A Meta Analysis of Transcutaneous Electrical Nerve Stimulation for Chronic Low Back Pain.
OBJECTIVE Transcutaneous electrical nerve stimulation (TENS) may provide a safe alternative to current side effect heavy narcotics and anti inflammatories utilized in chronic low back pain. Therefore, we performed a meta analysis to evaluate the efficacy of TENS for the treatment of chronic low back pain. MATERIALS AND METHODS We included randomized controlled trials (RCTs) cohort studies, and randomized crossover studies on TENS for the management of low back pain. We utilized a visual analogue scale (VAS) for pain as our primary outcome. Effectiveness of treatment was quantified using improvement in outcome scores for each study. Of the studies that met the criteria, 13 allowed for calculation of weighted mean differences in pain reduction. We used a random model effect to evaluate changes in pain produced by the intervention. RESULTS Included were nine level I and four level II, encompassing 267 patients (39% male) who had a mean follow up of seven weeks (range; 2 to 24 weeks) The mean duration of treatment was six weeks (range; 2 to 24 weeks) The standardized mean difference in pain from pre to post treatment for TENS was 0.844, which demonstrated significant improvement of TENS on pain reduction. When subdividing treatment duration, patients that were treated for 5 weeks had significant effects on pain, while those treated for 5 weeks did not. CONCLUSION Treatment of chronic low back pain with TENS demonstrated significant pain reduction. The application of TENS may lead to less pain medication usage and should be incorporated into the treatment armamentarium for chronic low back pain.
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