The use of TENS for the treatment of back pain in the emergency department: A randomized controlled trial.

IF 3.4 3区医学 Q1 EMERGENCY MEDICINE

Academic Emergency Medicine Pub Date : 2025-04-09 DOI:10.1111/acem.70013

Karalynn Otterness, Brian McMahon, Mason Ma, Henry C Thode, Adam J Singer

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引用次数: 0

Abstract

Objective: Back pain is one of the most common complaints in the emergency department (ED). Since current pharmacological treatments for back pain are often suboptimal, a multimodal approach that includes nonpharmacological modalities has promise to improve pain management. The objective of the current study was to test the hypothesis that transcutaneous electrical nerve stimulation (TENS) would be more effective at relieving back pain than sham TENS.

Methods: We conducted a patient- and observer-blinded, randomized controlled trial that included adult (≥18 years) ED patients with lumbar or thoracic back pain of at least moderate pain severity. Participants were randomly assigned (1:1) to TENS or sham TENS. The primary outcome was absolute reduction in pain severity at 30 min after treatment measured with a verbal numeric scale from 0 to 10 (none to worst). A sample of 80 patients had 80% power to detect a 1.5-point between-group difference in pain severity. The trial was registered with ClinicalTrials.gov (NCT04227067).

Results: We enrolled 80 subjects (40 to the TENS group, 40 to the sham group). Mean (±SD) age was 46 (±16) years, and 51% were female. Mean (±SD) pain scores before and after treatment were 8.4 (±1.6) and 6.8 (±2.4) in patients treated with TENS. Mean (±SD) pain scores before and after treatment were 8.0 (±1.7) and 7.5 (±2.1) in patients treated with sham TENS. The mean (±SD) reduction in pain score was significantly greater in TENS versus sham patients, 1.7 (±2.0) versus 0.5 (±1.0; p = 0.002). Rescue medication was administered to fewer patients treated with TENS than with sham (45% vs. 73%, p = 0.02) and patient satisfaction was higher in the TENS than in the sham group (78% vs. 50%, p = 0.02).

Conclusions: TENS was more effective than sham TENS at reducing pain severity in adult ED patients with back pain.

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在急诊科使用TENS治疗背痛：一项随机对照试验。

目的：背部疼痛是急诊科最常见的主诉之一。由于目前对背痛的药物治疗往往是次优的，包括非药物治疗的多模式治疗有望改善疼痛管理。本研究的目的是验证经皮神经电刺激（TENS）在缓解背痛方面比假TENS更有效的假设。方法：我们进行了一项患者和观察者双盲、随机对照试验，纳入了至少中度疼痛严重程度的腰椎或胸背部疼痛的成人（≥18岁）ED患者。参与者被随机（1:1）分配到TENS组或假TENS组。主要结局是治疗后30分钟疼痛严重程度的绝对减轻，用从0到10的口头数字量表测量（无到最差）。80名患者的样本有80%的能力检测到疼痛严重程度的组间差异为1.5分。该试验已在ClinicalTrials.gov注册（NCT04227067）。结果：共入组80例（TENS组40例，sham组40例）。平均（±SD）年龄为46（±16）岁，女性占51%。TENS患者治疗前后的平均（±SD）疼痛评分分别为8.4（±1.6）分和6.8（±2.4）分。假性TENS患者治疗前后的平均（±SD）疼痛评分分别为8.0（±1.7）分和7.5（±2.1）分。与假手术患者相比，TENS组疼痛评分的平均（±SD）降低幅度更大，分别为1.7（±2.0）和0.5（±1.0）；p = 0.002)。与假手术组相比，假手术组给予抢救药物的患者较少（45% vs. 73%, p = 0.02），患者满意度高于假手术组（78% vs. 50%, p = 0.02）。结论：在减轻成人ED腰痛患者疼痛程度方面，TENS比假TENS更有效。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Academic Emergency Medicine 医学-急救医学

CiteScore

7.60

自引率

6.80%

发文量

207

审稿时长

3-8 weeks

期刊介绍： Academic Emergency Medicine (AEM) is the official monthly publication of the Society for Academic Emergency Medicine (SAEM) and publishes information relevant to the practice, educational advancements, and investigation of emergency medicine. It is the second-largest peer-reviewed scientific journal in the specialty of emergency medicine. The goal of AEM is to advance the science, education, and clinical practice of emergency medicine, to serve as a voice for the academic emergency medicine community, and to promote SAEM''s goals and objectives. Members and non-members worldwide depend on this journal for translational medicine relevant to emergency medicine, as well as for clinical news, case studies and more. Each issue contains information relevant to the research, educational advancements, and practice in emergency medicine. Subject matter is diverse, including preclinical studies, clinical topics, health policy, and educational methods. The research of SAEM members contributes significantly to the scientific content and development of the journal.