Efficacy of transcutaneous electrical nerve stimulation in people with pain after spinal cord injury: a meta-analysis

Abstract

Study Design Meta-analysis. Objectives This study aimed to evaluate the effect of transcutaneous electrical nerve stimulation in people with pain after spinal cord injury by meta-analysis. Methods Reviewed PubMed, Embase, Cochrane library, as well as China National Knowledge Infrastructure (CNKI), Wanfang, and Vip databases to search the randomized controlled trials of pain after spinal cord injury through transcutaneous electrical nerve stimulation from the beginning of the library to March 2021, and analyze the literature with RevMan 5.3 software and the bias in the literature with STATA 12.0 software. Results There are six randomized controlled trials in the study with 165 cases. 83 cases in the test group were given transcutaneous electrical nerve stimulation, and 82 cases in the control group used sham stimulation or other treatments. Meta-analysis results showed the experimental group’s visual analog scale (MD = −1.52, 95%CI, −2.44 to −0.60, P = 0.001) and short-form McGill pain questionnaire scores (MD = −0.70, 95% CI, −1.03 to −0.25, P = 0.002) were lower than those of the control group. Conclusions Transcutaneous electrical nerve stimulation has some clinical therapeutic effects on persons with pain after spinal cord injury, but due to the lack of literature, the sample size is not large, and clinical trials need to be further improved later.

Narrative review of current neuromodulation modalities for spinal cord injury

“…TENS is proposed to provide its analgesic effect through maintenance of spinal opioid receptors through inhibition of mitogen activated protein kinase and proinflammatory expression, activation of glial cells to release inhibitory neurotransmitters, and reduction in dorsal horn neuron activity ( 119 – 121 ). Recent metanalysis involving six randomized-controlled trials and 165 cases revealed favorable results for the use TENS in pain secondary to SCI ( 122 ). The difference in VAS between the observation and controlled groups was statistically significant and the short-form McGill pain questionnaire (SF-MPQ) was generally lower in the TENS groups in comparison to the control groups ( 122 ).…”

“…Recent metanalysis involving six randomized-controlled trials and 165 cases revealed favorable results for the use TENS in pain secondary to SCI ( 122 ). The difference in VAS between the observation and controlled groups was statistically significant and the short-form McGill pain questionnaire (SF-MPQ) was generally lower in the TENS groups in comparison to the control groups ( 122 ). In addition to pain, peripheral nerve stimulation in persons with SCI has also been reported to improve lower extremity muscle mass, spasticity, neurogenic bladder, and respiratory function ( 116 , 123 – 126 ).…”

Principles of Rehabilitation Strategies in Spinal Cord Injury

“…The use of TENS in pain treatment is well-studied and mostly consists of delivering low-frequency electrical pulses to the affected area. A recent meta-analysis, including six RCTs with 165 patients, indicated that visual analog scale (VAS) for pain and short-form McGill pain questionnaire scores were significantly reduced in SCI patients who received TENS compared with the control group [75]. In addition to pain, prior evidence supports the use of TENS in improving spasticity [76].…”

Dolor en la persona con lesión medular

“…Otras intervenciones que se pueden considerar como coadyuvantes en el tratamiento del dolor son la hipnosis, la meditación, la biorretroalimentación y la atención plena (mindfulness), entre otros 41 . El uso de la estimulación eléctrica transcutánea (TENS) puede disminuir levemente y a corto plazo el DN 42 . La estimulación cerebral no invasiva, mediante la aplicación de pequeñas cantidades de corriente o la estimulación magnética transcortical, han demostrado disminuir el dolor, aunque con magnitudes de efecto moderadas 43,44 .…”