TENS for Neck Pain

EFFECTIVENESS: 3/5

Studies of TENS have shown conflicting results, but some reviews of the studies have demonstrated effectiveness for some patients. There have been problems with how the studies have been done, which contributes to confusion. Many guidelines indicate a trial of TENS is appropriate, and it should be used with other active treatments, such as exercise.

Similarly, studies on Interferential Therapy (IF) also suffer from flaws in the design of the study. There are a variety of ways to deliver IF, but the studies don’t really compare these. Most major guidelines indicate IF can be tried in conjunction with other treatments, but not by itself alone.

From a scientific standpoint, researchers cannot make any definite recommendations about the effectiveness of electrical stimulation because the quality of the studies done to date is generally poor. However, these treatments are widely used and may be helpful. TENS is listed as an alternative treatment in national treatment guidelines.

Sources:

Kroeling P, Gross A, Graham N, Burnie SJ, Szeto G, Goldsmith CH, Haines T, Forget M. Electrotherapy for neck pain. Cochrane Database of Systematic Reviews 2013, Issue 8. Art. No.: CD004251.

Blanpied PR, Gross AR, Elliott JM, et al. Neck Pain: Revision 2017. J Orthop Sports Phys Ther. 2017;47(7):A1-A83.

Zambito A, Bianchini D, Gatti D, Rossini M, Adami S, Viapiana O. Interferential and horizontal therapies in chronic low back pain due to multiple vertebral fractures: a randomized, double blind, clinical study. Osteoporos Int. 2007 Nov;18(11):1541-5. Epub 2007 Jul 4.

SELF CARE: 5/5

While electrical stimulation is frequently provided by medical providers, all of these therapies are available for home use, and can be purchased by the general public.

COST: 5/5

TENS units are available online for as little as $30, and interferential and muscle stimulation units are available for between $125 and $600.Durable medical equipment companies will often charge insurance carries several thousand dollars. In general, these units would be considered very affordable.

USEFULNESS (overall rating): 5/5

TENS, Interferential and muscle stimulation units don’t work for everyone, but can be very useful for those who do benefit. They are a reasonable alternative for those who cannot or choose not to use anti-inflammatory drugs, including patients with stomach issues, kidney or liver disease or heart disease. They are also an option for recovering substance abusers who cannot take pain medication. This article will focus on TENS, since electrical muscle stimulation has recently been shown in national guidelines to not be recommended for neck pain.

Sources:

Bussières AE, Stewart G, Al-Zoubi F, et al. The Treatment of Neck Pain-Associated Disorders and Whiplash-Associated Disorders: A Clinical Practice Guideline. J Manipulative Physiol Ther. 2016 Oct;39(8):523-564.e27. doi: 10.1016/j.jmpt.2016.08.007.

Electrical stimulation has been used therapeutically for more than 100 years. There are a number of different types of electrical stimulation, broadly they break down into 2 categories: stimulation of muscles (i.e., contraction of muscle) and stimulation of nerve pathways to reduce acute and chronic pain.

Electrical stimulation to reduce pain uses sticky electrodes or larger plastic pads placed over specific areas.

TENS (Transcutaneous Electrical Nerve Stimulation): usually a battery-operated portable device about the size of a cell phone. Typically prescribed for home use for acute and chronic pain.

http://www.electrotherapy.org/modality/transcutaneous-electrical-nerve-stimulation-tens