The influence of transcutaneous electrical nerve stimulation parameters on the level of pain perceived by participants with painful diabetic neuropathy: A crossover study

Upton, Gabrielle A.; Tinley, Paul; Al-Aubaidy, Hayder A.; Crawford, Rachel

doi:10.1016/j.dsx.2016.08.016

Cited by 14 publications

(10 citation statements)

References 18 publications

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“…Our results demonstrate that the use of TENS significantly enhances the analgesic effect of drug therapy as confirmed by multiple validated pain scales: VAS, MPQ, DN4 and Pain Drawing. The same results were obtained by other authors when studying the regression of pain syndrome using VAS [ 25 ] and MPQ [ 26 ]. In the literature, we did not find an application for DN4 and Pain Drawing to assess the dynamics of neuropathic pain using TENS.…”

Section: Discussionsupporting

confidence: 86%

Clinical Experience of High Frequency and Low Frequency TENS in Treatment of Diabetic Neuropathic Pain in Russia

et al. 2022

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Background: Transcutaneous electrical nerve stimulation (TENS) is presently one of the main methods of treatment for neuropathic pain in type II diabetes mellitus. The discussion about which TENS frequency is more effective in the treatment of neuropathic pain has been ongoing for many years. Despite this, the response of different aspects of neuropathic pain to various TENS modalities has not been sufficiently studied. Aim: To analyze changes in characteristics of neuropathic pain depending on the frequency of TENS. Materials and methods: Seventy-five Russian diabetic patients with painful distal axonal neuropathy were enrolled in the study. Patients were assigned to three groups: in the HF TENS group, 25 patients received standard drug therapy (Alpha-lipoic acid, Pentoxifylline, Vitamin B12, Gabapentin) + high-frequency TENS (HF); in the LF TENS group, 25 patients received standard drug therapy (Alpha-lipoic acid, Pentoxifylline, Vitamin B12, Gabapentin) + low-frequency TENS (LF); in the control group, 25 patients underwent just standard drug therapy (Alpha-lipoic acid, Pentoxifylline, Vitamin B12, Gabapentin). Pain intensity was calculated before and after treatment with visual analogue scale (VAS), McGill pain questionnaire (MPQ), Douleur Neuropathique 4 Questions (DN4) and Pain Drawing. Results: TENS increased the therapeutic effect of standard drug therapy, in the treatment of neuropathic pain, by 65.9% and prolonged its efficacy by 31% for up to 6 months after treatment. HF TENS had a more pronounced analgesic effect than LF TENS based on VAS (34.7%), sensory (57.6%) MPQ dimensions and DN4 (21%). Affective MPQ dimension with the use of LF TENS was lower than HF TENS by 34.7% immediately after treatment, by 47.3% after 2 months and by 34.8% after 6 months of the follow-up period. Conclusion: There are significant differences between HF and LF TENS based on pain assessment using various pain scales. This reflects the distinctive effects of different TENS modalities on different aspects of neuropathic pain.

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Section: Discussionsupporting

confidence: 86%

Clinical Experience of High Frequency and Low Frequency TENS in Treatment of Diabetic Neuropathic Pain in Russia

et al. 2022

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“…There were 381 studies, 383 population samples and 24,532 participants. Study sample size was 64.05 ± 58.29 participants (mean ± standard deviation (SD); maximum = 607 [63], minimum = 5 (370)) and TENS group size was 27.67 ± 21.90 participants (n = 10,596 participants, maximum = 144 [63]; minimum = 5 participants [26,93,101,370,382]). There were 13 studies with 100 or more participants in the TENS group (Figure 4), yet there was extractable data for only two studies (labour pain [352] and fibromyalgia [96]).…”

Section: Not Standard Electrical Characteristicsmentioning

confidence: 99%

Characterising the Features of 381 Clinical Studies Evaluating Transcutaneous Electrical Nerve Stimulation (TENS) for Pain Relief: A Secondary Analysis of the Meta-TENS Study to Improve Future Research

et al. 2022

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Background and Objectives: Characterising the features of methodologies, clinical attributes and intervention protocols, of studies is valuable to advise directions for research and practice. This article reports the findings of a secondary analysis of the features from studies screened as part of a large systematic review of TENS (the meta-TENS study). Materials and Methods: A descriptive analysis was performed on information associated with methodology, sample populations and intervention protocols from 381 randomised controlled trials (24,532 participants) evaluating TENS delivered at a strong comfortable intensity at the painful site in adults with pain, irrespective of diagnosis. Results: Studies were conducted in 43 countries commonly using parallel group design (n = 334) and one comparator group (n = 231). Mean ± standard deviation (SD) study sample size (64.05 ± 58.29 participants) and TENS group size (27.67 ± 21.90 participants) were small, with only 13 of 381 studies having 100 participants or more in the TENS group. Most TENS interventions were ‘high frequency’ (>10 pps, n = 276) and using 100 Hz (109/353 reports that stated a pulse frequency value). Of 476 comparator groups, 54.2% were active treatments (i.e., analgesic medication(s), exercise, manual therapies and electrophysical agents). Of 202 placebo comparator groups, 155 used a TENS device that did not deliver currents. At least 216 of 383 study groups were able to access other treatments whilst receiving TENS. Only 136 out of 381 reports included a statement about adverse events. Conclusions: Clinical studies on TENS are dominated by small parallel group evaluations of high frequency TENS that are often contaminated by concurrent treatment(s). Study reports tended focus on physiological and clinical implications rather than the veracity of methodology and findings. Previously published criteria for designing and reporting TENS studies were neglected and this should be corrected in future research using insights gleaned from this analysis.

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“…The addition of electromagnetic fields to a physiotherapy program was shown to help better treat pain and increase the rate of peroneal nerve conduction. Four studies have investigated the effect of TENS and all have shown a significant reduction in neuropathic pain [17][18][19][20] . One study found that applying TENS with a frequency of 14Hz and a pulse time of 250μs for 30 minutes, 3 times a week is a more effective treatment for pain relief than aerobic exercise [18] .…”

Section: Discussion-conclusionmentioning

confidence: 99%

“…In another study, nortriptyline was found to be more effective in pain management, but a higher percentage of patients experienced side effects [20] . Only one small-sample pilot study reported maintenance of pain relief for 1-2 hours after TENS treatment [19] . The application of low-power lasers, pulsed electromagnetic fields and TENS in patients with painful DPN seems safe, effective and with minimal side effects.…”

Section: Discussion-conclusionmentioning

confidence: 99%

“…Neither TENS nor aerobic exercise improved intraplantar nerve conduction velocity, initially evaluated. Upton et al [19] studied the efficacy of conventional TENS (80Hz, 200μs) versus low-frequency electro acupuncture (2Hz, 200μs) in pain relief in five patients, 61-88 years, with DMT2 and painful DPN lasting more than six months. Patients received the two forms of TENS treatment with a seven-day break between them and were randomly distributed without knowing the original form.…”

Section: Literature Reviewmentioning

confidence: 99%

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Effects of electrotherapy in neuropathic pain management in patients with diabetic peripheral neuropathy: A narrative review

Karypidou¹,

Lytras²,

Kottaras³

et al. 2021

Int. J. Adv. Community Med.

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Diabetes is one of the most prevalent diseases worldwide and Diabetic Peripheral Neuropathy (DPN) is the most common neuropathic syndrome affecting approximately 50% of patients with type 2 diabetes. One of its main clinical manifestations is neuropathic pain, which significantly complicates the daily life of patients and leads to a low quality of life related to health. The aim of this review is to describe research data on the means of electrotherapy used and their effects in the treatment of pain in patients with DPN. The PubMed, PEDro, Scopus and Google Scholar databases were searched in English with the following keywords: Diabetic Painful Neuropathy, Low-level Laser Therapy, Transcutaneous Electrical Nerve Stimulation, and Electromagnetic Fields. The review included 10 clinical studies published in the period of 2004-2019. Discussion-Conclusions: Low-power lasers, pulsed electromagnetic fields and Transcutaneous Electrical Nerve Stimulation (TENS) are treatment options for treating neuropathic pain in patients with DPN and are considered safe, effective, with minimal side effects compared to medication. However, diabetic neuropathic pain remains a challenge for health scientists. Although there is scientific evidence for the contribution of electrotherapy to its treatment, more focused research is needed.

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The influence of transcutaneous electrical nerve stimulation parameters on the level of pain perceived by participants with painful diabetic neuropathy: A crossover study

Cited by 14 publications

References 18 publications

Clinical Experience of High Frequency and Low Frequency TENS in Treatment of Diabetic Neuropathic Pain in Russia

Clinical Experience of High Frequency and Low Frequency TENS in Treatment of Diabetic Neuropathic Pain in Russia

Characterising the Features of 381 Clinical Studies Evaluating Transcutaneous Electrical Nerve Stimulation (TENS) for Pain Relief: A Secondary Analysis of the Meta-TENS Study to Improve Future Research

Effects of electrotherapy in neuropathic pain management in patients with diabetic peripheral neuropathy: A narrative review

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