Transcutaneous electrical nerve stimulation and heat to reduce pain in a chronic low back pain population: a randomized controlled clinical trial

Leemans, Liesbeth; Elma, Ömer; Nijs, Jo; Wideman, Timothy H.; Siffain, Carolie Nelly; Bandt, Hester den; Laere, Sven Van; Beckwée, David

doi:10.1016/j.bjpt.2020.04.001

Cited by 23 publications

(25 citation statements)

References 74 publications

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“…In the studies included in this review, there were various definitions postulated for HACS. In 3 of the studies, no definition was provided [61,72,73]. The references used for the definitions were retrieved to find the similarities and differences between the different definitions.…”

Section: Definition Of Human Assumed Central Sensitisationmentioning

confidence: 99%

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The Definition, Assessment, and Prevalence of (Human Assumed) Central Sensitisation in Patients with Chronic Low Back Pain: A Systematic Review

Schuttert

Timmerman

Petersen

et al. 2021

JCM

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Central sensitisation is assumed to be one of the underlying mechanisms for chronic low back pain. Because central sensitisation is not directly assessable in humans, the term ‘human assumed central sensitisation’ (HACS) is suggested. The objectives were to investigate what definitions for HACS have been used, to evaluate the methods to assess HACS, to assess the validity of those methods, and to estimate the prevalence of HACS. Database search resulted in 34 included studies. Forty different definition references were used to define HACS. This review uncovered twenty quantitative methods to assess HACS, including four questionnaires and sixteen quantitative sensory testing measures. The prevalence of HACS in patients with chronic low back pain was estimated in three studies. The current systematic review highlights that multiple definitions, assessment methods, and prevalence estimates are stated in the literature regarding HACS in patients with chronic low back pain. Most of the assessment methods of HACS are not validated but have been tested for reliability and repeatability. Given the lack of a gold standard to assess HACS, an initial grading system is proposed to standardize clinical and research assessments of HACS in patients with a chronic low back.

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Section: Definition Of Human Assumed Central Sensitisationmentioning

confidence: 99%

“…The CSI [25] was used to assess HACS in 22 of the 34 studies (64.7%) [25,41,42,[46][47][48][49][50][55][56][57][58][59][60][61][62]64,65,[67][68][69][70]. The CSI was developed to identify key symptoms associated with syndrome/disorder/disease related to HACS and quantifies the degree of these symptoms [25].…”

Section: Questionnairesmentioning

confidence: 99%

The Definition, Assessment, and Prevalence of (Human Assumed) Central Sensitisation in Patients with Chronic Low Back Pain: A Systematic Review

Schuttert

Timmerman

Petersen

et al. 2021

JCM

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“…On the other hand, transcutaneous electrical nerve stimulation (TENS) devices are generally utilized in hospitals for the purpose of pain control. TENS has been proven to be effective for pain symptoms associated with conditions like back pain, osteoarthritis, pancreatic cancer, and fibromyalgia [ 6 , 12 , 13 , 14 , 15 ]. However, until now, very little evidence on the pain alleviation effects of PLS in home settings has been recorded.…”

Section: Introductionmentioning

confidence: 99%

Effects of Personal Low-Frequency Stimulation Device on Myalgia: A Randomized Controlled Trial

Yoon

Cho

et al. 2022

IJERPH

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Electrotherapy is commonly used for myalgia alleviation. Low-frequency stimulation (LFS) is primarily used for controlling acute and chronic pain and is a non-invasive therapy that can be easily performed with electric stimulation applied on the skin. However, little evidence exists regarding the pain alleviation effects of personal low-frequency stimulation device for home use. Moreover, no studies have compared myalgia alleviation effects between personal low-frequency stimulation (PLS) and physical therapy (PT), which are most commonly used for patients with myalgia in hospitals and clinics. Therefore, we aimed to investigate the pain alleviation effects of PLS in patients with myalgia and compare these effects with those of conventional PT (transcutaneous electrical nerve stimulation + ultrasound). In total, 39 patients with myalgia in the neck, shoulder, back, and waist areas were randomly assigned to the personal low-frequency stimulation group (PLSG: n = 20) and physical therapy group (PTG: n = 19). Both groups were treated for 3 weeks (20 min per session and 5 sessions per week). Patients were assessed for pain intensity by surface electromyography (sEMG), visual analogue scale (VAS) and a short-form McGill pain questionnaire (SF-MPQ) before and after the intervention period. Our results showed that PLSG showed a tendency of muscle relaxation with a significant decrease in sEMG in the neck (p = 0.0425), shoulder (p = 0.0425), and back (p = 0.0046) areas compared to the control group. However, there was no significant difference in waist area. Additionally, VAS scores significantly decreased between pre- and post-treatment in both PTG (p = 0.0098), and PLSG (p = 0.0304) groups, but there was no significance difference between the groups. With respect to SF-MPQ, the PLSG showed greater pain alleviation (5.23 ± 0.25) effects than the PTG (6.23 ± 0.25). Accordingly, our results suggest that PLS treatment using a home device might offer positive assistance in pain alleviation for patients with myalgia that is as equally effective as conventional PT treatment. However, further detailed studies are required considering larger samples to fully claim the effectiveness of this device.

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“…13 Another technique used would be electrotherapy. 10,14,15 Electroanalgesia with transcutaneous electrical nerve stimulation (TENS) is one of the most used for the relief of chronic and acute pain. 14,15 TENS consists in the application of low frequency electrical impulse currents through the skin to stimulates the peripheral nerves and produce various physiological effects 15 .To the best of our knowledge, there is no further previous evidence from studies based on the comparison of these treatment techniques (i.e.…”

mentioning

confidence: 99%

“…10,14,15 Electroanalgesia with transcutaneous electrical nerve stimulation (TENS) is one of the most used for the relief of chronic and acute pain. 14,15 TENS consists in the application of low frequency electrical impulse currents through the skin to stimulates the peripheral nerves and produce various physiological effects 15 .To the best of our knowledge, there is no further previous evidence from studies based on the comparison of these treatment techniques (i.e. KT and TENS) for the control of pain and disability perception in patients with non-speci c Chronic LBP (CLBP).…”

mentioning

confidence: 99%

Short-Term Effects of a Supervised Exercise Program in Addition to Electrical Stimulation or Kinesio Taping on Pain and Disability in Patients with Chronic Low Back Pain: A Randomized Controlled Trial

Aguilar‐Ferrándiz

Matarán-Peñarrocha

Tapia-Haro

et al. 2022

Preprint

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Background: Chronic low back pain it is one of the most common health problems worldwide. Usually is accompanied by a complex set of symptoms and generates significant direct and indirect socioeconomic and health costs. From a therapeutic point of view, there are a wide variety of methods to address the treatment of this pathology, however, these therapies have not been shown definitive efficacy.To investigate the effect of a mixed treatment with exercise and electrical stimulation versus exercise and kinesio taping in patients with non-specific chronic low back pain. Methods: A total of 58 patients participated in this single-blinded randomised clinical trial. Participants were assigned to the exercises- kinesio taping group, or exercises- analgesic current group, both received 12 treatment sessions. Disability, fear of movement, anxiety, depression, sleeps quality, pain, lower limb mechanosensitivity and pressure-pain thresholds were recorded at baseline and after 4 weeks of treatment.Results: The 2x2 mixed analysis of covariance test showed statistically significant differences between groups for pain (P=0.046). Pair-wise comparisons with baseline demonstrated significant differences for both groups in pain (P ≤ 0.001), disability (P ≤ 0.001), pressure-pain thresholds (P ≤ 0.044), lower limb mechanosensitivity, (P ≤ 0.047), anxiety (P ≤ 0.001), depression (P ≤ 0.001) and sleep quality (P ≤ 0.010). Conclusions: Patients with chronic low back pain who received a combined treatment of exercises and kinesio taping or analgesic current showed an improvement in pain, disability, anxiety, depression and sleep pattern. Moreover, exercises combined with electrotherapy produces greater improvements over these variables.Trial registration number: NCT02812459

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Transcutaneous electrical nerve stimulation and heat to reduce pain in a chronic low back pain population: a randomized controlled clinical trial

Abstract: Highlights The combination of heat and TENS significantly improves pain pressure thresholds. The combination of heat and TENS does not affect maximum and average pain, nor movement-evoked pain (MEP). There is a need for standardized and sensitive assessment tools for measuring MEP.

Cited by 23 publications

References 74 publications

The Definition, Assessment, and Prevalence of (Human Assumed) Central Sensitisation in Patients with Chronic Low Back Pain: A Systematic Review

The Definition, Assessment, and Prevalence of (Human Assumed) Central Sensitisation in Patients with Chronic Low Back Pain: A Systematic Review

Effects of Personal Low-Frequency Stimulation Device on Myalgia: A Randomized Controlled Trial

Short-Term Effects of a Supervised Exercise Program in Addition to Electrical Stimulation or Kinesio Taping on Pain and Disability in Patients with Chronic Low Back Pain: A Randomized Controlled Trial

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