Evidence map›Paper›PMID 40709052›Full record

ArticleFrontiers in pain research (Lausanne, Switzerland)2025

Preventing opioid prescribing for low back pain using multimodal mechanical stimulation vs. TENS: a randomized-controlled trial.

Amy L Baxter, Jena L Etnoyer-Slaski, Jessica Allia Rice Williams, Kevin Swartout, Lindsey L Cohen, M Louise Lawson

Registry-linked trialAbstract read
In one paragraph

Article in Frontiers in pain research (Lausanne, Switzerland), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04491175 (Addressing Opioid Use Disorder With an External Multimodal Neuromodulation Device), which is not on this map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
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.

NCT04491175 nacompletednot on this map

Addressing Opioid Use Disorder With an External Multimodal Neuromodulation Device: Development and Clinical Evaluation of DuoTherm for Opioid-Sparing Pain Relief in Acute and Chronic Low Back Pain

TypeinterventionalSponsorMMJ Labs LLCRan2022 to 2025Enrolled160ConditionsOpioid Use, Low Back PainArmsM-Stim, TENS
3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Amy L BaxterDepartment of Emergency Medicine, Augusta University, Augusta GA, United States.
Jena L Etnoyer-SlaskiKaizo Clinical Research Institute, Landover, MD, United States.
Jessica Allia Rice WilliamsDepartment of Health Policy and Administration, Penn State College, University Park, PA, United States.
Kevin SwartoutDepartment of Psychology, Georgia State University, Atlanta, GA, United States.
Lindsey L CohenDepartment of Psychology, Georgia State University, Atlanta, GA, United States.
M Louise LawsonDepartment of Statistics and Analytical Sciences, Kennesaw State University, Kennesaw, GA, United States.

Funding

Addressing Opioid Use Disorder with an External Multimodal Neuromodulation Device: Development and Clinical Evaluation of DuoTherm for Opioid-Sparing in Acute and Chronic Low Back Pain.R44DA049631 · NIDA · MMJ LABS, LLC · PI BAXTER, AMY LYNN · 2019 to 2023
$1.8M
Creation and Validation of the Dose-Opioid-Source Evaluation tool (DOSE) - a Robust Opioid Use Clinical Outcome Assessment for Qualification as an FDA Medical Device Development Tool (MDDT)R44DA058952 · NIDA · MMJ LABS, LLC · PI Amy Lynn Baxter, Traci J Speed · 2023 to 2026
$962k
NIDA NIH HHS R44 DA049631NIDA NIH HHS R44 DA058952
6 · The paper itself

Abstract

Background: Low back pain (LBP) is the most common reason for outpatient opioid prescribing: a quarter of patients receive prescriptions, leading to opioid use disorder (OUD) in 5%. Guideline-recommended multimodal interventions often face implementation barriers, and effective modalities (e.g., electrical stimulation) lack coverage. A multimodal mechanical stimulation (M-Stim) device for LBP has demonstrated safety and efficacy in pain reduction, but its impact on opioid use has not yet been determined. Methods: As part of an NIH-funded double-blind study to reduce pain and opioid use, patients with moderate-to-severe LBP presenting to two suburban chiropractic centers were randomized to receive either the M-Stim device or a transcutaneous electrical nerve stimulation (TENS) unit for 30 min daily, in addition to other therapies. Analgesic use was reported daily for 28 days, with new prescribing followed weekly for 3 months. The primary outcome was prescribing in the opioid-naïve subjects. Secondary endpoints included risk factors for prolonged use in the opioid-naïve subjects, milligram morphine equivalents (MME) for opioid users between the first and last 2 weeks, and prescribing compared with national rates. Results: After informed consent, 159 eligible patients were randomized to M-Stim (87) or TENS (72) (mean age 42.6 years, 54% female, BMI 30.9, NRS 5.5) between 23 June 2022 and 31 December 2023. Zero opioid-naïve M-Stim participants ( Conclusions: Among chiropractic patients with moderate-to-severe LBP, added use of a multimodal M-Stim device in the opioid-naïve subjects significantly reduced factors associated with OUD compared with TENS and reduced use days for those with BMI ≥30. This novel device is a potential alternative to prescribing opioids as first line for LBP management. Clinical Trial Registration: https://clinicaltrials.gov/study/NCT04491175, identifier NCT04491175.

Indexed as

DuoThermfocal vibrationlow back painM-StimmultifidusopioidTENS

Identifiers

PMID40709052
PMCPMC12287057

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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.