TENS Not Effective For Back Pain, Good For Diabetics

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People who have chronic low back pain—and you know who you are—should not count on getting relief from TENS, or transcutaneous electric nerve stimulation. This popular non-drug treatment for pain is not effective for this condition, says the American Academy of Neurology, but it can be helpful for diabetics who have nerve pain.

Low-back pain is the second most common cause of disability among adults in the United States and a costly one, ringing up an estimated $100 to $200 billion annually, most of which is associated with decreased wages and productivity. More than 80 percent of the US population can expect to experience an episode of low back pain during their lives. Although most people recover within a few months of their attack, others develop a chronic condition, defined as pain that lasts for three months or longer.

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One reason TENS is a popular treatment option for low back pain is because it is drug-free, relieving patients of having to deal with side effects. A TENS unit is a portable, palm-sized device that sends a mild electrical current to the nerves through electrodes that are placed on the skin on sticky pads. Although it is widely used to treat various types of pain, how it works has remained largely a mystery. One theory is that nerves can carry only one signal at a time, and so the TENS stimulation may block real pain signals from reaching the brain.

The new guideline issued by the American Academy of Neurology states that TENS is not recommended to treat chronic low back pain. To arrive at their conclusion, researchers reviewed all the evidence for use of TENS for chronic low-back pain. Of the 263 articles found, only five met the scientific standards required to reach meaningful conclusions. Acute low back pain was not included in the analysis.

Guideline author Richard M. Dubinsky, MD, MPH, of Kansas University Medical Center in Kansas City and a Fellow of the American Academy of Neurology, noted that “The strongest evidence showed that there is no benefit for people using TENS for chronic low-back pain.” The authors did report, however, that TENS can be beneficial in treating diabetic nerve pain, also known as diabetic neuropathy.

Patients who have chronic low back pain and who are using a TENS unit may want to speak to their doctors about whether to continue its use. However, patients who are benefiting from TENS would seem to have no reason to stop. Diabetics who are experiencing diabetic neuropathy may be encouraged by the new guideline from the American Academy of Neurology.

SOURCES:
American Academy of Neurology news release, Dec. 30, 2009
Centers for Disease Control and Prevention. Journal of the American Medical Association 2001; 285(12): 1571-72
Katz JN. Journal of Bone and Joint Surgery American 2006; 88(suppl 2): 21-24
Rubin DI. Neurology Clinic 2007; 25(2): 353-71

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