Transcutaneous Electrical Nerve Stimulation in Rodent Models of Neuropathic Pain: A Meta-Analysis

Abstract

Transcutaneous electrical nerve stimulation (TENS) is a non-invasive therapeutic intervention that is typically used for many years to treat chronic pain in patients who are refractory to pain medications. However, evidence of the efficacy of TENS treatment for neuropathic pain is lacking in humans. To further understand the efficacy of TENS under various intervention conditions and illuminate the current circumstance and future research directions, we systematically reviewed animal studies investigating the efficacy of TENS in relieving pain in neuropathic pain rodent models. We searched the Cochrane Library, EMBASE, MEDLINE (via PubMed), and Web of Science and identified 11 studies. Two meta-analyses were performed. The first meta-analysis showed that a single TENS treatment was capable of temporarily ameliorating neuropathic pain when compared to control groups with a significant effect (standardized mean difference: 1.54; 95% CI: 0.65, 2.42; p = 0.0007; I2 = 58%). Significant temporary alleviation in neuropathic pain intensity was also observed in the meta-analysis of repetitive TENS (standardized mean difference: 0.85; 95% CI: 0.31, 1.40; p = 0.002; I2 = 75%). Subgroup analysis showed no effect of the timing of the application of TENS (test for subgroup difference, p = 0.47). Leave-one-out sensitivity analyses suggested that no single study had an outsized effect on the pooled estimates, which may partly prove the robustness of these findings. Other stratified analyses were prevented by the insufficient number of included studies. Overall, current data suggest that TENS might be a promising therapy to ameliorate neuropathic pain. However, the high risk of bias in the included studies suggests that cautions must be considered when interpreting these findings and it is not reasonable to directly generalize the results obtained from animal studies to clinical practice. Future studies should pay more attention to improving the quality of study design and reporting, thereby facilitating the understanding of mechanisms underlying TENS treatment, reducing more potentially unsuccessful clinical trials, and optimizing the efficacy of TENS for people with neuropathic pain.

Traumatic Brain Injury and Neuromodulation Techniques in Rehabilitation: A Scoping Review

“…General battery-powered TENS machines can adjust pulse width, frequency, and intensity. In general, TENS uses high frequencies (>50 Hz) and intensities below motor contractions (sensory intensity) or low frequencies [46,47].…”

The Benefits and Barriers of Providing Non-Pharmacological Pain Relief to Women in Labour during COVID-19: A Qualitative Study of Midwives in South Africa

“…Others, however, include music therapy [7,14], positions or posture change [5,6], acupuncture [13,15,16], and aromatherapy (use of essential oils) [17]. Transcutaneous electrical nerve stimulation (TENS) [18], sterile water injection [19], and psychological support [5,6,20] are also used to relieve labour pains. Additionally, contact therapy reduces labour pain and anxiety among mothers [21,22].…”

Effect of cold application versus transcutaneous nerve stimulation on chemotherapy induced diabetic peripheral neuropathy post mastectomy

“…Transcutaneous electrical nerve stimulation therapy has also been demonstrated to reduce dorsal horn neuron sensitization, increase levels of gamma‐aminobutyric acid and glycine, and block glial activation. High‐frequency (50 or 100 Hz and above), low‐intensity TENS and low‐frequency (10 Hz or less), high‐intensity TENS are the two most used TENS therapy modalities (Jiapeng et al., 2022).…”