Transcutaneous Electrical Nerve Stimulation Group Research Articles

Comparing the Outcomes of Titanium and Stainless Steel Flexible Nails in Repairing Pediatric Long Bone Fractures

Background Traditionally, pediatric femoral fracture treatment favored conservative methods, relying on casting and the inherent bone remodeling ability in immature bones. Surgical intervention was deferred until age 6, as nonoperative approaches often resulted in complications. Titanium elastic nailing (TENS) emerged as an effective treatment for diaphyseal femoral fractures in ages 6 to 16. However, the choice between TENS and stainless steel elastic nailing (SSENS) remains debated due to inconsistent findings. Objective This study aimed to evaluate the effectiveness of both nailing systems in pediatric long bone fractures. Methods A retrospective chart review at William Beaumont Hospital Royal Oak included 83 patients aged 6 to 16 treated with TENS or SSENS between January 2011 and January 2021. Data collected encompassed nail related issues, time to fracture union, full weight bearing, and nail removal. Results In the TENS group (n=29), the average age was 8.8±2.4 years, and the average BMI was 17.2±3.4. The SSENS group (n=54) had an average age of 9.3±2.7 and an average BMI of 19.7±8.4. Time to fracture union for TENS was 93.8±60.5 days, while SSENS was 82.2±40.0 days. Conclusion This study found no statistically significant differences in nail-related complications, time to fracture union, full weight bearing, or nail removal between TENS and SSENS in pediatric long bone fractures. The choice between these systems should be based on individual circumstances. Limitations include a small sample size and the study’s retrospective nature.

Effects of Transcutaneous Electrical Nerve Stimulation with Taping on Wrist Spasticity, Strength, and Upper Extremity Function in Patients with Stroke: A Randomized Control Trial.

Objective: Six months after the onset of stroke, over 60% of patients experience upper limb dysfunction, with spasticity being a major contributor alongside muscle weakness. This study investigated the effect of transcutaneous electrical nerve stimulation (TENS) with taping on wrist spasticity, strength, and upper extremity function in patients with stroke. Methods: In total, 40 patients with stroke were included and randomly divided into two groups: the TENS + taping (n = 20, age 52.4 ± 9.3 (range: 39 to 70)) and TENS (n = 20, age 53.5 ± 10.8 (range: 39 to 74)) groups. All subjects performed 30 sessions of task-related training, which included 10 min of postural control training and 20 min of task performance. Additionally, all subjects received TENS on the spastic muscle belly for 30 min before task-related training. In the TENS + taping group, taping was additionally applied to the forearm and wrist but not in the TENS group. The Modified Ashworth Scale was used to measure spasticity, and a handheld dynamometer was used to measure muscle strength. The Fugl-Meyer Assessment of Upper Extremity was used to evaluate the functional ability of the upper extremity. Results: In the TENS + taping group, spasticity and upper extremity function were significantly improved as compared to those in the TENS group (p < 0.05). However, no significant difference in muscle strength was observed between the two groups (p > 0.05). Conclusions: This study demonstrated that the combination of TENS and taping for spasticity and function of the upper extremity was more effective in relieving the spasticity than TENS alone. Therefore, we suggest this combination as an additional treatment for spasticity and function of the upper extremity.

Transcutaneous electrical nerve stimulation for the treatment of acute postoperative pain following spine surgery: a scoping review.

Given the ubiquity and severity of postoperative pain following spine surgery, developing adequate pain management modalities is critical. Transcutaneous electrical nerve stimulation (TENS) is a promising noninvasive modality that is well studied for managing postoperative pain following a variety of surgeries, but data on using TENS for pain management in the acute postoperative period of spine surgery are limited. Therefore, this review aimed to recapitulate the existing evidence for the use of TENS in postoperative pain management for spine surgery and explore the potential of this modality moving forward. A scoping review was conducted according to 2020 PRISMA guidelines. Two independently operating reviewers then conducted a systematic search of PubMed, Embase, and Scopus databases to identify studies that reported the use of TENS for the treatment of acute postoperative pain following spine surgery. The following data were abstracted from included studies: study type, sample size, demographics, surgery details, comparison group, assessment parameters, timing of postoperative assessment, TENS technical characteristics, relevant findings, length of hospital stay, complications with TENS, and notable limitations. Nine hundred thirty-two publications were screened, resulting in 6 studies included in this review, all of which were prospective clinical trials. The publication dates ranged from 1980 to 2011. Spine surgery types varied; the most common was posterior lumbar interbody fusion. No studies evaluated pain control in cervical- or thoracic-only surgeries. All 6 studies evaluated the level of postoperative pain directly. Five of the 6 studies that directly examined postoperative pain reported lower levels of pharmacological analgesia usage in the TENS groups compared with controls, with 4 of these studies reporting this difference as statistically significant. Length of hospital stay was evaluated in 2 studies, both of which reported decreases in mean length of stay, but these differences were not significant. Notably, every study reported distinct TENS administration parameters while also reporting similar results. This review concludes that TENS is effective at reducing postoperative pain in spine surgery. Further investigation is needed regarding the optimal settings for TENS administration, as well as efficacy in the thoracic and cervical spine.

The Effects Of Transcutaneous Electrical Nerve Stimulation Applied in the Early Postpartum Period After Cesarean Birth on Healing, Pain, and Comfort.

This study was conducted to determine the effects of transcutaneous electrical nerve stimulation (TENS) applied in the early postpartum period after cesarean birth on incision site healing, postoperative recovery, pain, and comfort. This randomized, single-blind, placebo-controlled study was conducted with 138 women (TENS group n = 46, placebo group n = 46, control group n = 46) who gave birth by cesarean between January and September 2023. TENS was applied twice at a frequency of 100 Hz with a pulse width of 100 microseconds, at 10 to 12 and 14 to 16 hours after birth, for 30 minutes each. Outcomes were measured with the Postoperative Recovery Index; Redness, Edema, Ecchymosis, Discharge, and Approximation Scale; Visual Analogue Scale; and Postpartum Comfort Questionnaire. Outcomes between groups were compared postintervention, correcting for baseline using analysis of covariance. The study was registered at www. gov (NCT05991921). Mean scores for postoperative recovery were significantly lower (improved) in the TENS group (113.58) compared with the placebo and control groups (134.67, 136.61; P <.001). The postoperative recovery subscales (psychological symptoms, physical activities, appetite symptoms, bowel symptoms, general symptoms) were also significantly decreased in the TENS group compared with the placebo and control groups. Similarly, mean scores for postpartum comfort, and the corresponding physical comfort, psychospiritual comfort, and sociocultural comfort subscales, were significantly improved in the TENS group (110.26) compared with the placebo and control group (83.80, 81.19; P <.05). TENS application can be preferred as an alternative method to increase pain control, recovery, and patient comfort after cesarean birth.

Comparison of the efficiency of transcutaneous electrical nerve stimulation and manual therapy in children with cerebral palsy with lower urinary system dysfunction- a randomized prospective trial

Neurological defects in children with cerebral palsy (CP) not only affect their motor skills but also lead to bladder and bowel problems. Although most children with CP have achieved urinary control, more than 50% of cases experience lower urinary tract symptoms (LUTS). Common LUTS complaints observed in CP include delayed toilet training, urinary incontinence, increased frequency of urination, urgency, urinary hesitancy, and recurrent urinary tract infections. This study aimed to prospectively evaluate and compare the effectiveness of two different physiotherapy approaches, sacral Transcutaneous Electrical Nerve Stimulation (TENS) and massage, on lower urinary tract dysfunction in children with CP. A total of 54 children with CP who had the Dysfunctional Voiding Scoring System (DVISS) of 8.5 or higher were included in the study. Children were randomized to the TENS (TG; n=27) and Manual Therapy (MG; n=27) groups. TENS application was performed 2 sessions in a week for 20min for a total of 12 weeks. The electrodes used during the application were adhered bilaterally to the parasacral region (S2-S4). 4 electrodes of 5×5cm were used. Classical bowel massage was applied to the MG with the friction massage technique twice a week for 12 weeks. Manual therapy applications were performed in the form of abdominal, colon, and friction massage, twice a week for 20min by the physiotherapist. Massage was applied to the abdominal region between the lower subcostal border and the anterior superior iliac spine. Questionnaires were applied before and after treatment interventions: DVISS, functional bladder capacity (FBC), frequency of voiding, and urinary incontinence episodes evaluated by bladder diary, Bristol Gaita Scale, and Pediatric Incontinence Quality of Life Scale (PIN-Q) used. The decrease in the episodes of incontinence was higher in the TG (p=0.037; p<0.05). FBC increased after treatment in both groups, but there was no statistically significant difference between the groups (p=0.683; p>0.05). Manual therapy was more effective in improving constipation symptoms. In both groups, DVISS and PIN-Q values decreased after treatment, but the decrease in TG was statistically significant in the evaluation made between groups (p=0.001; p<0.01). Both parasacral TENS and massage provided a significant improvement in LUTS, constipation, and quality of life but TENS showed a bigger improvement. We suggest adding these interventions to the treatment of bladder and bowel problems in CP children.

Comparison of Effectiveness of Interferential Therapy and Transcutaneous Electrical Nerve Stimulation in Construction Workers having Cervical Spondylosis Using McGill Pain Questionnaire

Background: Degeneration can occur as a result of moisture loss and decreased flexibility in the neck’s spinal discsover time. Cervical spondylosis can also be brought in addition to recurrent neck motions, prior neck injuries, badposture, and genetic factors and by poor posture.Purpose: The study objective was comparison of the efficiency of interferential therapy and transcutaneouselectrical nerve stimulation in construction workers having cervical spondylosis using the short form of the MCGill pain questionnaire.Methodology: 50 subjects participated in the study from Mars India Builds and selected based on the inclusion andexclusion criteria. Subjects assigned into interferential therapy group (n=25) and transcutaneous electrical nervestimulation group (n=25). Along with this, static neck exercises were given to both groups. The treatment periodwas given for 40 mins and 6 days per week and continued for 2 weeks. The entire study process is conducted fromNovember 2022 to April 2023.Result: From the finding of this study interferential therapy group post-test mean was 8.88 and whereas thetranscutaneous electrical nerve stimulation group was 11.72. This strongly suggests that interferential therapyin construction workers having cervical spondylosis along with static neck exercises is more effective thantranscutaneous electrical nerve stimulation.Conclusion: In this study interferential therapy with static neck exercises among construction workers was foundto be more effective than transcutaneous electrical nerve stimulation.

Compare the Effectiveness of Interferential Therapy with Mckenzie Versus TENS With Mckenzie to Reduce Low Back Pain

Background: Low back pain is not an illness but rather a collection of symptoms that are typically acute and selflimiting.It has an impact on work performance and general wellbeing. The most commonly used modalities ofLBP are Interferential therapy and TENS. Hence this research work is done to check the effectiveness of IFT withMcKenzie and TENS with McKenzie for reducing low back pain.Purpose: To compare the effectiveness of IFT and TENS combined with McKenzie to reduce low back pain.Materials and Methods: 60 subjects were selected based on selection criteria.. The subjects were assessed usingVAS and OSWESTRY Low back pain disability questionnaires . The subjects selected were divided into twogroups. IFT group(n=30) received IFT for 20 minutes per day combined with McKenzie exercises TENS group (n=30) received TENS for 20 minutes per day combined with McKenzie exercises. These interventions were given for4 days per week for 2 weeks. Study period: October 2022 to July 2023.Result: The pretest and posttest values were analyzed and results suggest that the IFT group has significantimprovement when compared with the TENS group with p value &lt;0.0001.Conclusion: The study concludes that the IFT with McKenzie and TENS with McKenzie is effective for patientswith low back pain but IFT with McKenzie seems to be more effective than TENS with McKenzie.

Compare the Effectiveness of Soft Tissue Mobilization and TENS with Stretching Exercises and TENS for Low Back Pain among Online Motorbike Delivery Workers

Background: The majority of the time that drivers are at work is spent seated this causes low back pain inmotorbike riders, motor bike riders were more likely to have Low Back Pain. The workload of each workersdifferent, according to the type of work. Workloads can be mental, physical and social.Purpose: To compare the effectiveness of soft tissue mobilization and TENS with stretching exercises and TENSfor low back pain among online motorbike delivery workers.Materials and Methods: Total of 60 subjects were selected based on the inclusion and exclusion criteria. Thedetailed procedure of the study was explained to the subjects, and the informed consent form was collected. Thesubjects were chosen from A.K.B Physiotherapy and Rehabilitation centre. The pre and post test values weremeasured using the numerical pain rating scale and low back pain rating scale. The subject were allocated in totwo groups soft tissue mobilization and TENS group and stretching exercises and TENS group.The study durationwas 4 weeks. study period:october 2022-june 2023.Result: Statistical analysis of post test result revealed that both the group show similar results but soft tissuemobilization and TENS exceeds the Stretching exercises and TENS statistically with a p value of&lt;0.0001 .Conclusion: Soft tissue mobilization and TENS is more effective than stretching exercises and TENS in reducinglow back pain among online motorbike delivery workers.

The Effectiveness of IASTM Versus Static Stretching in Improving Hamstring Flexibility Along with Quadriceps Strengthening Exercises, Tens in Patients with Osteoarthritis Knee

Background: Osteoarthritis (OA) of the knee is prevalent in the elderly and causes pain, stiffness, and functionallimitations. Hamstring inflexibility and weakened quadriceps worsen OA progression. Hence, Therapeuticinterventions like IASTM and Static Stretching show potential in addressing musculoskeletal issues.Objective: This study aimed to investigate and compare the effectiveness of IASTM versus Static Stretching, alongwith quadriceps strengthening exercises and TENS, in improving hamstring flexibility, and quadriceps strength,and reducing pain in patients with knee OA.Methodology: A randomized controlled trial with 30 knee OA patients: Group A (n=15) received IASTM,quadriceps strengthening exercises, and TENS; Group B (n=15) underwent Static Stretching, quadriceps exercises,and TENS. Both groups underwent a six-week intervention program, with pre-and post-assessments using NPRS,AKE Test, and WOMAC questionnaire.Results: Significant differences were observed between Group A and Group B in NPRS, AKE Test, and WOMACscores (p &lt; 0.0001). Group A exhibited lower values in NPRS, AKE Test, and WOMAC, indicating reduced pain,improved knee function, and decreased discomfort compared to Group B. The combination of interventions inGroup A appeared to offer better outcomes for knee OA patients.Conclusion: The study suggests that the combination of IASTM, quadriceps strengthening exercises, and TENS(Group A) yields better outcomes in improving knee OA patients’ hamstring flexibility, quadriceps strength, andpain reduction compared to Group B.

The Impact of Transcutaneous Electrical Nerve Stimulation (TENS) on Acute Pain and Other Postoperative Outcomes: A Systematic Review with Meta-Analysis.

This study aimed to investigate the efficacy and safety of transcutaneous electrical nerve stimulation (TENS) in postoperative acute pain control. PubMed, Scopus, and Cochrane Library were searched on 1-8 December 2022, for randomized controlled trials on the analgesic effects of TENS. The outcomes were pain intensity and opioid use (primary), and postoperative (PO) adverse events, blood pressure, and the duration of hospital stay (secondary); PROSPERO CRD42022333335. A total of 40 articles were included in the meta-analysis. Pain intensity at rest and during coughing for all types of surgeries combined was lower in the TENS group (standardized mean difference (SMD) = -0.51 [-0.61, -0.41], p < 0.00001, 29 studies, and -1.28 [-2.46, -0.09], p-value = 0.03, six studies, respectively). There was a statistically significant decrease in morphine requirements, as well as in the incidence of postoperative nausea and vomiting, dizziness, and pruritus. There was no difference between the groups in postoperative pain intensity during walking, in blood pressure, and only a borderline difference in the length of hospital stay. The subgroup analysis by surgery type did not show significant differences between the groups in pain severity at rest. Thus, TENS has a potential for pain control and postoperative recovery outcomes.

Reduction of Edema and Pain in Transcutaneous Electrical Nerve Stimulation Treated-Arthritic Rat.

Transcutaneous electrical nerve stimulation (TENS) has been used to reduce pain or improve motor function in musculoskeletal and neurological disorders in the clinic. Although some studies have suggested electrotherapy as an intervention for edema, the effects and mechanisms of TENS on inflammation-induced edema remain unclear. Thus, we aimed to investigate the effects of TENS on arthritic pain with edema. 1% carrageenan was injected into the right tibiofemoral joint of 69 male Sprague-Dawley rats (200-250 g). After the development of arthritic pain, low-frequency (4-Hz, Low-TENS, n = 25) and high-frequency (100-Hz, High-TENS, n = 25) TENS with sub-motor threshold or placebo-TENS (n = 19) was applied for 20-min to medio-lateral part of the ipsilateral side. Weight bearing and knee-bend tests were used to assess pain-like behaviors. Also, we examined the size of edema and measured tumor necrosis factor-alpha (TNF-α) and interleukin-1 beta (IL-1β) levels in the synovium by western blot. Eight rats in each of the two TENS groups were injected with Naloxone. Edema was reduced in the low- and high-frequency TENS groups at 6-h. TENS-treated rats showed reduced pain in the knee-bend test at 6-h. We observed decreased weight load shifts on the ipsilateral side in TENS groups. Naloxone reduced these effects. TNF-α and IL-1β expression decreased in the synovial membrane at 6-h. These results suggest that low- and high-frequency TENS have acutely positive effects on inflammatory edema, with the management of arthritic pain and reduction in pro-inflammatory mediators. Therefore, Low-TENS and High-TENS may be useful in treating acute inflammatory pain and edema.

Effects of Transcutaneous Electrical Nerve Stimulation, Laser Therapy, and Ultrasound in Managing Temporomandibular Disorders: A Randomised Clinical Study

Introduction: Temporomandibular Joint Disorders (TMDs) are considered multifactorial, and several treatment approaches have been proposed for their effective management. The use of non invasive treatment modalities is recommended, which includes Transcutaneous Electric Nerve Stimulation (TENS), Low-Level Laser Therapy (LLLT), acupuncture, ultrasound, and manual therapies. Aim: To evaluate the effectiveness of TENS, LLLT, and ultrasound therapy in patients suffering from TMDs. Materials and Methods: This prospective, randomised clinical trial was conducted on thirty patients (11 males, 19 females) clinically diagnosed with TMD associated with Temporomandibular Joint (TMJ) pain, clicking joint sound, pain in the muscles of mastication, and limited mouth opening. Patients were sequentially randomised into three groups to be treated with TENS, laser beam, and ultrasound therapies, respectively. The Visual Analog Scale (VAS) Score and painfree mouth opening were recorded before, during, and after treatment. Data were analysed using Statistical Package for Social Sciences(SPSS) version 16.0 statistical software. Statistical tests such as the paired sample t-test, Analysis of Variance (ANOVA), and post-hoc Tukey test were performed. Results: There was a significant reduction in the VAS score in the TENS group (3.15), LLLT group (5.75), and ultrasound group (5.50) post-treatment (p&lt;0.001). In addition, improvements in Mean Mouth Opening (MMO) levels were observed with TENS (7.80 mm), LLLT (9.09 mm), and ultrasound therapy (7.15 mm). These differences were found to be statistically significant (p&lt;0.05). The laser and ultrasound groups fared better than the TENS group in the reduction of VAS scores (p&lt;0.05), and there was no significant difference in MMO among the three therapies. Conclusion: Reductions in VAS scores and improvements in mouth opening were noticed in all three groups post-treatment. The laser and ultrasound therapies were more effective in reducing pain compared to TENS therapy. Comparing pretreatment and mid-treatment values, laser beam therapy proved to be more effective in reducing pain scores compared to TENS and ultrasound therapy.

Influence of Transcutaneous Electrical Nerve Stimulation (TENS) on Pressure Pain Thresholds and Conditioned Pain Modulation in a Randomized Controlled Trial in Women With Fibromyalgia

Transcutaneous electrical nerve stimulation (TENS) effectively reduces pain in fibromyalgia (FM). The purpose of this study was to examine the influence of TENS use on pressure pain thresholds (PPT) and conditioned pain modulation (CPM) in individuals with FM using data from the Fibromyalgia Activity Study with TENS trial (NCT01888640). Individuals with FM were randomly assigned to receive active TENS, placebo TENS, or no TENS for 4 weeks. A total of 238 females satisfied the per-protocol analysis among the active TENS (n = 76), placebo TENS (n = 68), and no TENS (n = 94) groups. Following 4 weeks of group allocation, the active TENS group continued for an additional 4 weeks of active TENS totaling 8 weeks (n = 66), the placebo and no TENS groups transitioned to receive 4 weeks of active TENS (delayed TENS, n = 161). Assessment of resting pain, movement-evoked pain (MEP), PPT, and CPM occurred prior to and following active, placebo, or no TENS. There were no significant changes in PPT or CPM among the active TENS, placebo TENS, or no TENS groups after 4 weeks. Individuals who reported clinically relevant improvements in MEP (≥30% decrease) demonstrated increases in PPT (P < .001), but not CPM, when compared to MEP non-responders. There were no significant correlations among the change in PPT or CPM compared to MEP and resting pain following active TENS use (active TENS + delayed TENS). PPT and CPM may provide insight to underlying mechanisms contributing to pain; however, these measures may not relate to self-reported pain symptoms. PerspectivePressure pain threshold increased in individuals with clinically relevant improvement (≥30%) in MEP, indicating the clinical relevance of PPT for understanding mechanisms contributing to pain. CPM was not a reliable indicator of treatment response in MEP responders.

Evaluation of the treatment efficacy of generic enrofloxacin compared to pioneer enrofloxacin for first treatment of naturally occurring bovine respiratory disease in a commercial feedlot

The primary objective of this study was to compare the treatment effectiveness of generic enrofloxacin (Tenotryl™ (enrofloxacin) injectable solution; TEN) to pioneer enrofloxacin (Baytril® 100; BAY) for first treatment of naturally occurring bovine respiratory disease (BRD) on subsequent health outcomes in a commercial feedlot. Five hundred cattle identified with BRD by pen riders with rectal temperature ≥ 104.0°F (40°C) were randomized to TEN or the BAY in a 1:1 ratio within each lot. Cattle treated for BRD were returned to their home pen and monitored for 60 days to observe subsequent health outcomes. Cattle were categorized by type (dairy-beef cross or traditional beef breed). General and generalized linear mixed models were used for statistical analyses. There were no differences in first treatment success (64.29% vs 58.16%; P = 0.19) or case fatality risk (10.97% vs 10.65%; P = 0.91) comparing the TEN group to the BAY group respectively. Traditional beef breed cattle had greater body weight at time of enrollment (890.3 lb vs 749.1 lb; P &lt; 0.01) and greater third treatment success (84.44% vs 41.67%; P &lt; 0.01) compared to the dairy-beef cross cattle. There were no differences in health outcomes in cattle administered Tenotryl compared to Baytril 100 for first treatment of BRD in commercial feedlot cattle. From an efficacy perspective, practitioners should be able to use these products interchangeably based upon the results of the study. Additional research on general animal health outcomes of dairy-beef crosses is needed for the industry.

Clinical efficacy of electroacupuncture-like magnetic therapy compared to conventional transcutaneous electrical nerve stimulation in individuals with carpal tunnel syndrome

This study aimed to evaluate the clinical efficacy of an electroacupuncture-like magnetic therapy (ELMT) and conventional transcutaneous electrical nerve stimulation (TENS) in patients with carpal tunnel syndrome (CTS). A prospective randomized controlled trial in single-centre was conducted. Thirty-four CTS patients confirmed by electrodiagnostic study were randomized into TENS or ELMT group and completed a six-week treatment program. TENS or ELMT treatment was applied on acupuncture point PC-6 (Neiguan) and one selected hand acupoint. Therapeutic exercises were also included after the electrophysical modality. Their physical signs, motor and sensory performances, Boston Carpal Tunnel Questionnaire (BCTQ) scores, and results of electrodiagnostic study were evaluated. After treatments, both groups demonstrated significantly decreased BCTQ scores and positive rate of Tinel’s sign in the major symptomatic side, which indicated improvements in the symptom severity and physical functions. Significant increases in distal sensory amplitude and nerve conduction velocity of the median nerve were only found in the ELMT group. Our study found either conventional TENS or ELMT plus therapeutic exercises could improve the symptomatology and physical provocation sign of CTS. The ELMT has additional improvement in the nerve conduction in patients with CTS.

Comparative Evaluation of Effect of TENS on Controlling Pain Associated with Orthodontic Separator Placement-A Clinical Study.

To assess and contrast the efficacy of transcutaneous electrical nerve stimulation (TENS) therapy and topical anesthetic gel in reducing the level of pain associated with the placement of orthodontic separators. A cohort of 40 individuals, aged between 16 and 20 years, who were in need of fixed orthodontic treatment, was chosen for the study. Elastomeric separators were positioned bilaterally adjacent to the first molars in all participants, who were subsequently separated into two distinct cohorts. Those in group I received topical anesthetic gel, while those in group II underwent TENS therapy. After the placement of separators, the assessment of pain was conducted using the Visual Analog Scale (VAS) at specific intervals: Immediately after placement, 6, 12, 24, and 48 hours. TENS group showed a significantly lower VAS score compared to the local anesthetic gel group at immediate, 6 hours, and 12 hours. Following the placement of elastomeric separators, it was found that TENS was more successful at reducing pain.

Analgesia Using Transcutaneous Electric Nerve Stimulation in Office Bladder Chemodenervation, a Randomized Controlled Trial

Importance Office bladder chemodenervation, performed via cystoscopy with intradetrusor onabotulinumtoxinA (BOTOX) injections, is a common treatment for overactive bladder/urge urinary incontinence. Transcutaneous electric nerve stimulation (TENS) has shown to provide analgesia during office hysteroscopy. Adjuvant analgesia using TENS during bladder chemodenervation has not been studied. Objective The primary outcome is a clinically significant (10-mm) difference in pain visual analog scale (VAS) measurements during injections for chemodenervation using active TENS compared with placebo TENS. We hypothesize that active TENS use will significantly change pain VAS scores. Secondary outcomes include 5-point pain Likert scale, satisfaction 10-point scale, and adverse events. Study Design This was a double-blind randomized control trial of men and women with urinary urge incontinence undergoing office chemodenervation performed in an academic and private setting. Participants were randomized into 2 groups: chemodenervation with active TENS or placebo TENS. Power calculation determined 100 patients would be required detect a difference of 10 mm on pain VAS. Results One hundred one (85 female and 16 male) participants were recruited. No differences were noted in the demographics. Participants in the active TENS group reported a difference of greater than 10 mm in pain VAS scores (48 ± 23 vs 31 ± 23, P = 0.01). Satisfaction index scores were high but no difference was noted between groups (8.6 vs 8.7, P = 0.68). Conclusions Most participants were eligible to use TENS units. Transcutaneous electric nerve stimulation is a safe and noninvasive adjuvant analgesia option for patients undergoing this procedure. Lower pain levels and high satisfaction rates suggest that this is an additional analgesic option during outpatient chemodenervation.

High-frequency, high-intensity transcutaneous electrical nerve stimulation compared with opioids for pain relief after gynecological surgery: a systematic review and meta-analysis.

Opioids are important for postoperative analgesia but their use can be associated with numerous side effects. Transcutaneous electrical nerve stimulation (TENS) has been used for acute pain treatment and has dose-dependent analgesic effects, and therefore presents an alternative to intravenous (iv) opioids for postoperative pain relief. The aim of this meta-analysis was to compare high-frequency, high-intensity (HFHI or intense) TENS to iv opioids with regard to postoperative pain intensity, recovery time in the Post Anesthesia Care Unit (PACU) and opioid consumption after elective gynecological surgery. We searched Medline, Embase, Web of Science, Cochrane, Amed and Cinahl for RCTs and quasi-experimental studies (2010-2022), and WHO and ClinicalTrials.gov for ongoing/unpublished studies. Meta-analysis and subsequent Trial Sequential Analysis (TSA) was performed for all stated outcomes. Quality of evidence was assessed according to GRADE. Only three RCTs met the inclusion criteria (362 participants). The surgical procedures involved surgical abortion, gynecologic laparoscopy and hysteroscopy. The applied TENS frequency was 80 Hz and intensity 40-60 mA. There was no difference in pain intensity according to Visual Analogue Scale (VAS) at discharge from PACU between the TENS and opioid group (MD VAS-0.15, 95 % CI-0.38 to 0.09) (moderate level of evidence). Time in PACU was significantly shorter in the TENS group (MD-15.2, 95 %-22.75 to-7.67), and this finding was manifested by TSA (high-level of evidence). Opioid consumption in PACU was lower in the TENS group (MD Morphine equivalents per patient mg-3.42, 95 %-4.67 to-2.17) (high-level of evidence). There was no detectable difference in postoperative pain relief between HFHI TENS and iv opioids after gynecological surgery. Moreover, HFHI TENS decreases recovery time and opioid consumption in PACU. HFHI TENS may be considered an opioid-sparing alternative for postoperative pain relief after gynecological surgery. PROSPERO CRD42021231048.

Does transcutaneous electrical nerve stimulation reduce the laparoscopic related shoulder pain?

Although laparoscopic surgery is a good substitute for laparotomy in reducing postsurgical pain, many patients complain of shoulder pain after laparoscopic surgery and require pain-relief. Post-operative pain management leads to increased patient satisfaction. Transcutaneous Electrical Nerve Stimulation (TENS) is a non-pharmacological, noninvasive modality that reduces pain by activating the descending inhibitory systems in the central nervous system. Given the importance of decreasing shoulder pain after gynecological laparoscopy, the current study aimed to investigate the management of shoulder pain in these patients using TENS. This was a retrospective case-control study. A total of 112 women aged 18-45 years who experienced shoulder pain due to gynecologic laparoscopic surgery were included in the study. Patients were divided into TENS and control groups. In the TENS group, TENS was used twice for 20 minutes each, but in the control group, the patients received regular treatment. Patients were evaluated at intervals of 2, 4, 8, 24, 48, and 72 hours after laparoscopy for shoulder pain score. The results showed a significant decrease in visual analog scale scores at 2, 4, and 8-hour in the TENS group compared with the control group. At 24 hours evaluation, although the pain was reduced, the difference was not significant. At 48- and 72-hour assessment, all patients in each group reported zero score for severity of pain. The findings suggest that TENS significantly reduces postoperative shoulder pain.

Comparative analysis of photobiomodulation therapy and transcutaneous electrical nerve stimulation for burning mouth: a randomized clinical trial.

To compare the effect of photobiomodulation (PBM) and transcutaneous electrical nerve stimulation (TENS) in the treatment of burning mouth. Randomized clinical trial of 25 patients with burning mouth treated by TENS (n=12) and PBM (n=13). The patients were treated weekly for 8 weeks. Two-factor ANOVA was used to determine whether the two interventions promoted significant differences in symptoms (measured with a visual analogue scale), unstimulated salivary flow, xerostomia, and dysgeusia between T0 (baseline), T1 (after the 4th treatment session), T2 (after the 8th treatment session), and T3 (30 days after the end of treatment). Intragroup comparison of VAS scores for pain showed a significant difference between T0xT1, T0xT2, and T0xT3 in the TENS group and between T0xT2 and T0xT3 in the PBM group (p˂0.001). Intergroup comparison of VAS scores for pain between T2xT3 showed a better response to PBM than to TENS (p=0.003). Patients of the TENS group showed an increase in salivary flow between T1 and T2 (p=0.052). There were no expressive variations in xerostomia or dysgeusia in the two groups analyzed. TENS and PBM were effective in reducing the symptoms of burning mouth during and after treatment. The PBM group showed a better response during follow-up. This clinical trial was registered at http://clinicaltrials.gov (Number: NCT05816200). TENS was found to be a safe and effective therapy for burning mouth. Trial registration number (TRN) and date of registration: This clinical trial was registered at http://clinicaltrials.gov (Number: NCT05816200; date: May 08, 2023).