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Guideline warns against using nerve stimulation device for chronic low back pain
Dubinski RM.Neurology. 2010 Jan 12;74(2):104-105
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Investigators sought to determine the efficacy of transcutaneous electric nerve stimulation (TENS) in the treatment of pain from neurologic disorders through a systematic literature search.
They reported conflicting reports of TENS compared to sham TENS in the treatment of chronic low back pain, with two Class II studies showing benefit, but two Class I studies and another Class II study not showing benefit. Because the Class I studies being stronger evidence, they concluded that TENS is ineffective for the treatment of chronic low back pain.
“The strongest evidence showed that there is no benefit for people using TENS for chronic low back pain,” Richard M. Dubinsky, MD, MPH, the author of the guideline, stated in an American Academy of Neurology (AAN) press release.
However, his evidence-based review revealed that TENS can relieve the pain of patients with diabetic neuropathy.
“Doctors should use clinical judgment regarding TENS use for chronic low back pain,” Dubinsky stated in the release. “People who are currently using TENS for their low back pain should discuss these findings with their doctors.”
Chronic low back pain is a challenging clinical problem and often has multiple causes. It is still possible that TENS may be effective for a subset of patients and, thus, in certain patients a trial may be warranted.
– Scott D. Boden, MD
Orthopedics Today Spine Section Editor