TENS - Transcutaneous Electrical Nerve Stimulation for lower back pain relief

TENS unit

TENS - Transcutaneous electrical nerve stimulation is a type of electrotherapy that is used extensively for pain relief in many settings. These devices are popular as they are relatively cheap and easy to use.

 

How does TENS provide pain relief?  

Using electrical impulses to reduce pain  has been around for many years, apparently the ancient Egyptians used to use electric eels to treat headaches. Modern day TENS is a bit less random and works by passing a small electrical signal through electrodes or pads which are attached to the body.  This mild electrical signal has several effects on pain.

  • One theory is that it blocks the pain signals for the affected area to the brain by offering an alternative form of stimulation – counter stimulation – a bit like rubbing a sore area. This fits in with the pain gate theory. 

  • The second theory behind its effectiveness is that it causes the release of endorphins or opiates from the brain, the bodies own naturally occurring pain killers.

There are a variety of settings and electrode placements available for most TNS units, you would need to discuss with your doctor or physical therapist which would be the most effective for you.

There are also a few side effects and contraindications with the use of TENS i.e. you mustn’t use it if you have a pacemakers fitted or are pregnant, it can also interfere with some hearing aids. Check before using it.

Does it help relieve lower back pain?

There is very little decent research to tell us the answer to this question. The most recent serious work was undertaken in 2005 (1) and is a little old now. This study found useful short term improvements with TNS. A major Cochrane review of the literature undertaken in May 2005 (2) found that there was limited or inconsistent evidence to support the use of electrical nerve stimulators in chronic lower back pain. One of the things that makes it so difficult to be sure about whether this works or not is the lack of any decent research trials that have thoroughly investigated it.

However, there is reasonable evidence to support the fact that nerve stimulation influences pain and I would suggest that you try it and see if it works for you. I have certainly met many people who have benefited from it.

The key points to remember are that TENS will not cure your back pain. It may give you some pain relief which hopefully will help you get more active (we know that activity is the best way to handle lower back pain), help you sleep better, and hopefully help you feel less worried about the problem – all of that  will help you recover from your back problem.

References

1.Transcutaneous electrical nerve stimulation for short-term treatment of low back pain - Randomised double blind crossover study of sham versus conventional TENS. Jarzem-P-F, Harvey-E-J, Arcaro-N, Kaczorowski-J.
Journal of Musculoskeletal Pain 2005, Vol/Iss / 13/2

2. Transcutaneous electrical nerve stimulation for chronic low-back pain
A Khadilkar, S Milne, L Brosseau, V Robinson, M Saginur, B Shea, P Tugwell, G Wells (Date of Most Recent Substantive Amendment: 24 May 2005)

Lower Back Pain Toolkit Home Page

24-Sep-2012