Evidence map›Paper›PMID 23641031›Full record

ArticlePhysical therapy2013

What makes transcutaneous electrical nerve stimulation work? Making sense of the mixed results in the clinical literature.

Kathleen A Sluka, Jan M Bjordal, Serge Marchand, Barbara A Rakel

3 registry-linked trialsOpen access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Physical therapy, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 97 papers, 18 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
97citing papers in PubMed, 18 pooled it
10.4field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03912493 naunknown statusnot on this mapstarted 2020, after this paper: background citation

The Effectiveness of Game-Based Virtual Reality Approach in Patients With Subacromial Impingement Syndrome

TypeinterventionalSponsorMarmara UniversityRan2020 to 2020Enrolled40ConditionsShoulder Impingement Syndrome, Virtual Reality, Rehabilitation, Subacromial Impingement SyndromeArmsGame Based Virtual Reality Exercises, Conventional Physiotherapy and Rehabilitation
NCT03992820 naterminatednot on this mapstarted 2019, after this paper: background citation

The Efficacy of Transcutaneous Electrical Nerve Stimulation Versus Local Anaesthetic Cream in Alleviating the Pain of Local Anaesthetic Injections in Adults - A Randomised Controlled Trial

TypeinterventionalSponsorUniversity Hospitals, LeicesterRan2019 to 2020Enrolled8ConditionsDonor Site Complication, Skin GraftArmsTENS machine, EMLA cream
NCT05348005 nacompletednot on this mapstarted 2022, after this paper: background citation

Study of the Use of Transcutaneous Electrical Nerve Stimulation Unit in the Management of Endometriosis Pain

TypeinterventionalSponsorMilton S. Hershey Medical CenterRan2022 to 2025Enrolled40ConditionsEndometriosis, Pelvic PainArmsOvira Transcutaneous Electrical Nerve Stimulation Unit
3 · Its place in the literature

Who cites it

97 citing papers in PubMed, 18 syntheses or guidelines pooled it, 192 citations in OpenAlex.

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  10. Transcutaneous electrical nerve stimulation (TENS) for chronic neck pain.The Cochrane database of systematic reviews · 2019
    Pooled it
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  17. Transcutaneous electrical nerve stimulation for acute pain.The Cochrane database of systematic reviews · 2015
    Pooled it
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  19. Effects of Using High-Frequency TENS During an Exercise Therapy Program in Knee Osteoarthritis: A Randomized Sham-Controlled Trial.Physiotherapy research international : the journal for researchers and clinicians in physical therapy · 2026
    Trial
  20. Trial

37 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

4 authors at 1 institution in 1 country.

Kathleen A SlukaK.A. Sluka, PT, PhD, FAPTA, Department of Physical Therapy and Rehabilitation Science, College of Medicine, College of Nursing, Pain Research Program, University of Iowa, 100 Medical Education Bldg, #1-252, Iowa City, IA 52242 (USA).
Jan M Bjordal
Serge Marchand
Barbara A Rakel
University of Bergen · NO

Funding

Fibromyalgia Activity Study with TENS "FAST"UM1AR063381 · NIAMS · UNIVERSITY OF IOWA · PI CROFFORD, LESLIE J, SLUKA, KATHLEEN A · 2013 to 2017
$3.4M
Central Mechanisms involved in the interactions between muscle pain and exerciseR01AR061371 · NIAMS · UNIVERSITY OF IOWA · PI SLUKA, KATHLEEN A · 2012 to 2016
$2.3M
Effectiveness of TENS on Hyperalgesia, Pain with Movement, and Function After TKRR01NR009844 · NINR · UNIVERSITY OF IOWA · PI RAKEL, BARBARA · 2007 to 2010
$1.9M
Central contributions to pathobiology of fibromyalgiaR01AR052316 · NIAMS · UNIVERSITY OF IOWA · PI SLUKA, KATHLEEN A · 2005 to 2009
$1.5M
Effectiveness of TENS on FibromyalgiaR34AR060278 · NIAMS · UNIVERSITY OF IOWA · PI SLUKA, KATHLEEN A · 2011 to 2011
$162k
NIAMS NIH HHS AR052316NIAMS NIH HHS AR061371NIAMS NIH HHS AR063381NIAMS NIH HHS R01 AR052316NIAMS NIH HHS R01 AR061371NIAMS NIH HHS R34 AR060278NIAMS NIH HHS UM1 AR063381NINR NIH HHS NR009844NINR NIH HHS R01 NR009844
6 · The paper itself

Abstract

Transcutaneous electrical nerve stimulation (TENS) is a nonpharmacological treatment for control of pain. It has come under much scrutiny lately with the Center for Medicare Services rendering a recent decision stating that "TENS is not reasonable and necessary for the treatment of CLBP [chronic low back pain]." When reading and analyzing the existing literature for which systematic reviews show that TENS is inconclusive or ineffective, it is clear that a number of variables related to TENS application have not been considered. Although many of the trials were designed with the highest of standards, recent evidence suggests that factors related to TENS application need to be considered in an assessment of efficacy. These factors include dosing of TENS, negative interactions with long-term opioid use, the population and outcome assessed, timing of outcome measurement, and comparison groups. The purpose of this perspective is to highlight and interpret recent evidence to help improve the design of clinical trials and the efficacy of TENS in the clinical setting.

Indexed as

Transcutaneous Electric Nerve StimulationAnalgesics, OpioidChronic PainClinical Trials as TopicHumansLow Back PainOutcome Assessment, Health CarePatient SelectionPlacebosResearch DesignTime FactorsAnalgesics, OpioidPlacebos

Identifiers

PMID23641031
PMCPMC3788712
OpenAlexW2121405554

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.