Guideline: Widely used device for pain therapy not recommended for chronic low back pain

Dec 31, 2009

A new guideline issued by the American Academy of Neurology finds that transcutaneous electric nerve stimulation (TENS), a widely used pain therapy involving a portable device, is not recommended to treat chronic low-back pain -- pain that has persisted for three months or longer -- because research shows it is not effective. The guideline is published in the December 30, 2009, online issue of Neurology, the medical journal of the American Academy of Neurology.

The guideline determined that TENS can be effective in treating diabetic nerve , also called diabetic neuropathy, but more and better research is needed to compare TENS to other treatments for this type of pain.

Research on TENS for chronic low-back pain has produced conflicting results. For the guideline, the authors reviewed all of the evidence for low-back pain lasting three months or longer. Acute low-back pain was not studied. The studies to date show that TENS does not help with chronic low-back pain.

All but one of the studies excluded people with known causes of low-back pain, such as a pinched nerve, severe scoliosis (curving of the spine), severe spondylolisthesis (displacement of a backbone or vertebra) or obesity. In the one study that looked at low-back pain associated with known conditions, TENS was not shown to be effective. The only specific neurologic cause of chronic low-back pain where TENS was studied was , and TENS was not shown to help.

"The strongest evidence showed that there is no benefit for people using TENS for chronic low-back pain," said guideline author Richard M. Dubinsky, MD, MPH, of Kansas University Medical Center in Kansas City and a Fellow of the American Academy of Neurology. "Doctors should use clinical judgment regarding TENS use for chronic low-back pain. People who are currently using TENS for their should discuss these findings with their doctors."

Dubinsky stated further that good evidence showed that TENS can be effective in treating diabetic nerve pain.

With TENS, a portable, pocket-sized unit applies a mild electrical current to the nerves through electrodes. TENS has been used for pain relief in various disorders for years. Researchers do not know how TENS may provide relief for pain. One theory is that nerves can only carry one signal at a time. The TENS stimulation may confuse the brain and block the real pain signal from getting through.

Back pain—both acute and chronic—is the second most common neurologic ailment in the United States, according to the National Institute of Neurological Disorders and Stroke, and is the most common cause of job-related disability. About 60 percent of people with diabetes will develop neuropathy.

Explore further: New mapping approach lets scientists zoom in and out as the brain processes sound

add to favorites email to friend print save as pdf

Related Stories

New clinical guideline for low-back pain

Oct 02, 2007

A summary of evidence on the diagnosis and treatment of low-back pain has prompted the American Pain Society (ASP) and the American College of Physicians (ACP) to issue a new treatment guideline. The guideline is based on ...

TENS for osteoarthritis: Not enough evidence to recommend

Oct 07, 2009

Despite twenty years of research on the use of electrostimulation techniques (TENS) for treatment of osteoarthritis in the knee, researchers still cannot say whether it reduces pain or physical disability. This is the conclusion ...

Study: Patients often don't report pain

Feb 13, 2006

A Rochester, Minn., study finds more than 20 percent of people with chronic pain don't seek medical help, suggesting many have unmet pain care needs.

Smokers suffer more back pain

Jul 01, 2008

Smokers suffer more chronic back pain. This was the result of the analysis of a questionnaire performed by Monique Zimmermann-Stenzel and her colleagues and published in the current edition of Deutsches Ärzteblatt International (Dtsch ...

Drug-free treatments offer hope for older people in pain

Sep 10, 2007

Mind-body therapies, which focus on the interactions between the mind, body and behavior, and the ways in which emotional, mental, social and behavioral factors can affect health, may be of particular benefit to elderly chronic ...

Recommended for you

Steering the filaments of the developing brain

2 hours ago

During brain development, nerve fibers grow and extend to form brain circuits. This growth is guided by molecular cues (Fig. 1), but exactly how these cues guide axon extension has been unclear. Takuro Tojima ...

Do we really only use 10% of our brain?

3 hours ago

As the new film Lucy, starring Scarlett Johansson and Morgan Freeman is set to be released in the cinemas this week, I feel I should attempt to dispel the unfounded premise of the film – that we only use 10% of our brains ...

Birthday matters for wiring-up the brain's vision centers

Jul 31, 2014

Researchers at the University of California, San Diego School of Medicine have evidence suggesting that neurons in the developing brains of mice are guided by a simple but elegant birth order rule that allows them to find ...

User comments : 0