According to new guidelines issued by the American Academy of Neurology, the popular pain-relief treatment called transcutaneous electric nerve stimulation, or TENS, is not likely to help the millions of Americans who live with chronic low back pain and should therefore not be recommended for that purpose. Currently, back pain is the second most common cause of disability in the U.S. with eight out of ten adults experiencing lower back pain in their lifetime. TENS is aimed at reducing this problem. It is administered through a small battery-operated generator, about the size of a Blackberry, which is connected to a set of electrodes placed at key points on the patient’s skin. Experts hope this will overstimulate the nerves that sense pain, which will confuse the brain in the process and block out the real pain signals. Although the process does not have many side effects and is relatively cheap (about $100), since the process is not proven to work, physicians are being asked to stop prescribing the treatment.
The guidelines were based on a series of studies that compared TENS with a mock TENS procedure, similar to a placebo, aimed at reducing chronic back pain, which is defined as pain that lasts longer than three months. Two of the studies showed no difference in chronic back pain when patients were given TENS, whereas the other studies had mixed results but were considered less reliable. Because the guidelines were based off of only a few tests, some physicians say the guidelines should not be considered "gospel". Two other studies have found the TENS technology to work in the cases of nerve pain associated with diabetes, though subsequent research is still needed.
In the new guidelines, professionals are calling for more studies of TENS particularly in patients that have never used the device before. In the meantime, some physicians say there is no reason that their patients should stop using TENS. It is an inexpensive, basically risk-free technology that may produce good results; if it does not produce the results the patient is receiving, they can return it.
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