Burst-mode transcutaneous electrical nerve stimulation (TENS) significantly improves short-term pain control for patients with chronic mechanical low back pain, according to results of a prospective study presented at the 2017 World Congress on Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (WCO).
TENS is a nonpharmacological treatment based on applying low-voltage electrical currents to the skin, explained Aysegül Ketenci, MD, Istanbul University, Istanbul, Turkey, on March 25.
Dr. Ketenci and colleagues randomised 73 patients (aged 18-65 years) who had mechanical low back pain for >3 months to receive 15 sessions of sham stimulation, conventional TENS, or burst-mode TENS.
For the posttreatment visual analogue scale (VAS) pain assessment, all patient groups showed significant decreases in pain from baseline (P < .001). Burst-mode TENS provided >50% reduction in VAS pain, significantly greater than the responses for sham and conventional treatments (P < .05).
At the 3-month follow-up, although the 2 active treatment groups continued to show some VAS pain improvements versus sham, the added benefit of burst-mode versus conventional TENS was no longer apparent.
In addition to VAS, efficacy measures evaluated included the Leeds Assessment of Neuropathic Symptoms and Signs Pain Scale, the Douler Neuropathic 4 Questions, the Modified Oswestry Disability Index, and the Beck Depression Inventory.
Although the researchers observed some benefits for all further efficacy measures at the 3-month follow-up, these were not significantly different among the 3 treatment groups.
“In [Turkey] we have a lot of patients with chronic back pain, and most of them have a neuropathic pain component, but it is not always clear,” noted Dr. Ketenci.
Back pain is usually mechanical by nature, the investigators noted, in that the source of the pain is associated with the load on the spine and its movements.
The WCO Congress is sponsored by the International Osteoporosis Foundation (IOF) and the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO).