Article

Transcutaneous electrical nerve stimulation (TENS) is a nonpharmacological
treatment for control of pain. It has come under much scrutiny lately with the
Center for Medicare Services rendering a recent decision stating that "TENS is
not reasonable and necessary for the treatment of CLBP [chronic low back pain]."
When reading and analyzing the existing literature for which systematic reviews
show that TENS is inconclusive or ineffective, it is clear that a number of
variables related to TENS application have not been considered. Although many of
the trials were designed with the highest of standards, recent evidence suggests
that factors related to TENS application need to be considered in an assessment
of efficacy. These factors include dosing of TENS, negative interactions with
long-term opioid use, the population and outcome assessed, timing of outcome
measurement, and comparison groups. The purpose of this perspective is to
highlight and interpret recent evidence to help improve the design of clinical
trials and the efficacy of TENS in the clinical setting.

Langue : ANGLAIS