Electrical Stimulators - Cigna

Neck Pain: Following a systematic review of the literature regarding electrotherapy, including TENS, for neck
pain, Kroeling et al. (2009) concluded that no definitive statements could be made regarding the efficacy and
clinical usefulness of these modalities. Eleven TENS trials (n=7-30) met inclusion criteria including: TENS
compared to placebo or another modality (i.e., ultrasound, manual therapy, electrical muscle stimulation); TENS
plus another therapy (i.e., hot packs, infrared, exercises, neck collar and/or analgesic) compared to the other
therapy alone; or different TENS regimens. The authors concluded that “very low quality” evidence showed that
TENS might relieve pain better than placebo or electrical muscle stimulation but not as well as exercise and
infrared and possibly as well as manual therapy and ultrasound.
Osteoarthritis of the Knee: Rutjes et al. (2009) conducted a systematic review of the literature to evaluate
transcutaneous electrical nerve stimulation for the treatment of osteoarthritis of the knee. Thirteen randomized
and quasi-randomized trials (n=465) using TENS met inclusion criteria. Due to the heterogeneity of the studies
and poor methodology, the authors could not confirm the effectiveness of TENS for this condition.
Phantom Pain and Stump Pain: Mulvey et al. (2010) conducted a systematic review of randomized controlled
trials to assess the effectiveness of TENS for the treatment of phantom pain and stump pain following
amputation in adults. No studies were identified.
Rheumatoid Arthritis: In a systematic review of the literature, Brosseau et al. (2003) evaluated the
effectiveness of TENS for the treatment of rheumatoid arthritis of the hand. Three randomized controlled trials
(n=78) met inclusion criteria. Conventional TENS (c-TENS) and acupuncture-TENS (acu-TENS) were compared
to either placebo or each other. Results were conflicting on the effect of TENS on pain outcomes. Acu-TENS
was beneficial for reducing pain intensity and improving muscle power scores compared to placebo. No clinical
benefit on pain was reported with C-TENS compared to placebo. C-TENS resulted in a clinical benefit on the
patients’ assessment of change compared to acu-TENS. The authors concluded that more well designed
studies with a standardized protocol and adequate number of subjects were needed to fully identify the effect of
TENS for the treatment of RA of the hand.
Stroke: NG and Hui-Chan (2009) conducted a randomized controlled trial (n=109) to determine if TENS would
improve functional walking performance (i.e., gait velocity, walking endurance and functional mobility) in
hemiparetic stroke patients with spastic plantar flexors. In addition to a control group (n=29), patients were
assigned to one of three intervention groups: TENS only (n=28), TENS plus exercise (n=27) or placebo
stimulation plus exercise (n=25). Each patient self-administered 20 sessions, five days per week for four weeks.
Each group received 60 minutes of TENS and the exercise groups received an additional 60 minutes of exercise
following TENS or placebo stimulation. Final follow-up occurred four weeks after the treatment ended. At the
final follow-up compared to all other groups, significant improvements were seen in the TENS plus exercise
group in gait velocity (p