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

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

back pain

http://www.eurekalert.org/pub_releases/2009-12/aaon-gwu122209.php

ST. PAUL, Minn. – 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 & #61630;pain that has persisted for three months or

longer & #61630;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

pain, 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 multiple sclerosis, 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 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

low-back pain 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.