Device used to treat chronic back pain not effective, medical group says

A device that is widely used to treat chronic back pain is not effective, according to a study.

For years, employees who suffer from chronic low back pain have been treated with a transcutaneous electric nerve stimulation, a portable device that applies a mild electrical current to the nerves through electrodes. The theory behind the treatment was that nerves can only carry one signal at a time. Physicians believed that transcutaneous electric nerve stimulation confused the brain and blocked the real pain signal. However, according to a guideline issued by the American Academy of Neurology, this method is not recommended.

Research on transcutaneous electric nerve stimulation for chronic low back pain has produced conflicting results. For the guideline, the authors reviewed studies for low back pain lasting three months or longer. Acute low back pain was not studied. The report concluded that transcutaneous electric nerve stimulation does not help chronic low back pain.

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Researchers noted that all but one of the studies excluded people with known causes of low back pain, such as a pinched nerve, severe scoliosis (curving of the spine), severe spondylolisthesis (displacement of a backbone or vertebra), or obesity. In the study that looked at low back pain associated with known conditions, transcutaneous electric nerve stimulation was not shown to be effective.

"The strongest evidence showed that there is no benefit for people using transcutaneous electric nerve stimulation for chronic low back pain," said Richard M. Dubinsky, lead author of the guideline and a fellow of the AAN. "Doctors should use clinical judgment regarding transcutaneous electric nerve stimulation use for chronic low back pain. People who are currently using transcutaneous electric nerve stimulation for their low back pain should discuss these findings with their doctors."

The guideline determined that transcutaneous electric nerve stimulation can be effective in treating diabetic nerve pain, also called diabetic neuropathy. However, researchers said more and better research is needed to compare transcutaneous electric nerve stimulation to other treatments for this type of pain.

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February 18, 2010

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