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Transcutaneous Electrical Nerve Stimulation (TENS): A Technology Assessment

  • Janis Reeve (a1), Devidas Menon (a1) and Paula Corabian (a2)

Abstract

The scientific evidence for clinical effectiveness of transcutaneous electrical nerve stimulation (TENS) for treatment of acute, chronic, and labor and delivery pain is assessed in this paper, and it is concluded that there is little evidence for other than a limited use of TENS. The utilization of TENS in Canadian hospitals and payments for TENS services are addressed. Some practicalities regarding the use and assessment of health technologies are discussed.

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1.Abelson, K., Langley, G. B., Sheppeard, H., Vlieg, M.,& Wigley, R. D.Transcutaneous electric nerve stimulation in rheumatoid arthritis. New Zealand Medical Journal, 1983, 96, 156–58.
2.Akyuz, G., Kayhan, O., Babacan, A., & Gener, A. A.Transcutaneous electrical nerve stimulation (TENS) in the treatment of postoperative pain and prevention of paralytic ileus. Clinical Rehabilitation, 1993, 7, 218–21.
3.Augustinsson, L-E., Bholin, P., Bundsen, P., et al. Pain relief during delivery by transcutaneous electrical nerve stimulation. Pain, 1977, 4, 5965.
4.Ballegaard, S., Christopherson, S. J., Dawids, S. G., et al. Acupuncture and transcutaneous electrical nerve stimulation in the treatment of pain associated with chronic pancreatitis. Scandinavian Journal of Gastroenterology, 1985, 20, 1249–54.
5.Barr, J. T. Transcutaneous electrical nerve stimulation. In Barr, J. T., (Comp.), Critical literature review: Clinical effectiveness in allied health practices. Rockville, MD: Agency for Health Care Policy & Research, Department of Health and Human Resources, 1993, 8993.
6.Bayindir, O., Paker, T., Akpinar, B., et al. Use of transcutaneous electric nerve stimulation in the control of postoperative chest pain after cardiac surgery. Journal of Cardiothoracic and Vascular Anesthesia, 1991, 5, 589–91.
7.Bundsen, P., Ericson, K., Peterson, L. E., & Thiringer, K.Pain relief in labor by transcutaneous electrical nerve stimulation. Acta Obstetricia Gynecologica Scandinavica, 1982, 61, 129–36.
8.Bussey, J. G., & Jackson, A.TENS for postsurgical analgesia. Contemporary Surgery, 1981, 18, 3541.
9.Chalmers, T. C., Smith, H. Jr., Blackburn, B., et al. A method for assessing the quality of a randomized control trial. Clinical Trials Journal, 1981, 2, 3149.
10.Chia, Y. T., Arulkumaran, S., Chua, S., & Ratnam, S.Effectiveness of transcutaneous electrical nerve stimulator for pain relief in labour. Asia-Oceania Journal Obstetrics Gynaecology, 1990, 16, 145–51.
11.Conn, I. G., Marshall, A. H., Yadav, S. N., et al. Transcutaneous electrical nerve stimula tion following appendectomy: The placebo effect. Annals of the Royal College of Surgeons of England, 1986, 68, 191–92.
12.Cooperman, A., Hall, B., Mikalacki, K., et al. Use of transcutaneous electrical stimulation in the control of postoperative pain. American Journal of Surgery, 1977, 133, 185–87.
13.Cuschieri, R. J., Morran, C. G., & McArdle, C. S.Transcutaneous electrical stimulation for postoperative pain. Annals of the Royal College of Surgeons of England, 1985, 67, 127–29.
14.Dawood, M. Y., & Ramos, J.Transcutaneous electrical nerve stimulation (TENS) for the treatment of primary dysmenorrhea: A randomized crossover comparison with placebo TENS and ibuprofen. Obstetrics and Gynecology, 1990, 75, 656–60.
15.Deyo, R. A. Introduction. In Weinstein, J. N. (ed.). Clinical efficacy and outcome in the diagnosis and treatment of low back pain. New York: Raven Press, 1992, p. xxi.
16.Deyo, R. A., Walsh, N. E., Martin, D. C. et al. Controlled trial of transcutaneous electrical nerve stimulation (TENS) and exercise for chronic low back pain. New England Journal of Medicine, 1990, 322, 1627–34.
17.Don, R. G., & Tay, G.Transcutaneous nerve stimulation for the relief of chronic pain. Singapore Medical Journal, 1982, 23, 322–24.
18.Ekblom, A., & Hansson, P.Extra-segmental transcutaneous electrical nerve stimulation and mechanical vibratory stimulation as compared to placebo for the relief of acute oro-facial pain. Pain, 1983, 23, 223–29.
19.Erkkola, R., Pikkola, P., & Kanto, J.Transcutaneous nerve stimulation for pain relief during labour: A controlled study. Annales Chirurgiaeet Gynaecologiae, 1980, 69, 273–77.
20.Evidence-based medicine: A new approach to teaching the practice of medicine, Journal of the American Medical Association, 1992, 268, 2420–25.
21.Fargas-Babjak, A., Rooney, P., & Gerecz, E.Randomized trial of codetron for pain control in osteoarthritis of the hip/knee. Clinical Journal of Pain, 1989, 5, 137–41.
22.Finsen, V., Persen, L., Lovlien, M., et al. Transcutaneous electrical nerve stimulation after major amputation. Journal of Bone and Joint Surgery, 1988, 70, 109–12.
23.Fried, T., Johnson, R., & McCracken, W.Transcutaneous electrical nerve stimulation: Its role in the control of chronic pain. Archives of Physical Medicine Rehabilitation, 1984, 65, 228–31.
24.Graff-Radford, S. B., Reeves, J. L., Baker, R. L., & Chiu, D.Effects of transcutaneous electrical nerve stimulation on myofacial pain and trigger point sensitivity. Pain, 1989, 37, 15.
25.Geirsson, G., Wang, Y. H, Londstrom, S., & Fall, M.Traditional acupuncture and electrical stimulation of the posterior tibial nerve. Scandinavian Journal of Urology an Nephrology, 1993, 27, 6770.
26.Gilbert, J. M., Gledhill, T., Law, N., & George, C.Controlled trial of transcutaneous electrical nerve stimulation (TENS) for postoperative pain relief following inguinal herniorrhaphy. British Journal of Surgery, 1986, 73, 749–51.
27.Goldbloom, R., & Battista, R. N.The periodic health examination, I: Introduction. Canadian Medical Association Journal, 1988, 134, 721–23.
28.Gowers, S. R.A stimulating experience: Case study. Midwives Chronicle, 1985, 98, 295–96.
29.Griffin, J. W., Newsome, L. S., Stralka, S. W., & Wright, P. E.Reduction of chronic posttraumatic hand edema: A comparison of high voltage pulsed current, intermittent pneumatic compression, and placebo treatments. Physical Therapy, 1990, 70, 279–86.
30.Grim, L. C., & Morey, S. H.Transcutaneous electrical nerve stimulation for relief of parturition pain: A clinical report. Physical Therapy, 1985, 65, 337–40.
31.Ham, C., Hunter, D. J., & Robinson, R.Evidence-based policy making. British Medical Journal, 1995, 310, 7172.
32.Hansson, P., & Ekblom, A.Transcutaneous electrical nerve stimulation (TENS) as compared to placebo TENS for the relief of acute oro-facial pain. Pain, 1983, 15, 157–65.
33.Hansson, P., & Ekblom, A.Afferent stimulation induced pain relief in acute oro-facial pain and its failure to induce sufficient pain reduction in dental and oral surgery. Pain, 1984, 20, 273–78.
34.Hargreaves, A., & Lander, J.Use of transcutaneous electrical nerve stimulation for postoperative pain. Nursing Research, 1989, 38, 159–61.
35.Harrison, R. F., Shore, M., Woods, T., et al. A comparative study of transcutaneous electrical nerve stimulation (TENS), entonox, pethidine + promazine and lumbar epidural for pain relief in labour. Acta Obstetricia et Gynecologica Scandinavica, 1987, 66, 914.
36.Harrison, R. F., Woods, T., Shore, M., & Mathews, A. U.Pain relief in labour using transcutaneous electrical nerve stimulation (TENS): A TENS/TENS placebo controlled study in two parity groups. British Journal of Obstetrics and Gynaecology, 1986, 93, 739–46.
37.Herman, E., Williams, R., Stratford, P., et al. A randomized controlled trial of transcutaneous electrical nerve stimulation (CODETRON) to determine its benefits in a rehabilitation program for acute occupational low back pain. Spine, 1994, 19, 561–68.
38.Hollinger, J. L.Transcutaneous electrical nerve stimulation after cesarean birth. Physical Therapy, 1986, 66, 3638.
39.Howell, C. J., Transcutaneous electrical nerve stimulation (TENS) in labour. In Enkin, M. W., Keirse, M. J., Renfrew, M. J., & Neilson, J. P., (eds.), Cochrane database of systematic reviews: Pregnancy and childbirth module. Review no. 02553, 10 13, 1993. Oxford: Update Software, 1994. Cochrane updates on disk: Disk issue 1.
40.Hughes, S. C., Dailey, P. A., & Partridge, C.Transcutaneous electrical nerve stimulation for labor analgesia. Anesthesia and Analgesia, 1988, 67, S99.
41.International Journal of Technology Assessment in Health Care, 1992, 8, 1132.
42.Issenman, J., Nolan, M. F., Rowley, J., & Hobby, R.Transcutaneous electrical nerve stimulation for pain control after spinal fusion with Harrington rods. Physical Therapy, 1985, 65, 1517–20.
43.Jennett, B.Health technology assessment: The rule should be ‘no evaluation—no technology.’ British Medical Journal, 1992, 305, 6768.
44.Jensen, H., Zesler, R., Christensen, T.Transcutaneous electric nerve stimulation (TNS) for painful osteoarthritis of the knee. International Journal of Rehabilitation Research, 1991, 41, 356–58.
45.Kahn, J.Principles and practice of electrotherapy. New York: Churchill Livingstone Inc., 1993, 124.
46.Kahn, J.Principles and practice of electrotherapy. New York: Churchill Livingstone Inc., 1994, 107–25.
47.Keenan, D. L., Simonsen, L., & McCrann, D. J.Transcutaneous electrical nerve stimulation for pain control during labor and delivery: A case report. Physical Therapy, 1985, 65, 1363–64.
48.Langley, G. B., Sheppeard, H., Johnson, M., & Wigley, R. D.The analgesic effects of transcutaneous electrical nerve stimulation and placebo in chronic pain patients. Rheumatology International, 1984, 4, 119–23.
49.Leandri, M., Parodi, C. I., Corrieri, N., & Rigardo, S.Comparison of TENS treatments in hemiplegic shoulder pain. Scandinavian Journal of Rehabilitation Medicine, 1990, 22, 6972.
50.Lee, E. W., Chung, I. W., Lee, J. Y., Lam, P. W., & Chin, R. K.The role of transcutaneous electric nerve stimulation in management of labour in obstetric patients. Asia-Oceania Journal of Obstetrics and Gynaecology, 1990, 16, 247–54.
51.Lehmann, T. R., Russell, D. W., Spratt, K. F., et al. Efficacy of electroacupuncture and TENS in the rehabilitation of chronic low back pain patients. Pain, 1986, 26, 277–90.
52.Lewers, D., Clelland, J. A., Jackson, J. R., et al. Transcutaneous electrical nerve stimulation in the relief of primary dysmenorrhea. Physical Therapy, 1989, 26, 277–90.
53.Lewis, D., Lewis, B., & Sturrock, R. D.Transcutaneous electric nerve stimulation in osteoarthritis: A therapeutic alternative? Annals of the Rheumatic Diseases, 1984, 43, 4749.
54.Loeser, J. D., Black, R. G., & Christman, A.Relief of pain by transcutaneous stimulation. Journal of Neurosurgery, 1975, 42, 308–14.
55.Long, D. M., Campbell, J. N., & Gucer, G.Transcutaneous electrical nerve stimulation for relief of chronic pain. Advances in Pain Research Therapy, 1979, 3, 593–99.
56.Lundeberg, T.A comparative study of the pain alleviating effect of vibratory stimulation, transcutaneous electrical nerve stimulation, electroacupuncture and placebo. American Journal of Chinese Medicine, 1984, 12, 7279.
57.Lundeberg, T., Bondesson, L., & Lundstrom, V.Relief of primary dysmenorrhea by transcutaneous electrical nerve stimulation. Ada Obstetricia Gynecologica Scandinavica, 1985, 64, 491–97.
58.Mannheimer, C., Carlsson, C.-A., Emanuelsson, H., Vedin, A., Waagstein, F., & Wilhelmsson, C.The effects of transcutaneous electrical nerve stimulation in patients with severe angina pectoris. Circulation, 1985, 71, 308–16.
59.Mannheimer, C., Carlsson, C. A., Vedin, A., & Wilhelmsson, C.Transcutaneous electrical nerve stimulation (TENS) in angina pectoris. Pain, 1986, 26, 291300.
60.Mannheimer, C., Lund, S., & Carlsson, C.-A.The effect of transcutaneous electrical nerve stimulation (TNS) on joint pain in patients with rheumatoid arthritis. Scandinavian Journal of Rheumatology, 1978, 7, 1316.
61.Marchand, S., Charest, J., Li, J., Chenard, J.-R., Lavignolle, B., & Laurencelle, L. 1993. Is TENS purely a placebo effect? A controlled study on chronic low back pain. Pain, 1993, 54, 99106.
62.McCallum, M. I., Glynn, C. J., Moore, R. A., et al. Transcutaneous electrical nerve stimulation in the management of acute post-operative pain. British Journal of Anesthesia, 1988, 61, 308–12.
63.Melzack, R., Vetere, P., & Finch, L.Transcutaneous electrical nerve stimulation for low back pain. Physical Therapy, 1983, 63, 489–93.
64.Melzack, R., Jeans, M. E., Stratford, J. G., & Monks, R. G.Ice massage and transcuta neous electrical stimulation: Comparison of treatment for low-back pain. Pain, 1980, 9, 209–17.
65.Melzack, R., & Wall, P. D.Pain mechanisms: A new theoiy. Science, 1965, 150, 971–79.
66.Merrill, D. C.Clinical evaluation of FasTENS, an inexpensive, disposable transcutaneous electrical nerve stimulator designed specifically for postoperative electroanalgesia. Urology, 1989, 33, 2730.
67.Navarathnam, R. G., Wang, I. Y., Thomas, D., & Klineberg, P. L.Evaluation of the transcutaneous electric nerve stimulator for postoperative analgesia following cardiac surgery. Anaesthesia and Intensive Care, 1984, 12, 345–50.
68.Nesheim, B. I.The use of transcutaneous electrical nerve stimulation for pain relief during labor. Ada Obstetricia et Gynecologica Scandinavica, 1981, 60, 1316.
69.Nordemar, R., & Thorner, C.Treatment of acute cervical pain: A comparative group study. Pain, 1981, 10, 93101.
70.Office of Health Technology Assessment. Transcutaneous electrical nerve stimulation fo acute pain treatment for ambulatory patients. Washington, DC: U.S. Department of Health and Human Services, 1985, DHHS publication no. (PHS) 85–3373.
71.Office of Health Technology Assessment. Transcutaneous electrical nerve stimulation for acute post-operative incision pain. Washington, DC: U.S. Department of Health and Human Services, 1984, DHHS publication no. (PHS) 84–3370.
72.Oosterwijk, R. F., Meyler, W. J., Henley, E. J., Scheer, S. S., & Tannenbaum, J. 1994. Pain control with TENS and team nerve stimulators: A review. Critical Reviews in Physical and Rehabilitation Medicine, 1994, 6, 219–58.
73.Ordog, G. J.Transcutaneous electrical nerve stimulation versus oral analgesic: A randomized double-blind controlled study in acute traumatic pain. American Journal of Emergency Medicine, 1987, 5, 610.
74.Procacci, P., Zoppi, M., Maresca, M., & Francini, F.Hypoalgesia induced by transcutaneous electrical stimulation: A psychological and clinical investigation. Journal of Neurosurgical Science, 1977, 21, 221–28.
75.Quarnstrom, F. C., & Milgrom, P.Clinical experience with TENS and TENS combined with nitrous-oxide oxygen: Report of 371 patients. Anesthesia Progress, 1989, 36, 6669.
76.Rawat, B., Genz, A., Fache, J. S., Ong, M., Coldman, A. J., & Burhenne, H. J.Effectiveness of transcutaneous electrical nerve stimulation (TENS) for analgesia during biliary lithotripsy. Investigative Radiology, 1991, 26, 866–69.
77.Reuss, R., Cronen, P., & Abplanalp, L. 1988. Transcutaneous electric nerve stimulation for pain control after cholecystectomy: Lack of expected benefits. Southern Medical Journal, 1988, 81, 1361–63.
78.Roche, P. A., Gijsbers, K., Belch, J. J., & Forbes, C. D.Modification of haemophiliac haemorrhage pain by transcutaneous electrical nerve stimulation. Pain, 1985, 21, 4348.
79.Rooney, S. M., Jain, S., & Goldiner, P. L.Effect of transcutaneous nerve stimulation on post-operative pain. Anesthesia Analgesia, 1983, 62, 1010–12.
80.Rosenberg, M., Curtis, L., & Bourke, D. L.Transcutaneous electrical nerve stimulation for the relief of post-operative pain. Pain, 1978, 5, 129–33.
81.Sackett, D. L.Rules of evidence and clinical recommendations on use of antithrombotic agents. Chest, 1989, 95, 25.
82.Schuster, G. D., & Infante, M. C. 1980. Pain relief after low back surgery: The efficacy of transcutaneous electric nerve stimulation. Pain, 1980, 8, 299302.
83.Sim, D. T.Effectiveness of transcutaneous electrical nerve stimulation following cholecystectomy. Physiotherapy, 1991, 77, 715–22.
84.Sloan, J. P., Muwanga, C. L., Waters, E. A., Dove, A. F., & Dave, S. H.Multiple rib fractures: Transcutaneous nerve stimulation versus conventional analgesia. Journal of Trauma, 1986, 26, 1120–22.
85.Smedley, F., Taube, M., & Wastell, C.Transcutaneous electrical nerve stimulation for pain relief following inguinal hernia repair: A controlled trial. European Surgical Research, 1988, 20, 233–37.
86.Smith, C. M., Guralnick, M. S., Gelfand, M. M., & Jeans, M. E.The effects of transcutaneous electrical nerve stimulation on post-cesarian pain. Pain, 1986, 27, 181–93.
87.Stubbing, J. F., & Jellicoe, J. A.Transcutaneous electrical nerve stimulation after thoracotomy: Pain relief and peak expiratory flow rate: A trial of transcutaneous electrical nerve stimulation. Anaesthesia, 1988, 43, 296–98.
88.Taylor, P., Hallett, M., & Flaherty, L.Treatment of osteoarthritis of the knee with transcutaneous electric nerve stimulation. Pain, 11, 233–40.
89.Thomas, I. L., Tyle, V., Webster, J., & Neilson, A.An evaluation of transcutaneous electrical nerve stimulation for pain relief in labour. Australian and New Zealand Journal of Obstetrics and Gynaecology, 1988, 28, 182–89.
90.Thorsteinsson, G., Stonnington, H. H., Stilwell, G. K., & Eleveback, L. R.The placebo effect of transcutaneous stimulation. Pain, 1978, 5, 3141.
91.Torres, W. E., Fraser, N. P.Baumgartner, B. R., et al. The use of transcutaneous electrical nerve stimulation during the biliary lithotripsy procedure. Journal of Stone Disease, 1992, 4, 4145.
92.Tulgar, M., McGlone, F., Bowsher, D., & Miles, J. B.Comparative effectiveness of different stimulation modes in relieving pain, II: A double-blind controlled long-term clinical trial. Pain, 1991, 47, 157–62.
93.VanderArk, G. D., & McGrath, K. A.transcutaneous electric stimulation in treatment of post-operative pain. American Journal of Surgery, 1975, 13, 338–40.
94.Wachter, K. W.Disturbed by meta-analysis? Science, 1988, 241, 1407–08.
95.Wang, W. C., George, S. L., & Wilimas, J. A.Transcutaneous electrical nerve stimulation treatment of sickle cell pain crises. Ada Haematologica, 1988, 80, 99102.
96.Warfield, C. A., Stein, J. M., & Frank, H. A.The effect of transcutaneous electric nerve stimulation on pain after thoracotomy. Annals of Thoracic Surgery, 1985, 39, 462–65.

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Transcutaneous Electrical Nerve Stimulation (TENS): A Technology Assessment

  • Janis Reeve (a1), Devidas Menon (a1) and Paula Corabian (a2)

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