Does Adding Electroanalgesic Modalities to a Multimodal Therapeutic Program Improve Clinical Outcomes in Individuals With Chronic Nonspecific Neck Pain? A Randomised Controlled Trial

IF 3.4 2区医学 Q1 ANESTHESIOLOGY

European Journal of Pain Pub Date : 2025-09-05 DOI:10.1002/ejp.70121

Gabriela Nascimento de Santana, Aron Charles Barbosa da Silva, Patrícia Gabrielle dos Santos, Carlos Eduardo Girasol, Adriano Rodrigues de Oliveira, Almir Vieira Dibai-Filho, Cid André Fidelis de Paula Gomes

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Abstract

Background

Chronic nonspecific neck pain (CNSNP) is a prevalent and complex condition. Although many studies have evaluated the effectiveness of transcutaneous electrical nerve stimulation (TENS), interferential current (IFC), therapeutic exercise (TE), and manual therapy (MT) individually, this study aimed to determine whether adding IFC and/or TENS to a Multimodal Therapeutic Intervention Program (MTIP) would produce better outcomes than the MTIP alone concerning functional capacity, pain intensity, pain catastrophising, kinesiophobia and overall perceived effect in individuals with CNSNP.

Methods

Seventy-five individuals with CNSNP were randomly assigned to one of three groups: MTIP, MTIP + IFC, or MTIP + TENS. Interventions were conducted over 8 weeks. Outcomes were assessed at baseline, post-intervention, and at a 1-month follow-up. The primary outcome was the Neck Disability Index (NDI). Secondary outcomes included the Numeric Pain Rating Scale (NPRS) at rest and during movement, the Pain-Related Catastrophizing Thoughts Scale (PRCTS), the Tampa Scale for Kinesiophobia (TSK), the Copenhagen Neck Functional Disability Scale (CNFDS), the WHO Disability Assessment Schedule (WHODAS 2.0), and the Global Perceived Effect Scale (GPES).

Results

No significant differences were observed between groups for the primary outcome. For secondary outcomes, the MTIP group showed improved results for NPRS-m and CNFDS. Additionally, MTIP was superior to MTIP + IFC for NPRS-r post-intervention, while MTIP + TENS outperformed both groups at follow-up. No significant differences were found for GPES, and none of the differences reached clinical significance.

Conclusions

The addition of IFC and/or TENS to an MTIP did not enhance clinical outcomes in individuals with CNSNP.

Significance

The results of this study assist clinicians in making informed decisions regarding the selection of therapeutic resources for managing chronic nonspecific neck pain. They also support researchers in refining and conducting new studies focused on improving the implementation of multimodal intervention protocols. Additionally, these findings help individuals with chronic nonspecific neck pain better understand which interventions may be most appropriate to include in their rehabilitation process.

Trial Registration

NCT05400486

Abstract Image

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在多模式治疗方案中加入电镇痛模式是否能改善慢性非特异性颈痛患者的临床结果？随机对照试验

慢性非特异性颈部疼痛（CNSNP）是一种普遍而复杂的疾病。虽然许多研究已经分别评估了经皮神经电刺激（TENS）、干扰电流（IFC）、治疗性运动（TE）和手工疗法（MT）的有效性，但本研究旨在确定在多模式治疗干预计划（MTIP）中加入IFC和/或TENS是否会比单独使用MTIP在功能容量、疼痛强度、疼痛突变、运动恐惧症和CNSNP个体的整体感知效应。方法将75例CNSNP患者随机分为MTIP组、MTIP + IFC组和MTIP + TENS组。干预进行了超过8周。在基线、干预后和1个月随访时评估结果。主要观察指标为颈部残疾指数（NDI）。次要结果包括休息和运动时的数值疼痛评定量表（NPRS）、疼痛相关灾难思维量表（PRCTS）、运动恐惧症坦帕量表（TSK）、哥本哈根颈部功能障碍量表（CNFDS）、世界卫生组织残疾评估表（WHODAS 2.0）和全球感知效应量表（GPES）。结果两组间主要转归无显著差异。对于次要结果，MTIP组在NPRS-m和CNFDS方面表现出改善的结果。此外，干预后NPRS-r的MTIP优于MTIP + IFC，而MTIP + TENS在随访时优于两组。GPES无显著性差异，且均无临床意义。结论：在MTIP中加入IFC和/或TENS并不能改善CNSNP患者的临床结果。意义：本研究的结果有助于临床医生在选择治疗慢性非特异性颈部疼痛的治疗资源方面做出明智的决定。他们还支持研究人员完善和开展新的研究，重点是改进多模式干预方案的实施。此外，这些发现有助于慢性非特异性颈部疼痛患者更好地了解哪些干预措施可能最适合纳入他们的康复过程。试验注册NCT05400486

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来源期刊

European Journal of Pain 医学-临床神经学

CiteScore

7.50

自引率

5.60%

发文量

163

审稿时长

4-8 weeks

期刊介绍： European Journal of Pain (EJP) publishes clinical and basic science research papers relevant to all aspects of pain and its management, including specialties such as anaesthesia, dentistry, neurology and neurosurgery, orthopaedics, palliative care, pharmacology, physiology, psychiatry, psychology and rehabilitation; socio-economic aspects of pain are also covered. Regular sections in the journal are as follows: • Editorials and Commentaries • Position Papers and Guidelines • Reviews • Original Articles • Letters • Bookshelf The journal particularly welcomes clinical trials, which are published on an occasional basis. Research articles are published under the following subject headings: • Neurobiology • Neurology • Experimental Pharmacology • Clinical Pharmacology • Psychology • Behavioural Therapy • Epidemiology • Cancer Pain • Acute Pain • Clinical Trials.