Does transcutaneous electrical nerve stimulation (TENS) simultaneously combined with local heat and cold applications enhance pain relief compared with TENS alone in patients with knee osteoarthritis?
Takaya Maeda, Hideki Yoshida, Tomoyuki Sasaki and 1 others
PMID 29184307WHAT IT FOUND
Adding heat or cold to TENS did not relieve knee pain better than TENS alone.
All groups saw immediate pain reduction, but only the heat group improved walking speed. This suggests heat may aid movement, not just pain.
Key findings
01There were no significant differences in pain reduction between TENS alone and TENS combined with heat or cold.
02Walking time improved significantly only in the group that received TENS with heat.
03All three groups experienced significant immediate pain relief during walking and standing.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study measured effects only immediately after a single 20-minute session, so it does not show if these benefits last or if they accumulate over multiple treatments. The sample size was small, with only 15 patients in each group. The study did not use a placebo control for the heat or cold applications, so the psychological effect of receiving a treatment cannot be ruled out.
Declared interests
No conflicts of interest or funding sources are reported in the provided text.
The easy way to misread this
Do not conclude that heat combined with TENS is a better painkiller than TENS alone. The pain relief was statistically the same in all groups. The only difference was in walking speed, which improved only with heat.