Electrical Nerve Stimulation for Pain

Electrical nerve stimulation, or ENS, may be an effective treatment for chronic musculoskeletal pain, a new study reports.

Researchers from the Philosopher's River Consultancy in Montana explained that previous studies and meta-analyses of the efficacy of electrical nerve stimulation for the treatment of chronic pain associated with various diseases have produced mixed results.

The researchers investigated whether ENS is an effective treatment for chronic musculoskeletal pain by using statistical techniques that permit accumulation of a sample size with adequate power.

The analysis included randomized, controlled trials published between January 1976 and November 2006 and obtained from the National Libraries of Medicine, EMBASE and the Cochrane Library. In addition, prospective, placebo-controlled studies using any modality of ENS to treat chronic musculoskeletal pain in any anatomical location were included. The main outcome measure was pain at rest.

A total of 38 studies in 29 papers, which included 335 placebo, 474 ENS and 418 cross-over (both placebo and at least one ENS treatment) patients, met the selection criteria.

The overall results showed a significant decrease in pain with ENS therapy using a random-effects model. These results indicate that ENS may be an effective treatment modality for chronic musculoskeletal pain and that previous, equivocal results may have been due to underpowered studies.

Integrative therapies with good scientific evidence for the treatment of chronic pain include acupuncture, bromelain, comfrey, guided imagery, hypnotherapy, hypnosis, music therapy, physical therapy and therapeutic touch.

For more information about electrical nerve stimulation, please refer to Natural Standard's monograph on TENS. For information about the integrative therapies for chronic pain listed above, please visit Natural Standard's Foods, Herbs & Supplements and Health & Wellness databases.

Comments

[Paul]

This is pretty cool, and hopefully this study won’t be buried or attacked by those who do not agree with the technique. Chronic pain is one of the most difficult things to treat. Low back pain, long-term muscle cramps and others just don’t respond to drugs a lot of times, even the potent narcotics. Plus, the medications have a lot of side effects, especially CNS depression and sleepiness. This could be a great way to integrate therapy for a lot of people.

[Emily P.]

I remember reading a study on this a long time ago. The study investigated ENS and EMS (electrical muscle stimulation) therapies. The study also showed significant pain relief with ENS therapy but did not help patients increase their range of motion. EMS therapy worked conversely, having little effect on pain but relieved muscle tension.

[Pierce]

I’m sure the electrical nerve stimulation methods used in this study are different than the magnetic stimulation my mother swears by, but I’d be interested to see if there are any similarities. Whenever my mother has had pain in her wrists and knees, she uses a magnetic wrap and claims to feel better within hours. I see that the research is still out on whether this magnet method is truly effective. Maybe the people over at the Philosopher's River Consultancy in Montana can solve this question once and for all!

[marcia b]

I wonder how long it takes for patients to notice results from electrical nerve stimulation. Does anyone know how often patients receive this type of therapy to treat pain?

[Caren]

I agree with the above comment by Paul. It seems that there are many credible options for patients with lower back problems, but that each treatment works differently for different individuals. It seems that the best approach for a patient would be to try as many treatments as possible to see which works best.

[K. T.]

Hmm.. is this therapy expensive? If it is, is it worth it? I'd like to know how well this treatment does compared to all the others listed at the end of the article; anybody know?

[Cassie]

I would be curious to know how long the effects of this treatment lasted. I can't imagine having to receive this therapy often and consistently in order to prevent your pain from returning. Can one undergo a series of treatments and then be cured? Can they spread treatments out monthly, yearly or over several years and still experience the benefits? Although ENS may have promising results, I doubt many people can afford or have the time to receive this treatment on a frequent and regular basis.

[W Thomas]

I have used an electrical stimulation unit for pain and find it very helpful. The relief is immediate, though it does not last. But you simply reapply the unit when the pain gets bad again. All in all, it's pretty cost efficient. The unit was not terribly expensive, and the electrodes and pads seem to last for a long time (I have yet to replace mine after a year). To me, it beats taking medication that dopes you up and works better.

[dalz]

I would be interested in learning the mechanism of how this therapy works. The skin has the largest amount of nociceptors, which are receptive to electrical stimuli. Perhaps the flooding of the painful area with ENS allows the brain to be distracted from other sources? Anyone know?