Transcutaneous electrical nerve stimulation and heat to reduce pain in a chronic low back pain population: a randomized controlled clinical trial.
Lynn Leemans, Ömer Elma, Jo Nijs and 5 others
PMID 32434666WHAT IT FOUND
For chronic low back pain, heat plus TENS did not reduce pain more than no treatment over 4 weeks.
Pressure pain thresholds were higher, but main pain outcomes did not differ.
Key findings
01The main pain outcomes did not differ between groups over time.
02Pressure pain thresholds at the lower back and second toe were higher in the HeatTens group after 30 min and after 4 weeks.
03Temporal summation, conditioned pain modulation, central sensitization symptoms, quality of life, fear avoidance, and medication use did not differ between groups over time.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The main pain outcomes did not differ, so the pressure pain threshold results are secondary and should not be read as pain relief. The intervention combined heat and TENS, so the contribution of either component cannot be separated. There was no sham device, and participants were not blinded. Treatment compliance was not assessed. Home use intensity was self-selected and not controlled. Conditioned pain modulation testing may not generalize. Medication diary data were missing for 5 HeatTens participants and 9 controls. The study included 50 participants.
Declared interests
The authors declare no conflicts of interest.
The easy way to misread this
Do not conclude that heat plus TENS reduces pain in chronic low back pain. The primary pain outcomes did not differ from no treatment, and the higher pressure pain thresholds were secondary findings in an unblinded trial without a sham device.