A Randomised Comparative Trial of Acupuncture Versus Tens for Chronic Back Pain in the Elderly

Nonpharmacological Approaches to the Management of Chronic Pain in Community‐Dwelling Older Adults: A Review of Empirical Evidence

“…Three studies that used RCTs for measuring the effectiveness of TENS in community‐dwelling older adults with chronic pain were reviewed. The results from the studies were mixed in measuring effectiveness of TENS.…”

“…A study of TENS for relieving knee pain found that older adults showed significant reduction in pain . Another study showed significant pain relief in older adults with back pain, but another study concluded that TENS was not effective in the treatment of chronic low back pain. Although the findings of the effectiveness of TENS are inconsistent in the reviewed studies, there was a trend toward greater pain reduction with active TENS than with placebo or the combination of TENS and acupuncture.…”

“…In addition, it is unclear in many of the reviewed articles whether the researchers controlled for comorbidities, including different locations of chronic pain, different types of chronic pain (e.g., musculoskeletal pain, visceral pain, nociceptive pain, neuropathic pain), and different medical problems associated with pain (e.g., diabetes mellitus, heart failure). In terms of use of prescribed and over‐the‐counter pain medications, only four studies excluded participants who were using pain medication before the intervention was introduced. Thus, the genuine effect of the interventions may be less likely to be revealed unless participants taking pain medication were used as a control group.…”

“…There is emerging evidence of the benefits of physical (e.g., exercise, acupuncture, transcutaneous electric nerve stimulation (TENS), qigong,) and psychosocial (e.g., self‐management education, cognitive behavioral therapy (CBT), mindfulness‐based meditation, music listening, guided imagery, stress management) nonpharmacological therapies as effective adjuncts to conventional treatment for chronic pain . Although nonpharmacological pain management therapies have been increasingly used in the United States, studies of their effectiveness in treating older adults in particular have been limited, and there is no clear consensus regarding the best pain treatment for older adults.…”

“…Although efficacy of nonpharmacological therapies has not been studied to the extent of pharmacological approaches, randomized trials are reported in the current literature to support their use, particularly as these therapies are applied in conjunction with pharmacological treatments. 4 There is emerging evidence of the benefits of physical (e.g., exercise, 5-8 acupuncture, 9,10 transcutaneous electric nerve stimulation (TENS), [11][12][13][14][15] qigong, [16][17][18] ) and psychosocial (e.g., self-management education, 19 cognitive behavioral therapy (CBT), 20 mindfulness-based meditation, music listening, guided imagery, stress management) nonpharmacological therapies as effective adjuncts to conventional treatment for chronic pain. 21 Although nonpharmacological pain management therapies have been increasingly used in the United States, studies of their effectiveness in treating older adults in particular have been limited, and there is no clear consensus regarding the best pain treatment for older adults.…”