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Outcome of a High‐Frequency Transcutaneous Electrical Nerve Stimulator (hfTENS) Device for Low Back Pain: A Randomized Controlled Trial
Author(s) -
Jamison Robert N.,
Wan Limeng,
Edwards Robert R.,
Mei Anna,
Ross Edgar L.
Publication year - 2019
Publication title -
pain practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.899
H-Index - 58
eISSN - 1533-2500
pISSN - 1530-7085
DOI - 10.1111/papr.12764
Subject(s) - medicine , transcutaneous electrical nerve stimulation , physical therapy , randomized controlled trial , anxiety , pain catastrophizing , randomization , low back pain , depression (economics) , chronic pain , anesthesia , surgery , alternative medicine , pathology , psychiatry , economics , macroeconomics
Objective This controlled trial examined the benefit of a high‐frequency transcutaneous electrical nerve stimulation (hfTENS) device (the Quell, NeuroMetrix, Inc., Waltham, MA, U.S.A.) for patients with chronic low back pain (CLBP). Methods Thirty‐five ( n = 35) participants were randomly assigned to use the device each day for 3 months (experimental group) and were compared with 33 subjects without the device (treatment‐as‐usual control group). All patients were instructed to complete baseline questionnaires and were assessed on thresholds of pressure pain and mechanical temporal summation as part of standardized quantitative sensory testing (QST). The subjects also uploaded smartphone applications (apps) for tracking use of the hfTENS and for daily pain assessment. Each participant completed weekly phone interviews, was prompted to complete daily pain app assessments, and was asked to repeat the baseline questionnaires again after 6 weeks and 3 months. Results Sixty percent of the subjects were female, 77.9% were Caucasian, and the average age was 46.2 years. Significant reductions in pain intensity ( P < 0.01) and activity interference ( P < 0.025) and significant improvements in pain catastrophizing ( P < 0.025) were noted in the experimental group compared with the control group. No group differences were found on depression, anxiety, or pain‐related disability. Older subjects with a longer duration of pain tended to use the hfTENS more often. Subjects who showed greater sensitivity based on QST results revealed increased use of the hfTENS ( P < 0.025) and tended to believe that the hfTENS was more helpful in reducing their back pain, but these findings did not reach significance ( P = 0.09). Conclusion These results suggest that hfTENS can have a moderate effect in reducing pain and improving quality of life in low back pain patients. Further trials designed to determine the mechanism of action of the hfTENS are needed.