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Updated: Mar 20, 2026
Author Spotlight: Fu's Subcutaneous Needling for Knee Osteoarthritis Pain
Published on: March 24, 2023
Dose-response effects of transcutaneous electrical nerve stimulation for knee osteoarthritis: A systematic review and
Simón Bueno-López1, Jaime Jordán-López1, Maria Dolores Arguisuelas2
1Department of Biomedical Sciences, School of Health Sciences, Universidad Cardenal Herrera CEU, CEU Universities, Spain.
Objective:
To clarify the analgesic efficacy of transcutaneous electrical nerve stimulation (TENS) in knee osteoarthritis (KOA) and examine whether stimulation parameters moderate treatment effects.
Methods:
We meta-analysed randomized controlled trials evaluating TENS for pain in KOA. Thirty-six trials (n = 2518) were included. Pain outcomes were pooled overall and stratified by comparator (control/placebo vs other active treatments). Mixed-effects models examined moderation by frequency, intensity, session duration, and number of sessions.
Results:
Across all trials, TENS produced a small but statistically significant reduction in pain. Effects were larger versus control/placebo, suggesting a specific benefit relative to minimal or no intervention. Effects were smaller versus other active treatments, likely reflecting effective co-interventions. Session duration moderated analgesia, with greater pain relief when stimulation lasted ≥40 min. No significant moderation was observed for frequency, intensity, or number of sessions.
Conclusion:
TENS may provide clinically relevant pain relief in KOA when delivered with treatment fidelity to pre-specified, literature-informed dosing criteria. However, higher-quality sham-controlled trials with complete parameter reporting and pain assessed during or immediately after stimulation are needed to better quantify the specific analgesic effect beyond contextual influences.
