AIM: To identify where electrodes should be placed for transcutaneous electrical nerve stimulation (TENS) for low back pain. METHOD: A prospective randomized trial involving 28 patients with low back pain. Subjects in the control and intervention groups were of similar age (mean age 47 +/- 10 years, range 28 to 60 years, and 47 +/- 10 years, range 34 to 70 years, respectively) and had complaints of a similar duration (5 +/- 7 years, range 0.5 to 27 years, and 4 +/- 2 years, range 1 to 7 years, respectively). In the control group electrode placement was determined by palpation of tender or painful spots and anatomical knowledge. In the intervention group electrode placement was determined on the basis of palpation, anatomical knowledge, and diadynamic current. The effect of treatment was assessed by means of the Dutch version of the McGill Pain Questionnaire. Severity of pain was determined with a visual analogue scale. RESULTS: Data from four patients were not included because the questionnaires were not completed. There were no significant differences between the groups for scores for the different parts of the McGill questionnaire, but there was a tendency towards significance for the absolute decrease in pain in the intervention group. CONCLUSION: We consider this method useful because it resulted in a greater absolute decrease in pain in the intervention group. Use of diadynamic current reduces the problem of anatomic individuality and may make it possible to achieve the same results with fewer TENS session than when electrode placement is based on a knowledge of anatomy and palpation alone.

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