Comparison of Routine Care Versus Transcutaneous Electrical Nerve Stimulation (TENS) for Treatment of Back Pain in the ED

Introducation: There are limitations to acute medical management of low back pain in the ED. Transcutaneous electrical nerve stimulation (TENS) provides a non-invasive, safe, accessible, and promising therapy.

Objective: To evaluate the role of a TENS unit in managing low back pain in the ED, and to compare the average patient length of stay in the ED to conventional treatment.

Methods: 71 patients with a chief complaint of low back pain were enrolled in the active arm. Pain scores on a 0-10 scale were obtained before and after treatment with the TENS units. The control group included 70 historical cases with conventional treatment. T-test analysis was used to evaluate for any statistical difference in pain reduction.

Results: The pain scale before and after treatment was statistically significant between control and active arms: Before--controls 8.53 ± 1.52 and active arm 7.65 ± 1.81; after-- controls 5.89 ± 2 and active arm (5.01 ± 2.65). The Delta score related variables were not statistically significant between historical and treatment groups. An analysis was conducted for the EXACT matched pairs (n=25). The pain scale before treatment was statistically significant between historical arm (8.52 ± 1.45) and active arm (7.56 ± 1.83). The pain scale after treatment was NOT statistically significant between historical and active arms. The delta score related variables were NOT statistically significant between the two arms. Length of stay was not statistically significant between the arms.

Conclusion: These results suggest that TENS is a viable treatment modality for lower back pain in the ED.

Keywords: back pain, transcutaneous electrical nerve stimulation, TENS, ED, therapy.