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Effectiveness of percutaneous electrical nerve stimulation for musculoskeletal pain: A systematic review and meta‐analysis
Author(s) -
PlazaManzano Gustavo,
GómezChiguano Guido F.,
Cleland Joshua A.,
AríasBuría Jose L.,
FernándezdelasPeñas César,
NavarroSantana Marcos J.
Publication year - 2020
Publication title -
european journal of pain
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.305
H-Index - 109
eISSN - 1532-2149
pISSN - 1090-3801
DOI - 10.1002/ejp.1559
Subject(s) - medicine , cinahl , meta analysis , cochrane library , strictly standardized mean difference , physical therapy , transcutaneous electrical nerve stimulation , medline , psychological intervention , randomized controlled trial , web of science , percutaneous , alternative medicine , pathology , psychiatry , political science , law
Background and Objective To evaluate the effects of percutaneous electrical stimulation (PENS) alone or as an adjunct with other interventions on pain and related disability in musculoskeletal pain conditions. Databases and Data Treatment Search of MEDLINE, EMBASE, AMED, CINAHL, EBSCO, PubMed, PEDro, Cochrane Library, SCOPUS and Web of Science databases. Randomized controlled trials where at least one group received any form of PENS for musculoskeletal condition. Studies had to include humans and collect outcomes on pain and related disability in musculoskeletal pain. Risk of bias was assessed by the Cochrane Guidelines, the quality of evidence by using the GRADE approach. Standardized mean differences (SMD) were calculated. Results Sixteen studies were included and included heterogeneous musculoskeletal conditions with short‐ or midterm follow‐ups. PENS alone had a large effect (SMD −1.22, 95% CI −1.66 to −0.79) on pain and a small effect (SMD −0.33, 95% CI −0.61 to −0.06) on related disability at short‐term as compared with sham. A moderate effect of PENS alone (SMD −0.71, 95% CI −1.23 to −0.19) on pain when compared with other interventions was observed. The inclusion of PENS with other interventions had a moderate effect for decreasing pain at short‐ (SMD −0.70, 95% CI −1.02 to −0.37) and midterm (SMD −0.68, 95% CI −1.10 to −0.27). No effect at midterm (SMD −0.21, 95% CI −0.52 to 0.10) on related disability was seen. The risk of bias was generally low; but the heterogenicity of the results downgraded the level of evidence. Conclusion There is low level of evidence suggesting the effects of PENS alone or in combination for pain, but not related disability, in musculoskeletal pain. Level of Evidence Therapy, level 1a. Registration number: CRD42019131331. Significance This meta‐analysis investigating the effectiveness of PENS for the management of pain and related disability in musculoskeletal pain conditions found that PENS could decrease level of pain intensity but not relateddisability in musculoskeletal pain disorders.