Conventional, Acupuncture-Like or Brief-Intense: Is There Any Difference Between TENS Modalities According to Outcomes of Chronic Low Back Pain with Lumbar Disc Herniation

Abstract

Objectives: To evaluate the differences between Conventional, Acupuncture-like and Brief-intense TENS in chronic low back pain with lumbar disc herniation. Methods: 160 patients who were diagnosed as lumbar disc herniation were randomized into 4 groups: Group1= Conventional TENS, Group2= Acupuncture-like TENS, Group3= Brief-intense TENS, Group4= Sham TENS. Hotpack, ultrasound and exercise were applied all groups (5 days/week for 3 weeks). Patients were evaluated before treatment, a week after baseline, at the end of treatment and a month after the end of treatment. Ostwestry Low Back Pain Disability Questionnaire (OLBP) and Short-Form 36 physical component (SF-36PCS), mental component (SF-36MCS) scores, Modified Lumbar Schober test (MLS), Straight Leg Raising test (SLR) and Femoral Stretching test (FS) results and Visual Analog Scale for pain (VAS) at activity and at rest were recorded. After the exclusion, statistical analysis was administered to 135 participants (44 males and 91 females). Results: There were no differences according to demographic data (p>0,05). For each evaluation step, we compared the means of MLS, SLR, VASactivity, VASrest, OLBP, SF-36PCS and SF-36MCS and found no significant difference (p>0,05). At the end of first week, all groups showed significant improvement according to SLR (p=0,046, p=0,035, p=0,035, p=0,045, respectively) and VASrest (p=0,038, p=0,048, p=0,045, p=0,048, respectively); only group 1 (p=0,034) and group 3 (p=0,045) showed significant improvement for VASactivity. At the end of treatment, all groups showed significant improvement for MLS, SLR, VASactivity, VASrest, OLBP and SF-36PCS (p<0,05). Conclusions: Pain relief is seem to be starting earlier in treatment regimens including conventional and brief-intense TENS. Probably, final outcomes of the treatment regimens for pain and functional capacity, with or without TENS don’t differ.