TENS Efficacy on Acute Back Pain in an Emergency Department Triage
Condition: Acute Back Injury
MeSH terms: Back Pain; Emergencies; Back Injuries
Study type: Interventional

Summary: 
      Transcutaneous Electrical Nerve Stimulation (TENS) devices produce a gentle electrical
      stimulation that when applied through pads applied directly to the skin, has a noticeable
      effect in reducing pain associated with various types of injuries and ailments. Several
      recent studies have shown efficacy when used for acute pain specific to primary dysmenorrhea,
      renal colic, lower-extremity pain, and pain associated with spinal cord injury, and was
      achieved without adverse effects. This study is intended to compare the effects of TENS units
      on acute back pain on ambulatory patients who are awaiting emergency medical treatment, to
      uncover if a statistically-significant analgesic effect is noted compared to a placebo
      device.
    

Detailed description: 
      With the emerging amount of new data on the treatment specific to acute pain, it is theorized
      that early TENS application can be an adjunct for acute pain reduction, specifically for
      patients awaiting treatment in an emergency department triage waiting room. TENS stimulators
      are advantageous to patients in that they are non-pharmacologic and non-invasive therapy.
      TENS devices have an excellent safety profile, are associated with very few
      contraindications, and have negligible side-effects or adverse events: the most common being
      minor skin irritation. (Sluka and Walsh 2003) Of financial benefit to a hospital considering
      their implementation, these devices are also inexpensive. In the realm of emergency medicine,
      which is being scrutinized to reduce opioid prescriptions, measures must be taken to maximize
      the efficacy of alternative pain-relief adjuncts.

      There are significant gaps in the literature which have depicted no significant benefits
      compared to physical therapy and other modalities. These studies had used variable treatments
      times and frequencies, which were not solidified in scientific research at the time of their
      results. The use of these stimulators has been extensively studied, and the evidence to
      support their use on various conditions has been inconclusive. Early meta-analyses and
      systematic reviews have noted the data are inconsistent to suggest a mean reduction of pain
      when assessed on chronic pain. (Brosseau et al. 2002) However, when applied extensively and
      at regular settings, TENS has shown the presence of tolerance to TENS when used chronically
      in as few as four days. (Chandran and Sluka, 2003) This study is intended to harness the
      newest research comparing the most-effective settings and durations of TENS units, and
      compare the effects of TENS units on acute back pain on ambulatory patients who are awaiting
      emergency medical treatment.
    

Intervention name(s): Transcutaneous Electrical Nerve Stimulation
Intervention type(s): Device
Intervention description(s): Application of TENS pads and wearing of the TENS device.
Other intervention name(s): TENS
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Using a sample population in a military treatment facility emergency department, this prospective, randomized controlled trial utilized forty-six total participants evenly divided to both a active and placebo group, were used to determine the efficacy of Transcutaneous Electrical Nerve Stimulation (TENS) on acute back pain of ambulatory patients presenting for emergent care.
Masking: Double (Participant, Care Provider)
Primary purpose: Treatment
Keywords: Transcutaneous Electrical Nerve Stimulation, Acute back pain