Tell us something most of us don't know. TENS unit not effective for chronic back pain.

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Jim1969
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Date Joined Jul 2009
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   Posted 12/30/2009 5:27 PM (GMT -7)   
[quote=WEB MD]Dec. 30, 2009 -- A widely used, somewhat controversial treatment for chronic low back pain is not effective and cannot be recommended, the American Academy of Neurology (AAN) now says.

Transcutaneous electric nerve stimulation, or TENS, is a pocket-sized, battery-operated device that sends electric currents to the nerves via electrodes with the goal of treating pain.

TENS has been used for pain relief for four decades, but studies evaluating its effectiveness have been mixed.

A review of the available research assessing the use of TENS for pain led to the newly published recommendation against its use for chronic low back pain, says neurologist and guideline co-author Richard M. Dubinsky, MD, MPH, of Kansas University Medical Center.


www.webmd.com/back-pain/news/20091230/tens-gets-thumbs-down-as-back-pain-treatment

What are they going to tell us next? Aspirin doesn't do any good for chronic pain either.
2 confirmed herniated lumbar discs. Spinal Arthritis. Spinal Stenosis, diabetic peripheral nueropathy.


White Beard
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Date Joined Feb 2009
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   Posted 12/30/2009 9:52 PM (GMT -7)   
I put my TENS unit away in the closet years and years and years ago! It never did any thing for me except shock me! I used to have and old bag phone, before the newer cell phones they use now, and in the car if I had the TENS unit on and the bag phone rang, the electrodes on my back would shock the daylights out of me! I also found that before I was put on disability and I was working on my unit at the hospital that if I had a patient on heart telemetry and the alarm went off I and I was wearing the TENS unit that would also shock the heck out of me! I couldn't keep the electrodes on anyway, and I am alergic to most adhesives tapes. It was just more of a problem than it was worth! Anyway this news does not surprise me about the TENS !! I never really thought it done much anyway!


White Beard

straydog
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Date Joined Feb 2003
Total Posts : 13481
   Posted 12/31/2009 1:22 PM (GMT -7)   
Under did you say might need. My gawd after what he did to you whether he refills the meds or not the best thing you can do is find a new dr. Why in the world would you stay with him after the crap he has pulled on you? You can bet if you stay with him you will be in constant fear every time you are due a refill as to whether you get one or not. Sorry, not trying to be so abrupt, but life is too short for that kind of misery.

straydog
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   Posted 12/31/2009 1:23 PM (GMT -7)   
Oops forgot, my Tens Unit does help with the muscle spasms, I guess its just a freak thing but I always got some relief with mine. I know a few others that they have helped too.

Jim1969
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Date Joined Jul 2009
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   Posted 12/31/2009 3:12 PM (GMT -7)   
I have had TENS therapy several times for pulled/strained back muscles and it was wonderful for that, but even though the pain I had from the pulled muscles lasted for 1-3 weeks I would still view that as an acute case. Also many people I know who have back pain that was caused by the muscles had good luck with TENS. It is the ones with bad discs, arthritis, stenonsis, etc that it didn't do much for.

I can understand wanted to try TENS therapy on other types of back pain but IMHO it is pathetic that it has taken this long to say "Hey!!! It don't work in most if not all cases of chronic back pain" which is something people have been saying for years.

Now if they would only take a better look at the various types of injections done and see exactly what the success rate is for the various conditions it is used on maybe there will be one less treatment we won't have to waste our time with.
2 confirmed herniated lumbar discs. Spinal Arthritis. Spinal Stenosis, diabetic peripheral nueropathy.


White Beard
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Date Joined Feb 2009
Total Posts : 3611
   Posted 12/31/2009 3:55 PM (GMT -7)   
You know Jim I could see TENS helping strained muscles and the like, but if your pain is caused by nerve root impingement such as from a herniated disk or bone spurs, even most oral pain med don't even knock out that pain unless you take enough to know you out all together! And I know for me it just made my muscle spasms worse! But again everyone is different!

underthebus I am with you about the implanted stimulator, the VA wanted to implant one back in the late 90's and at that time they had some issues with the wires and electrodes actually breaking, and considering the luck I had had with the TENS I just said "NO WAY!" I would not have that put into me! A couple of years ago my current PM mentioned the possibility of trying it, but it was agreed I had to many areas in my spine causing me problems to effectively use one of these devices! I do think Straydog is right after the way your PM has treated you, I would definitely be looking for a new one that really cares about you as a person! They can be rare but they are out there!

Good Luck!


White Beard

Mrs. Dani
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Date Joined Jun 2009
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   Posted 12/31/2009 7:47 PM (GMT -7)   
 
   

AAN.com: Briefly summarize your conclusions regarding the efficacy of TENS for pain in neurological conditions.

Dubinsky: TENS was found to be of no benefit for people with chronic low back pain. However, people with diabetic neuropathy received some benefit from therapy with TENS.

AAN.com: What was the motivation of the Technology and Therapeutics Assessment (TTA) Subcommittee for assessing TENS?

Dubinsky: We sought to address the lack of any evidence-based guidelines on the utility of TENS for neurologic conditions.

 
 
 
 
 
Published online before print December 30, 2009
(Neurology 2009, doi:10.1212/WNL.0b013e3181c918fc)
 Received July 13, 2009
Accepted October 19, 2009

 

Assessment: Efficacy of transcutaneous electric nerve stimulation in the treatment of pain in neurologic disorders (an evidence-based review). Report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology

Richard M. Dubinsky MD, MPH, FAAN and Janis Miyasaki MD, MEd, FAAN

From the Department of Neurology (R.M.D.), University of Kansas Medical Center, Kansas City, KS; and Toronto Western Hospital (J.M.), Toronto, Ontario, Canada.


Objective: To determine if transcutaneous electric nerve stimulation (TENS) is efficacious in the treatment of pain in neurologic disorders.

Methods: We performed a systematic literature search of Medline and the Cochrane Library from inception to April 2009.

Results: There are conflicting reports of TENS compared to sham TENS in the treatment of chronic low back pain, with 2 Class II studies showing benefit, but 2 Class I studies and another Class II study not showing benefit. Because the Class I studies are stronger evidence, TENS is established as ineffective for the treatment of chronic low back pain (2 Class I studies). TENS is probably effective in treating painful diabetic neuropathy (2 Class II studies).

Recommendations: Transcutaneous electric nerve stimulation (TENS) is not recommended for the treatment of chronic low back pain (Level A). TENS should be considered in the treatment of painful diabetic neuropathy (Level B). Further research into the mechanism of action of TENS is needed, as well as more rigorous studies for determination of efficacy.

 

~~> " http://www.neurology.org/cgi/content/abstract/WNL.0b013e3181c918fcv1

 

     I read all the information I could reguarding the Class1 research done. It is very intresting, and I too believe that more research is needed. I do not know any chronic low back pain patients that use a TeNS unit as their SOLE means of pain control. In all those I have met thus far it "seems" TeNS unit is used in conjuction with other pain relief methods.

     ....Now, I have and use a TeNS 3x per day. It is but one small part of a rather large pain management program. I do realize that being a young lady with rapidly progressing spinal deformity with extensive bone loss does present rather unique set of circumstances... I firmly believe that each persons "pain" is unique and as such the methods of treatment should be tailored to the needs of the individual patient. If the patient has a safe, effective method for treating their pain (even palliative care) then by all means use the tools that you have at your disposal.

        My pain management consists of Cognitive behavioural therapy, biofeedback, Modified physical therapy, TeNS (in conjuction with "wet" heat heating pad), Tricyclic antidepressant, opioid analgesic, NSAID (arylalkanoic), and Steroid Injections.

     I am not a candidate for ANY other types of pain relief at this time due to my specific set of circumstances. But, each aspect of my "pain management" creates a "whole" that *I* need to function.

     All pain is unique, and my pain management is tailored to my specific needs. I use what works for me. I am a mother of 2 very small children and have no family to speak of other than my husbands family in florida. So, the "goal" in my case is to restore "quality" of life so that I may "live".

     I say it all the time, and this is no exception. "Use what works for you." I once met a lady who used different colors of light and specific "scented oils" to help relieve her mild, yet chronic pain..... Hey! If it works (and your doctor(s) give a thumbs up) smilewinkgrin  go for it!

 smile

dani


 

 

Two roads diverged in a yellow wood,
And sorry I could not travel both
And be one traveler, long I stood

 

 


Chartreux
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Date Joined Aug 2006
Total Posts : 9622
   Posted 12/31/2009 9:08 PM (GMT -7)   
I have to agree with Dani, in that if used with a moist heat pad it can help...I've never used a tens unit without my moist heating pad so maybe further studies need to be done and with a bigger study group...
so count me as impartial on this til further studies are done..
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Enlarged Pituitary Gland, Sjogren's, Ocular Migraines, mild carpel tunnel, ect.... "Would be nice if we could use the edit button in real life"...

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straydog
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Date Joined Feb 2003
Total Posts : 13481
   Posted 12/31/2009 9:27 PM (GMT -7)   
Very well said Dani. You are so right, everyone's pain is unique and each must have a program designed to help that person. Its when we all get lumped together in one category we run into trouble.
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