Transcutaneous electrical nerve stimulation for acute pain

Deirdre M Walsh, TE Howe, MI Johnson, Fidelma Moran, KA Sluka

Research output: Contribution to journalArticlepeer-review


Background: This is an updated version of the original Cochrane review published in Issue 2, 2009. Transcutaneous Electrical Nerve Stimulation (TENS) is a non-pharmacological agent, based on delivering low voltage electrical currents to the skin. TENS is used for the treatment of a variety of pain conditions. Objectives: To assess the analgesic effectiveness of TENS for acute pain in adults to see if it had any analgesic effect in its own right. Search methods: The following databases were searched: Cochrane Pain, Palliative and Supportive CareGroup Specialised Register; the Cochrane Central Register of Controlled Trials, CENTRAL (in The Cochrane Library); MEDLINE; EMBASE; CINAHL; AMED; PEDro; OTseeker; OpenSIGLE; and, reference lists of included studies. The most recent search was undertaken on January 7th 2011. Selection criteria: Randomised controlled trials (RCTs) of adults with acute pain (less than 12 weeks) were included if they examined TENS given as a sole treatment and assessed pain with subjective pain scales. Studies were eligible if they compared TENS to placebo TENS, notreatment controls, pharmacological interventions or non-pharmacological interventions. Studies on experimental pain, case reports, clinical observations, letters, abstracts or reviews were excluded. Studies on TENS and labour pain, pain due to dental procedures and primary dysmenorrhoea were excluded. Studies where TENS was given with another treatment as part of the formal study design were also excluded. No restrictions were made regarding language. Data collection and analysis: Two review authors independently assessed study eligibility and extracted data.Datawere extracted on the following: types of participants and pain condition, study design and methods, treatment parameters, adverse effects, and outcome measures. Study authors were contacted for additional information if necessary. Main results: No new included studies were included in this update, however, two new studies are awaiting classification. Of 1775 studies identified in the search, 163 were identified as relevant. Of these, 145 were excluded; the vast majority of these were excluded due to TENS being given with another treatment. Six studies were categorised as awaiting classification as the information provided in the full text failed to clarify their eligibility. Twelve RCTs involving 919 participants at entry were included. The types of acute pain conditions included procedural pain, e.g. cervical laser treatment, venipuncture, screening flexible sigmoidoscopy and non-procedural pain, e.g. postpartum uterine contractions, rib fractures. It was not possible to perform a meta-analysis due to insufficient data. Authors’ conclusions: There are no changes to the conclusions since the original version of the review was published in issue 2, 2009. Due to insufficient extractable data in the studies included in this review, we are unable to make any definitive conclusions about the effectiveness of TENS as an isolated treatment for acute pain in adults.Transcutaneous electrical nerve stimulation for acute pain (Review) Copyright © 2011 The Cochrane Collaboration. Published by JohnWiley & Sons, Ltd.
Original languageEnglish
JournalCochrane Database of Systematic Reviews
Publication statusPublished (in print/issue) - 2011

Bibliographical note

Reference text: References for included studies:
Cheing 2005 {published data only}
Cheing GL, Luk ML. Transcutaneous electrical nerve
stimulation for neuropathic pain. Journal of Hand Surgery -
British Volume 2005;30(1):50–5.
Coyne 1995 {published data only}
Coyne PJ,MacMurrenM, Izzo T, Kramer T. Transcutaneous
electrical nerve stimulator for procedural pain associated
with intravenous needlesticks. Journal of Intravenous
Nursing 1995;18(5):263–7.
Crompton 1992 {published data only}
Crompton AC, Johnson N, Dudek U, Batra N, Tucker A.
Is transcutaneous electrical nerve stimulation of any value
during cervical laser treatment. British Journal of Obstetrics
& Gynaecology 1992;99(6):492–4.
De Angelis 2003 {published data only}
De Angelis C, Perrone G, Santoro G, Nofroni I, Zichella
L. Suppression of pelvic pain during hysteroscopy with a
transcutaneous electrical nerve stimulation device. Fertility
& Sterility 2003;79(6):1422–7.
Hansson 1983 {published data only}
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(2):157–65.
Hruby 2006 {published data only}
Hruby G, Ames C, Chen C, Yan Y, Sagar J, Baron P, et
al.Assessment of efficacy of transcutaneous electrical nerve
stimulation for pain management during office-based
flexible cystoscopy. Urology 2006;67(5):914–7.
Limoges 2004 {published data only}
Limoges MF, Rickabaugh B. Evaluation of TENS during
screening flexible sigmoidoscopy. Gastroenterology Nursing
Liu 1985 {published data only}
Liu YC, Liao WS, Lien IN. Effect of transcutaneous
electrical nerve stimulation for post-thoracotomic pain.
Journal of the Formosan Medical Association 1985;84(7):
Olsen 2007 {published data only}
Olsen MF, Elden H, Janson ED, Lilja H, Stener-Victorin
E. A comparison of high- versus low-intensity, highfrequency
transcutaneous electric nerve stimulation for
painful postpartum uterine contractions. Acta Obstetricia Et
Gynecologica Scandinavica 2007;86(3):310–4.
Oncel 2002 {published data only}
Oncel M, Sencan S, Yildiz H, Kurt N. Transcutaneous
electrical nerve stimulation for pain management in patients
with uncomplicated minor rib fractures. European Journal
of Cardio-Thoracic Surgery 2002;22(1):13–7.
Ordog 1987 {published data only}
Ordog GJ. Transcutaneous electrical nerve stimulation
versus oral analgesic: a randomized double-blind controlled
study in acute traumatic pain. American Journal of
Emergency Medicine 1987;5(1):6–10.
Roche 1985 {published data only}
Roche PA, Gijsbers K, Belch JJ, Forbes CD. Modification of
haemophiliac haemorrhage pain by transcutaneous electrical
nerve stimulation. Pain 1985;21(1):43–8.


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