Transcutaneous electrical nerve stimulation and heat to reduce pain in a chronic low back pain population: a randomized controlled clinical trial

Lynn Leemans; Ömer Elma; Jo Nijs; Timothy H Wideman; Carolie Siffain; Hester den Bandt; Sven Van Laere; David Beckwée

doi:10.1016/j.bjpt.2020.04.001

Transcutaneous electrical nerve stimulation and heat to reduce pain in a chronic low back pain population: a randomized controlled clinical trial

Braz J Phys Ther. 2021 Jan-Feb;25(1):86-96. doi: 10.1016/j.bjpt.2020.04.001. Epub 2020 May 12.

Authors

Lynn Leemans¹, Ömer Elma², Jo Nijs³, Timothy H Wideman⁴, Carolie Siffain⁵, Hester den Bandt⁶, Sven Van Laere⁷, David Beckwée⁸

Affiliations

¹ Rehabilitation Research Department, Vrije Universiteit Brussel, Brussels, Belgium; Pain in Motion International Research Group, Belgium. Electronic address: Lynn.Leemans@vub.be.
² Pain in Motion International Research Group, Belgium.
³ Pain in Motion International Research Group, Belgium; Department of Physical Medicine and Physiotherapy, University Hospital Brussels, Belgium.
⁴ School of Physical and Occupational Therapy, McGill University, Canada.
⁵ Rehabilitation Research Department, Vrije Universiteit Brussel, Brussels, Belgium; Pain in Motion International Research Group, Belgium.
⁶ Pain in Motion International Research Group, Belgium; Department of Physiotherapy, University of Applied Sciences Rotterdam, Rotterdam, The Netherlands.
⁷ Interfaculty Center Data Processing and Statistics, Vrije Universiteit Brussel, Belgium.
⁸ Rehabilitation Research Department, Vrije Universiteit Brussel, Brussels, Belgium; Frailty in Ageing Research Department, Vrije Universiteit Brussel, Brussels, Belgium; Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Belgium.

Abstract

Background: Low back pain is the leading cause of disability worldwide. The therapeutic management of patients with chronic LBP is challenging.

Objectives: The aim of this study is to evaluate the effects of heat and transcutaneous electrical nerve stimulation combined on pain relief in participants with chronic low back pain.

Methods: Fifty participants with chronic (≥3 months) low back pain were randomly assigned to two groups: HeatTens (n=25) and control group (n=25). Primary outcome was pain. Secondary outcomes were pressure pain thresholds, temporal summation, conditioned pain modulation, fear-avoidance and beliefs questionnaire, central sensitization inventory, quality of life, and medication use. The control group received no treatment and continued usual care. After four weeks of treatment, all measurements were repeated.

Results: Fifty individuals participated in this study. Significant higher pressure pain threshold measures after both 30min and 4 weeks for the lower back region and the second plantar toe were found only in the experimental group.

Conclusion: The combination of heat and transcutaneous electrical nerve stimulation does not reduce pain scores in patients with chronic low back pain. Pressure pain threshold values significantly improved, showing beneficial effects of the experimental treatment. ClinicalTrials.gov: NCT03643731 (https://clinicaltrials.gov/ct2/show/NCT03643731).

Keywords: Chronic pain; Low back pain; Movement-evoked pain; Musculoskeletal pain; TENS.

Publication types

Randomized Controlled Trial

MeSH terms

Central Nervous System Sensitization
Chronic Pain / therapy*
Disabled Persons
Hot Temperature
Humans
Low Back Pain / therapy*
Pain Management
Pain Threshold
Quality of Life
Transcutaneous Electric Nerve Stimulation

Associated data

ClinicalTrials.gov/NCT03643731