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DOI: 10.1055/s-0035-1566735
Do the Effects of Transcutaneous Electrical Nerve Stimulation on Knee Osteoarthritis Pain and Function Last?
Publication History
21 April 2015
20 September 2015
Publication Date:
05 November 2015 (online)
![](https://www.thieme-connect.de/media/jks/201606/lookinside/thumbnails/10-1055-s-0035-1566735_150030oa-1.jpg)
Abstract
Transcutaneous electrical nerve stimulation (TENS) has been shown to decrease pain associated with knee osteoarthritis, which potentially leads to better function, improved quality of life, and postpones the need for surgical intervention. The purpose of this study was to perform a 1-year follow-up of a previous prospective group of patients with knee osteoarthritis, randomized to TENS or standard of care, who were asked to rate their changes in: (1) patient pain perception; (2) subjective medication use; (3) subjective functional abilities; (4) quality of life; (5) device use; and (6) conversion to TKA. A population of 70 patients were randomized to receive either a TENS device or a standard conservative therapy regimen. Patients were evaluated based on various subjective outcomes at minimum 1-year (mean, 19 months) follow-up. The TENS cohort had lower visual analog pain scores compared with the matching cohort. Subjective functional outcomes, as well as functional and activity scores, were also greater in the TENS cohort. Patients in TENS cohort showed significant improvements in their subjective and functional outcomes as compared with their initial status, while the control group did not show significant change. A majority of the TENS patients were able to reduce the amount of pain medications. Additionally, a large portion of the patients assigned to the TENS group continue to use the device, after completion of the trial. This study demonstrated the benefit of TENS for improving subjective outcomes in patients with pain due to knee osteoarthritis, compared with standard conservative treatments. The results of the study suggest that TENS is a safe and effective adjunct as part of the spectrum of current nonoperative treatment methods for knee osteoarthritis.
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References
- 1 Suri P, Morgenroth DC, Hunter DJ. Epidemiology of osteoarthritis and associated comorbidities. PM R 2012; 4 (5, Suppl): S10-S19
- 2 Braden JB, Fan MY, Edlund MJ, Martin BC, DeVries A, Sullivan MD. Trends in use of opioids by noncancer pain type 2000-2005 among Arkansas Medicaid and HealthCore enrollees: results from the TROUP study. J Pain 2008; 9 (11) 1026-1035
- 3 Edlund MJ, Martin BC, Devries A, Fan MY, Braden JB, Sullivan MD. Trends in use of opioids for chronic noncancer pain among individuals with mental health and substance use disorders: the TROUP study. Clin J Pain 2010; 26 (1) 1-8
- 4 Edlund MJ, Martin BC, Fan MY, Braden JB, Devries A, Sullivan MD. An analysis of heavy utilizers of opioids for chronic noncancer pain in the TROUP study. J Pain Symptom Manage 2010; 40 (2) 279-289
- 5 Edlund MJ, Martin BC, Fan MY, Devries A, Braden JB, Sullivan MD. Risks for opioid abuse and dependence among recipients of chronic opioid therapy: results from the TROUP study. Drug Alcohol Depend 2010; 112 (1–2) 90-98
- 6 Sullivan MD, Howe CQ. Opioid therapy for chronic pain in the United States: promises and perils. Pain 2013; 154 (Suppl. 01) S94-S100
- 7 Manchikanti L, Abdi S, Atluri S , et al; American Society of Interventional Pain Physicians. American Society of Interventional Pain Physicians (ASIPP) guidelines for responsible opioid prescribing in chronic non-cancer pain: Part I—evidence assessment. Pain Physician 2012; 15 (3, Suppl): S1-S65
- 8 Gaffney K, Ledingham J, Perry JD. Intra-articular triamcinolone hexacetonide in knee osteoarthritis: factors influencing the clinical response. Ann Rheum Dis 1995; 54 (5) 379-381
- 9 Herzog JL, Solomon JA, Draelos Z , et al. A randomized, double-blind, vehicle-controlled crossover study to determine the anti-pruritic efficacy, safety and local dermal tolerability of a topical formulation (srd174 cream) of the long-acting opiod antagonist nalmefene in subjects with atopic dermatitis. J Drugs Dermatol 2011; 10 (8) 853-860
- 10 Anastassopoulos KP, Chow W, Tapia CI , et al. Economic study on the impact of side effects in patients taking oxycodone controlled-release for noncancer pain. J Manag Care Pharm 2012; 18 (8) 615-626
- 11 Mota RE, Tarricone R, Ciani O, Bridges JF, Drummond M. Determinants of demand for total hip and knee arthroplasty: a systematic literature review. BMC Health Serv Res 2012; 12: 225
- 12 Liebano RE, Rakel B, Vance CG, Walsh DM, Sluka KA. An investigation of the development of analgesic tolerance to TENS in humans. Pain 2011; 152 (2) 335-342
- 13 Philadelphia Panel. Philadelphia Panel evidence-based clinical practice guidelines on selected rehabilitation interventions for knee pain. Phys Ther 2001; 81 (10) 1675-1700
- 14 Kellgren JH, Lawrence JS. Radiological assessment of osteo-arthrosis. Ann Rheum Dis 1957; 16 (4) 494-502
- 15 Scuderi GR, Bourne RB, Noble PC, Benjamin JB, Lonner JH, Scott WN. The new Knee Society Knee Scoring System. Clin Orthop Relat Res 2012; 470 (1) 3-19
- 16 Clark HD, Wells GA, Huët C , et al. Assessing the quality of randomized trials: reliability of the Jadad scale. Control Clin Trials 1999; 20 (5) 448-452
- 17 Jensen H, Zesler R, Christensen T. Transcutaneous electrical nerve stimulation (TNS) for painful osteoarthrosis of the knee. Int J Rehabil Res 1991; 14 (4) 356-358
- 18 Lewis D, Lewis B, Sturrock RD. Transcutaneous electrical nerve stimulation in osteoarthrosis: a therapeutic alternative?. Ann Rheum Dis 1984; 43 (1) 47-49
- 19 Palmer S, Domaille M, Cramp F , et al. Transcutaneous electrical nerve stimulation as an adjunct to education and exercise for knee osteoarthritis: a randomized controlled trial. Arthritis Care Res (Hoboken) 2014; 66 (3) 387-394
- 20 Law PP, Cheing GL, Tsui AY. Does transcutaneous electrical nerve stimulation improve the physical performance of people with knee osteoarthritis?. J Clin Rheumatol 2004; 10 (6) 295-299
- 21 Nnoaham KE, Kumbang J. Transcutaneous electrical nerve stimulation (TENS) for chronic pain. Cochrane Database Syst Rev 2008; (3) CD003222