Transcutaneous electrical nerve stimulation for the management of painful conditions: focus on neuropathic pain

Abstract

The management of neuropathic pain is challenging, with medication being the first-line treatment. Transcutaneous electrical nerve stimulation (TENS) is an inexpensive, noninvasive, self-administered technique that is used as an adjunct to medication. Clinical experience suggests that TENS is beneficial providing it is administered at a sufficiently strong intensity, close to the site of pain. At present, there are too few randomized controlled trials on TENS for neuropathic pain to judge effectiveness. The findings of systematic reviews of TENS for other pain syndromes are inconclusive because trials have a low fidelity associated with inadequate TENS technique and infrequent treatments of insufficient duration. The use of electrode arrays to spatially target stimulation more precisely may improve the efficacy of TENS in the future.

Keywords::

• chronic pain
• electrode array
• gate-control theory of pain
• neuromodulation
• neuropathic pain
• randomized controlled clinical trial
• systematic review
• transcutaneous electric nerve stimulation
• TENS

Financial & competing interests disclosure

Mark Johnson has taken part in TENS symposia that have been sponsored by TENS and pharmaceutical companies. 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 manuscript.