SynthesisEuropean journal of pain (London, England)2026
Dose-Response Effects of Transcutaneous Electrical Nerve Stimulation for Chronic Low Back Pain: A Systematic Review and Meta-Analysis.
Synthesis in European journal of pain (London, England), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled 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.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
2 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Dose-Response Effects of Transcutaneous Electrical Nerve Stimulation for Chronic Low Back Pain: A Systematic Review and Meta-Analysis.European journal of pain (London, England) · 2026Pooled it
- Electromagnetic neuromodulation for chronic pain: historical context, contemporary modalities, and evidence gaps.Frontiers in pain research (Lausanne, Switzerland) · 2026Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
Abstract
backgroundTranscutaneous electrical nerve stimulation (TENS) is a widely used non-pharmacological method for pain management, though its effectiveness in individuals with chronic low back pain (CLBP) is uncertain. Previous studies and systematic reviews have not systematically analysed the influence of TENS dosing parameters on treatment outcomes.
objectivesTo assess the impact of TENS on pain relief in individuals with CLBP and to explore the dose-dependent effects of TENS parameters on pain relief.
methodsA systematic review and meta-analysis was conducted following PROSPERO registration. Searches were performed in PubMed, Cochrane and Scopus databases. A total of 29 studies out of 1162 screened were included. Study quality was assessed using the PEDro scale and RoB-2 tool. Meta-analyses using random- and mixed-effects models were conducted.
resultsThe initial random-effects model showed no significant effect of TENS on pain (d
conclusionsTENS can reduce pain in individuals with CLBP when delivered at a sensory-level intensity that is clearly perceptible and titrated throughout the session. Fixed intensity and stimulation strong enough to elicit muscle contractions are generally not recommended. These findings support the relevance of dosing in optimising TENS effectiveness. Overall, the certainty of evidence appears low due to the high risk of bias and substantial heterogeneity. SIGNIFICANCE STATEMENT: This meta-analysis provides a comprehensive synthesis of the evidence on transcutaneous electrical nerve stimulation (TENS) for pain relief in chronic low back pain (CLBP), with a specific focus on the role of stimulation parameters as sources of heterogeneity. By systematically examining dose-related characteristics, particularly stimulation intensity, this work helps clarify why previous reviews have reported inconsistent findings. The results suggest that inadequate dosing may obscure potential analgesic effects, highlighting the importance of parameter reporting and implementation when interpreting existing trials. Overall, this review offers a clinically and methodologically relevant framework to inform the design of future high-quality trials and to guide more nuanced evaluation of TENS within multimodal CLBP management.
trial registrationPROSPERO: CRD42023468176.
Indexed as
Identifiers
What OpenQuestion holds
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.