TENS treatment in any type of pain
Level of evidence: B
TENS likely decreases pain in patients with any type of pain.
A systematic review measured effectiveness of Transcutaneous electrical nerve stimulation (TENS) on any pain compared to placebo (91 trials) and suggested a clinically meaningful benefit from TENS (SMD -0.96, 95% CI -1,14 to -0,78) «Johnson MI, Paley CA, Jones G, et al. Efficacy and safety of transcutaneous electrical nerve stimulation (TENS) for acute and chronic pain in adults: a systematic review and meta-analysis of 381 studi»1. A Cochrane review measured effectiveness of TENS on neuropathic pain and found -1.58 points (95% CI -2.08 to -1.09, scale 0-10) decrease in pain, translating to about 31% decrease in pain «Gibson W, Wand BM, O'Connell NE. Transcutaneous electrical nerve stimulation (TENS) for neuropathic pain in adults. Cochrane Database Syst Rev 2017;9(9):CD011976 »2.
TENS use may cause skin irritation. Other adverse effects are rare, although usually inadequately reported «Johnson MI, Paley CA, Jones G, et al. Efficacy and safety of transcutaneous electrical nerve stimulation (TENS) for acute and chronic pain in adults: a systematic review and meta-analysis of 381 studi»1.
The quality of evidence was downgraded due to high risk of bias.
| Reference | Study type | Population | Intervention and comparison | Outcomes | Risk of bias |
|---|---|---|---|---|---|
| RCT=randomized controlled trial; SR=systematic review; MA=meta-analysis | |||||
| «Johnson MI, Paley CA, Jones G, et al. Efficacy and safety of transcutaneous electrical nerve stimulation (TENS) for acute and chronic pain in adults: a systematic review and meta-analysis of 381 studi»1 | SR/MA | Adult patients with any pain | Tens vs sham TENS (placebo). | Decrease of Pain by VAS or NRS. | High |
| «Gibson W, Wand BM, O'Connell NE. Transcutaneous electrical nerve stimulation (TENS) for neuropathic pain in adults. Cochrane Database Syst Rev 2017;9(9):CD011976 »2 | SR/MA | Adult patients with Neuropathic Pain | Tens vs sham TENS (placebo). | Decrease of Pain by VAS or NRS. | High |
| Reference | Comments |
|---|---|
| «Johnson MI, Paley CA, Jones G, et al. Efficacy and safety of transcutaneous electrical nerve stimulation (TENS) for acute and chronic pain in adults: a systematic review and meta-analysis of 381 studi»1 | Trials tested the efficacy of TENS several reasons of PAIN – both Acute and Chronic. Due to incomplete reporting, most trials had unclear risk of bias. |
| «Gibson W, Wand BM, O'Connell NE. Transcutaneous electrical nerve stimulation (TENS) for neuropathic pain in adults. Cochrane Database Syst Rev 2017;9(9):CD011976 »2 | 11 of 15 trials had a high risk of bias. Included trials with over 24 hours follow up. |
Results
| Reference | Number of studies and number of patients (I/C) | Follow-up time | Mean (SD) I | Mean (SD) C | Mean difference (95% CI) |
|---|---|---|---|---|---|
| Level of evidence: moderate The quality of evidence was downgraded due to high risk of bias. I=intervention; C=comparison; CI=confidence interval | |||||
| «Johnson MI, Paley CA, Jones G, et al. Efficacy and safety of transcutaneous electrical nerve stimulation (TENS) for acute and chronic pain in adults: a systematic review and meta-analysis of 381 studi»1 | 91 studies (TENS 2426 and 2415 placebo). | During treatment or immediately after | Not reported | Not reported, | SMD -0.96 (-1,14 to -0,78) |
| «Gibson W, Wand BM, O'Connell NE. Transcutaneous electrical nerve stimulation (TENS) for neuropathic pain in adults. Cochrane Database Syst Rev 2017;9(9):CD011976 »2 | 5 studies (207) | over 24 hours | not reported | not reported | -1.58 (-2.08 to -1.09) |
References
- Johnson MI, Paley CA, Jones G, et al. Efficacy and safety of transcutaneous electrical nerve stimulation (TENS) for acute and chronic pain in adults: a systematic review and meta-analysis of 381 studies (the meta-TENS study). BMJ Open 2022;12(2):e051073 «PMID: 35144946»PubMed
- Gibson W, Wand BM, O'Connell NE. Transcutaneous electrical nerve stimulation (TENS) for neuropathic pain in adults. Cochrane Database Syst Rev 2017;9(9):CD011976 «PMID: 28905362»PubMed