TENS, a popular portable device used for pain relief, will not help back pain. There is not adequate evidence to show the machine works, says new US guideline.
The Technology and Therapeutics Assessment Subcommittee of the Practice Committee of the American Association of Neurology has just released its evidence-based review of the efficacy of TENS (transcutaneous electric stimulation) for treatment of pain.
nerve stimulation (TENS) is not recommended for the treatment
of chronic low back pain (Level A). TENS should be considered
in the treatment of painful diabetic neuropathy (Level B). Further
research into the mechanism of action of TENS is needed, as
well as more rigorous studies for determination of efficacy, the researchers concluded.
Dr Richard Dubinsky of Kansas University Medical Centre, who wrote the guideline, said: 'The strongest evidence showed that there is no benefit for people using Tens machines for chronic low-back pain.
'Doctors should use clinical judgment regarding Tens use for chronic low-back pain. 'People who are currently using Tens for their low-back pain should discuss these findings with a doctor.'
The research did not look at acute lower back pain or other conditions that have been reportedly alleviated by Tens machines.
Published online in Neurology journal, it examined people with 'unknown' causes of back pain, rather than triggers such as a pinched nerve, obesity or spinal displacement.
'The studies to date show that Tens does not help with chronic lower back pain,' the report says.
However, there is 'good evidence' that Tens can be effective in treating diabetic nerve pain, the guideline published in Neurology journal says.
Thousands of Britons use Tens machines, which have been around for more than 30 years and deliver small electrical pulses to the body via electrodes placed on the skin.
They can be bought for just Ģ20 and many pregnant women hire them as a drug-free alternative for pain during labour.
It is unclear how Tens may provide pain relief, but one theory is that stimulating nerves may confuse the brain and block real pain signals from getting through.
Because there are virtually no side effects when using a Tens machine, pain specialists in the UK are likely to support its use when medication and other approaches do not work.
However, they advise against using them if the cause of the pain has not been medically diagnosed - to rule out other conditions.
Pregnant women should seek medical advice first, while people with pacemakers or those who have epilepsy or certain types of heart disease should not use them, writes Jenny Hope in Daily Mail.