Effects of TDCS and TENS on chronic low back pain: A randomized controlled clinical trial

The objective of this study was to investigate whether transcranial direct current stimulation (tDCS) can enhance Transcutaneous Electrical Nerve Stimulation (TENS) outcomes in patients with chronic low back pain, and whether stimulating the primary motor cortex and dorsolateral prefrontal cortex results in distinct clinical effects.

This study is a sham-controlled, double-blind, randomized clinical trial with a one-month follow-up. A total of 60 individuals (18 years or older) with low back pain for ≥6 months were enrolled and randomized into one of three tDCS + TENS groups: primary motor cortex (n = 20), dorsolateral prefrontal cortex (n = 20), and sham stimulation (n = 20). The participants underwent transcranial direct current stimulation combined with TENS over the lumbar region versus simulated tDCS with active TENS for 30 min daily for 10 consecutive days. Assessments were performed at baseline, post-intervention, and 30 days follow-up. Outcomes were pain assessments, functional capacity evaluations, emotional state, and quality of life.

No superior effects were observed at post-intervention with tDCS + TENS compared to sham tDCS + TENS (P > 0.05), regardless of stimulation site, for pain relief, functional capacity, quality of life, or emotional state in chronic low back pain patients.

The use of TENS alone in long-term protocols is sufficient for chronic low back pain patients, with few contraindications and the ability to reduce pain and improve functional capacity and emotional state over a 10-day intervention period.