) encompasses diverse modalities with potentially varying clinical benefits.
  • Impaired function due to acute and chronic pain significantly impacts productivity and healthcare costs.
  • This review critically evaluates the comparative efficacy of different ES forms on functional and pain outcomes.

Purpose of the Study:

  • To compare the relative effects of various electrical stimulation modalities on functional improvement and pain reduction.
  • To assess the quality of evidence supporting the use of different ES forms for pain and function.
  • To identify specific indications where ES demonstrates clinically meaningful benefits.

Main Methods:

  • A comprehensive literature search was conducted for peer-reviewed studies on commonly marketed ES devices for pain and function.
  • Studies were categorized by evidence level: "Important" (systematic reviews, RCTs, cohort studies) and "Minor" (case series, reports, opinion reviews).
  • The review focused on identifying clinically significant impacts on pain perception, functional gains, and medication reduction.

Main Results:

  • Varying ES forms exhibit distinct parameters and applications, with differential impacts on pain, function, and medication use.
  • Neuromuscular electrical stimulation (NMES) and Functional electrical stimulation (FES) show demonstrated benefits in specific rehabilitation contexts (e.g., stroke, SCI).
  • H-Wave® device stimulation (HWDS) presented moderate evidence for acute and chronic pain, showing consistent functional and pain improvements.
  • Transcutaneous electrical nerve stimulation (TENS), despite widespread use, yielded insignificant or minimal improvements in pain and function.

Conclusions:

  • Limited high-quality evidence supports the efficacy of most reviewed ES forms for significant pain reduction or functional improvement.
  • NMES and FES are effective for specific clinical rehabilitation indications.
  • HWDS demonstrated the most significant outcomes, combining functional gains with reduced pain and medication reliance.
  • Further rigorous, long-term clinical trials are necessary to establish definitive indications and validate the use of various ES modalities.