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TENS: does the type of stimulus really matter?
Nash TP, Williams JD, Machin D
The Pain Clinic 1990;3:161-168
clinical trial
8/10 [Eligibility criteria: No; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: No; Blind subjects: Yes; Blind therapists: Yes; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

A randomized double-blind evaluation of transcutaneous electrical nerve stimulation (TENS) in the treatment of chronic pain was done to show which stimulation mode (pulsed or continuous) and which frequency (10 or 100 Hz) is the most effective. Two hundred consecutive patients who were considered suitable for TENS for relief of chronic pain were randomly assigned to one of four groups (50 patients in each). One group received stimulation at 10 Hz, pulsed at 2.3 Hz, a second continuous 10 Hz, a third 100 Hz plused at 2.3 Hz and a fourth continuous 100 Hz. Patients were followed up until they were considered cured or no longer helped by treatment or for a maximum of 2 years. They were assessed over the study period by means of a visual analoge scale (VAS). The results suggested a speedier reduction in pain levels, albeit not statistically significant, in patients receiving high as opposed to low frequency TENS (OR 1.4, 95% CI 0.8 to 2.6). There appeared to be no difference in efficacy between pulsed and continuous stimulation.

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