Has long-standing uncertainty about the clinical efficacy of TENS finally been resolved?

Pain ManagementVol. 13, No. 4 EditorialHas long-standing uncertainty about the clinical efficacy of TENS finally been resolved?Mark I Johnson, Carole A Paley & Gareth JonesMark I Johnson *Author for correspondence: E-mail Address: m.johnson@leedsbeckett.ac.ukhttps://orcid.org/0000-0002-9421-9622Centre for Pain Research, School of Health, Leeds Beckett University, Leeds, LS1 3HE, UKSearch for more papers by this author, Carole A PaleyCentre for Pain Research, School of Health, Leeds Beckett University, Leeds, LS1 3HE, UKAcademic Unit of Palliative Care, University of Leeds, Leeds, LS2 9JT, UKSearch for more papers by this author & Gareth JonesCentre for Pain Research, School of Health, Leeds Beckett University, Leeds, LS1 3HE, UKSearch for more papers by this authorPublished Online:27 Apr 2023https://doi.org/10.2217/pmt-2023-0029AboutSectionsView ArticleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareShare onFacebookTwitterLinkedInRedditEmail View articleReferences1. Johnson MI, Jones G. Transcutaneous electrical nerve stimulation: current status of evidence. Pain Manag 7(1), 1–4 (2017).Link, Google Scholar2. Johnson MI, Paley CA, Jones G, Mulvey MR, Wittkopf PG. Efficacy and safety of transcutaneous electrical nerve stimulation (TENS) for acute and chronic pain in adults: a systematic review and meta-analysis of 381 studies (the meta-TENS study). BMJ Open 12(2), e051073 (2022).Crossref, Medline, Google Scholar3. Johnson MI. Transcutaneous electrical nerve stimulation (TENS). Research to support clinical practice. Oxford University Press Oxford, UK (2014).Crossref, Google Scholar4. Long DM. Cutaneous afferent stimulation for relief of chronic pain. Clin. Neurosurg. 21, 257–268 (1974).Crossref, Medline, CAS, Google Scholar5. Carroll D, Moore RA, Mcquay HJ, Fairman F, Tramer M, Leijon G. Transcutaneous electrical nerve stimulation (TENS) for chronic pain. Cochrane Database Syst Rev (3), CD003222 (2001).Medline, Google Scholar6. Gibson W, Wand BM, Meads C, Catley MJ, O'connell NE. Transcutaneous electrical nerve stimulation (TENS) for chronic pain - an overview of Cochrane Reviews. Cochrane Database Syst Rev 2, CD011890 (2019).Medline, Google Scholar7. Carroll D, Tramer M, Mcquay H, Nye B, Moore A. Randomization is important in studies with pain outcomes: systematic review of transcutaneous electrical nerve stimulation in acute postoperative pain. Br. J. Anaesth. 77(6), 798–803 (1996).Crossref, Medline, CAS, Google Scholar8. Bjordal JM, Johnson MI, Ljunggreen AE. Transcutaneous electrical nerve stimulation (TENS) can reduce postoperative analgesic consumption. A meta-analysis with assessment of optimal treatment parameters for postoperative pain. Eur J Pain 7(2), 181–188 (2003).Crossref, Medline, Google Scholar9. Walsh DM, Howe TE, Johnson MI, Sluka KA. Transcutaneous electrical nerve stimulation for acute pain. Cochrane Database Syst Rev (2), CD006142 (2009).Medline, Google Scholar10. Johnson MI, Paley CA, Howe TE, Sluka KA. Transcutaneous electrical nerve stimulation for acute pain. Cochrane Database Syst Rev 6, CD006142 (2015).Google Scholar11. Paley CA, Wittkopf PG, Jones G, Johnson MI. Does TENS reduce the intensity of acute and chronic pain? A comprehensive appraisal of the characteristics and outcomes of 169 reviews and 49 meta-analyses. Medicina (Kaunas) 57(10), 1060 (2021).Crossref, Medline, Google Scholar12. National Institute for Health and Clinical Excellence. Osteoarthritis: the care and management of osteoarthritis in adults. NICE Clinical Guideline [CG59] (2008).Google Scholar13. National Institute for Health and Care Excellence. Osteoarthritis: care and management. NICE Clinical Guideline [CG177] (2014). https://www.nice.org.uk/guidance/cg177Google Scholar14. National Institute for Health and Care Excellence. Osteoarthritis in over 16s: diagnosis and management. NICE Clinical Guideline [NG226] (2022). https://www.nice.org.uk/guidance/ng226Google Scholar15. National Institute for Health and Care Excellence. Chronic Pain (Primary and Secondary) in over 16s: Assessment of all chronic pain and management of chronic primary pain. NICE Clinical Guideline [NG193] (2021). https://www.nice.org.uk/guidance/ng193 Google Scholar16. National Institute for Health and Clinical Excellence. Low back pain and sciatica in over 16s: assessment and management. NICE Clinical Guideline [NG59] (2016). https://www.nice.org.uk/guidance/ng59Google Scholar17. National Institute for Health and Clinical Excellence. Intrapartum care: care of healthy women and babies. NICE Clinical Guideline [CG190] (2014). https://www.nice.org.uk/guidance/cg190Google Scholar18. National Institute for Health and Clinical Excellence. Rheumatoid Arthritis in Adults. NICE Clinical Guideline [NG100] (2018). http://www.nice.org.uk/NG100Google Scholar19. Johnson MI. Resolving long-standing uncertainty about the clinical efficacy of transcutaneous electrical nerve stimulation (TENS) to relieve pain: A comprehensive review of factors influencing outcome. Medicina (Kaunas, Lithuania) 57(4), (2021).Google Scholar20. Bennett MI, Hughes N, Johnson MI. Methodological quality in randomised controlled trials of transcutaneous electric nerve stimulation for pain: low fidelity may explain negative findings. Pain 152(6), 1226–1232 (2011).Crossref, Medline, Google Scholar21. Pivec R, Minshall ME, Mistry JB, Chughtai M, Elmallah RK, Mont MA. Decreased opioid utilization and cost at one year in chronic low back pain patients treated with transcutaneous electric nerve stimulation (TENS). Surg Technol Int 27, 268–274 (2015).Medline, Google Scholar22. Pivec R, Stokes M, Chitnis AS, Paulino CB, Harwin SF, Mont MA. Clinical and economic impact of TENS in patients with chronic low back pain: analysis of a nationwide database. Orthopedics 36(12), 922–928 (2013).Crossref, Medline, Google Scholar23. Woods B, Manca A, Weatherly H et al. Cost-effectiveness of adjunct non-pharmacological interventions for osteoarthritis of the knee. PLOS ONE 12(3), e0172749 (2017).Crossref, Medline, Google Scholar24. Gladwell PW, Cramp F, Palmer S. Foundational research could improve future transcutaneous electrical nerve stimulation evaluations. Medicina (Kaunas) 58(2), 149 (2022).Crossref, Medline, Google Scholar25. National Institute for Health and Clinical Excellence. Low back pain in adults: early management. NICE Clinical guideline [CG88] (2009). https://www.nice.org.uk/guidance/cg88Google Scholar26. Moore A, Fisher E, Eccleston C. Flawed, futile, and fabricated-features that limit confidence in clinical research in pain and anaesthesia: a narrative review. Br. J. Anaesth. doi: 10.1016/j.bja.2022.09.030 (2022).Google Scholar27. Horton R. Offline: what is medicine's 5 sigma? The Lancet 385, 1380 (2015).Crossref, Google Scholar28. Jureidini J, Mchenry LB. The illusion of evidence based medicine: Exposing the crisis of credibility in clinical researc. Wakefield Press, Mile End, South Australia (2020).Google Scholar29. Ritchie S. Science Fictions: Exposing Fraud, Bias, Negligence and Hype in Science. Vintage, London (2020).Google ScholarFiguresReferencesRelatedDetailsCited ByBroadening the lens through which we view pain and its management: an interview with Mark JohnsonMark I Johnson9 July 2023 | Pain Management, Vol. 13, No. 5 Vol. 13, No. 4 STAY CONNECTED Metrics Downloaded 20 times History Received 17 March 2023 Accepted 31 March 2023 Published online 27 April 2023 Published in print April 2023 Information© 2023 Future Medicine LtdFinancial & competing interests disclosureIn the previous 5 years, MI Johnson's employer has received income for expert consultancy activities from GlaxoSmithKline, TENSCare, and LifeCare Ltd. that lie outside of the submitted work. MI Johnson declares book royalties from Oxford University Press. All other authors declare no conflicts of interests. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.No writing assistance was utilized in the production of this manuscriptEdboard disclosureMI Johnson is a member of the Pain Management Editorial Board. They were not involved in any editorial decisions related to the publication of this article, and all author details were blinded to the article’s peer reviewers as per the journal’s double-blind peer review policy.PDF download