Effectiviteit van uitwendige elektrostimulatie ter behandeling van chronische pijn

PG064.11

Effectiviteit van uitwendige elektrostimulatie ter behandeling van chronische pijn. Een systematisch onderzoek van de beschikbare literatuur en een inventarisatie van de huidige behandelpraktijk in Nederland.

Onderzoek in opdracht van het College voor Zorgverzekeringen, uitgevoerd door het Universitair Medisch Centrum St Radboud, Afdeling Epidemiologie, Biostatistiek en HTA, IQ Health Care, Afdeling Anesthesiologie, en de afdeling Orthopedie, subafdeling Fysiotherapie Centraal. Nijmegen, 19 januari 2011.

Uitwendige elektrotherapie bij chronische pijn

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Inhoudsopgave Samenvatting

5 ‐ 7

Inleiding

9 ‐ 11

Methodische verantwoording

12 ‐ 14

Resultaten

15 ‐ 30

Interpretatie

31 ‐ 34

Geciteerde literatuur

35 ‐ 37

Bijlagen: Bijlage 1: Samenstelling projectgroep en geraadpleegde deskundigen

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Bijlage 2: Zoekstrategieën

39 ‐ 42

Bijlage 3: Formulier beoordeling methodologische kwaliteit (Jadad)

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Bijlage 4. Opbrengst zoekstrategie

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Bijlage 5: Redenen voor exclusie

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46 ‐ 48

Bijlage 7: Beoordeling methodologische kwaliteit geïncludeerde studies

49 ‐ 93

Bijlage 8. Enquête

94 ‐ 98

Bijlage 6: Referenties geïncludeerde studies

Bijlage 9. Referenties van geëxcludeerde studies, met reden voor exclusie

99 ‐ 188


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Lijst met gebruikte afkortingen AL‐TENS

Acupuncture‐like Transcutaneous Electrical Nerve Stimulation

APS

Action Potential Simulation

Cov

Co‐variantie

ES

Electrostimulation

KNGF

Koninklijk Nederlands Genootschap voor Fysiotherapie

NMES

NeuroMuscular Electrical Stimualtion

NNT

Number Needed to Treat

OA

Osteo Artrose

OR

Odds Ratio

PENS

Percutaneous Electrical Nerve Stimulation

PES

Periosteal Electrical Stimulation

RA

Rheumatoide Arthritis

SD

Standard Deviation

SMD

Standardized Mean Difference

TENS

Transcutaneous Electrical Nerve Stimulation

TSE

Trans Spinal Electrostimulation,

Var

variantie

VAS

Visual Analogue Scale (pijnschaal)


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Samenvatting Doel: een systematisch overzicht bieden van wat er over de effectiviteit van uitwendige elektrotherapie ter behandeling van chronische pijn bekend is uit de literatuur, en inzicht bieden in de huidige praktijk van behandeling van chronische pijn in Nederland. Methode: Systematisch literatuuronderzoek in PubMed, Embase, CINAHL, PEDRo, Scopus, Web of Science en de Cochrane Library van 1980 – heden. Selectiecriteria: Typen studies: prospectieve, gerandomiseerde, placebogecontroleerde studies (RCTs), zowel met parallelle groepen als cross‐over designs. Patiëntenpopulaties: ambulante patiënten met chronische, onbehandelbare pijn, gedefinieerd als persisterende pijn die minstens 3 maanden bestaat, ondanks optimale (medicamenteuze) behandeling. Interventies: uitwendig draagbare apparatuur waarmee d.m.v. elektroden op de huid elektrische stroomprikkels gegeven kunnen worden met als primair doel bestrijding van pijn, voorgeschreven door fysiotherapeut of arts. Eindpunten: verandering van pijn, gemeten m.b.v. een pijnschaal (Visual Analogue Scale of VAS) of een gevalideerd meetinstrument (bv. McGill Pain Questionnaire), direct na afloop van de behandeling in vergelijking tot start van behandeling. Taalrestricties: Engels, Nederlands, Duits, of Frans. Selectie van artikelen en data‐extractie werden door twee onderzoekers onafhankelijk van elkaar verricht. Methodologische kwaliteit werd beoordeeld m.b.v. de Jadad score. De gemiddelde verandering in pijn (met standaard deviatie) werd berekend voor de behandelde groep en de placebogroep. Data van geïncludeerde studies werden gepoold in een meta‐analyse (random‐effect model van het gestandaardiseerde gemiddelde verschil). Publicatie bias werd geanalyseerd m.b.v. een funnel plot. Subgroepanalyses werden uitgevoerd voor trial design, indicatie, en type elektrotherapie. Gegevens over de huidige behandelpraktijk werden verzameld d.m.v. een web‐based vragenlijst. Een oproep werd verspreid via de elektronische nieuwsbrief van relevante beroepsgroepen. Resultaten: De zoekstrategie leverde 1181 treffers op. Hiervan werden 34 artikelen geïncludeerd, met in totaal 1519 patiënten met chronische pijn. De methodologische kwaliteit van de geïncludeerde studies was redelijk tot goed (Jadad score 1 – 5). Zestien studies hadden betrekking op TENS, negen op PENS, en zeven op AL‐TENS. In de overige studies werden microcurrent elektrostimulatie (2), TSE (1), noxious level ES (1), NMES (1), en PES (1) onderzocht. Zestien studies hadden betrekking op behandeling van chronische (lage) rugpijn. Overige indicaties waren artrose van de knie (4), overige pijn in arm of been (4), diabetische neuropathie (3), nek‐ of schouderpijn (2), hoofdpijn (1), fibromyalgie (1), reumatoïde artritis (1), bekkenpijn (1), en pijn gerelateerd aan kanker (1). Uitwendige elektrotherapie bij chronische pijn

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Het effect van uitwendige elektrotherapie op chronische pijn, uitgedrukt in SMD en berekend over alle geïncludeerde studies, bedroeg 1.14 (95% Betrouwbaarheidinterval: 0.52 – 1.48; p < 0.001). Gemiddeld zal ongeveer bij 40% van de patiënten in de placebogroep de pijn met 30% of meer afnemen. De Number Needed to Treat (NNT) bedraagt 3.2. Gemiddeld moeten dus ongeveer 3 patiënten worden behandeld met uitwendige elektrotherapie om bij één extra patiënt een verbetering van de pijn met minimaal 30% te bereiken. De heterogeniteit onder de studies was zeer hoog (I2 = 92.7%). Er zijn sterke aanwijzingen voor publicatie bias (Egger test, p = 0.04). De effectiviteit van de verschillende typen van elektrotherapie, uitgedrukt in SMD, bedroegen 0.50 (TENS), 0.64 (AL‐TENS), en 1.78 (PENS) (p < 0.001 voor elk van de drie vormen van elektrotherapie). De SMD in studies met een crossover design (n=11) was aanzienlijk hoger dan de SMD in trials met parallelle groepen (n=23) (1.88 vs. 0.65). Van de studies naar TENS had 28% een crossover design; voor AL‐TENS was dit 22%, en voor PENS 64%. De vragenlijst werd door 174 respondenten ingevuld, voor het merendeel fysiotherapeuten (89%), en enkele anesthesiologen (6.7%), revalidatieartsen, neurochirurgen, en (ortho)manueel therapeuten (overige 4.3%). Van de respondenten gaf 68% aan TENS te gebruiken in de behandeling van chronische pijn. Van hen gaf 65% aan dat het daarbij om maximaal 2 patiënten per maand gaat; voor 27% waren dit 3 – 10 patiënten per maand, en voor 8% waren dit meer dan 10 patiënten per maand. Overige behandelmodaliteiten die werden gerapporteerd waren andere vormen van uitwendige elektrotherapie (APS, interferentiestroom, en combinaties van elektrotherapie en ultrageluidsgolven), braces, tapes, prothesen, spalken, acupunctuur, aangepast schoeisel, bindweefselmassage, hydrotherapie, diverse loopmiddelen, en elastische kousen. De belangrijkste indicatie vormde pijn van het bewegingsapparaat (95.7% van de respondenten), gevolgd door zenuwletsels (66.2% van de respondenten) en pijn bij kanker (36% van de respondenten).

Interpretatie: Uitwendige elektrostimulatie lijkt een vermindering van chronische pijn te bewerkstelligen die, ten opzichte van een placebo behandeling, zowel klinisch relevant is als statistisch significant. Deze conclusie moet echter genuanceerd worden vanwege de grote, onverklaarde heterogeniteit tussen de studies, publicatie bias en de veelal inadequate blindering van patiënten. Als uitwendige elektrotherapie een effect heeft op chronische pijn dat onderscheiden kan worden van placebo, dan zal dat effect minder groot zijn dan in de overall analyse wordt gesuggereerd, zal het niet gelijk zijn voor alle behandelmodaliteiten, en zal het niet gelijk zijn voor alle typen van pijn. De vraag of uitwendige elektrotherapie een specifiek effect kan hebben op chronische pijn dat te onderscheiden is van het aspecifiek effect dat via placebobehandeling tot stand komt, kan daarom op grond van de beschikbare literatuur niet zonder meer bevestigend worden beantwoord. Deze conclusie is in overeenstemming met richtlijnen, uitgebracht door het Koninklijk Nederlands Genootschap voor Fysiotherapie (KNGF) en met recente Cochrane reviews over uitwendige elektrostimulatie voor specifieke vormen van chronische pijn en voor chronische pijn in het algemeen (Khadilkar et al, 2008; Rutjes et al, 2009; Nnoaham en Kumbang, 2008;

Robb et al, 2008; Mulvey et al, 2010). Op grond van de enquête blijkt uitwendige elektrotherapie ter behandeling van chronische pijn een wezenlijk onderdeel van het behandelrepertoire te zijn. De vraag, welke vorm van uitwendige elektrotherapie, voor welke patiënt, in welke fase van de ziekte, onder welke voorwaarden therapeutische meerwaarde heeft, blijft in wezen onbeantwoord. Het CVZ staat, als pakketbeheerder, voor de principiële keuze of het bereid is positief te adviseren over de Uitwendige elektrotherapie bij chronische pijn

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vergoeding van een behandeling die in de praktijk pijnverlichting kan bewerkstelligen, maar waarvan in onderzoek het effect voor een mogelijk belangrijk deel aspecifiek lijkt te zijn.


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1. Inleiding

Chronische pijn komt veel voor onder de bevolking (Verhaak et al, 1998; Friessem et al, 2009). Exacte gegevens voor Nederland ontbreken, maar uit een recente landelijke survey in een vergelijkbare context (Denemarken) blijkt dat de prevalentie van chronische pijn ca. 20% bedraagt (Sjǿgren et al, 2009). Chronische pijn wordt daarbij gedefinieerd als pijn die aanhoudt gedurende een periode die langer is dan de periode die normaal gesproken nodig is voor herstel van weefselschade, ondanks optimale (medicamenteuze) behandeling; doorgaans wordt hiervoor een periode van 3 maanden gehanteerd (Wood, 2008). De maatschappelijke kosten die chronische pijn met zich meebrengt zijn aanzienlijk (Phillips et al, 2008; Gilron en Johnson, 2010). Onder patiënten die voor chronische pijn onder behandeling waren van een multidisciplinair pijnteam waren de kosten van medische zorg in het eerste jaar gemiddeld ca. €2350 hoger dan in de voorafgaande jaren, en ca. €1075 hoger in elk volgend jaar. Patiënten besteedden gemiddeld 20% minder tijd aan hun werk, en als ze werkten lag hun productiviteit ca. 50% lager dan normaal (Kronborg et al, 2009). Voor de individuele patiënt betekent chronische pijn doorgaans een aanzienlijke aantasting van zijn of haar kwaliteit van leven, zowel wat betreft fysiek functioneren, sociaal functioneren, vitaliteit, en algemeen welbevinden (Smith et al, 2007). Er is een grote variëteit aan behandelingen die worden ingezet ter verlichting van chronische pijn, zowel farmacologisch als niet‐farmacologisch (Priest en Hoggart, 2002). Onder de niet‐farmacologische behandelingen van chronische pijn neemt uitwendige elektrotherapie een belangrijke plaats in. Het gebruik van elektriciteit ter verlichting van pijn is al bekend uit de Egyptische oudheid en uit de Romeinse tijd, toen elektrogene vissen voor dit doel werden ingezet. Belangstelling voor medische toepassingen van elektriciteit nam sterk toe in de 18e eeuw, maar nam af met de komst van farmacologische behandelingen (Johnson, 2008). In de 20e eeuw was er hernieuwde belangstelling als gevolg van het werk van Melzack en Wall, die een fysiologische verklaring ontwikkelden voor het effect van uitwendige elektrotherapie op pijnsensatie (Melzack en Wall, 1965). Zij veronderstelden dat de transmissie van informatie die uiteindelijk een pijnsensatie oplevert geremd kan worden door selectieve aktivatie van dik gemyeliniseerde zenuwvezels. Deze zenuwvezels kunnen beïnvloed worden door middel van uitwendige elektrische stroom. Wall en Sweet (1967) pasten dit principe toe bij patiënten met chronische pijn. De sindsdien meest gebruikte vorm van uitwendige elektrotherapie is TENS, Transcutaneous electrical nerve stimulation (Johnson, 2008). De werking van TENS berust op het principe van selectieve activatie van de Aβ vezels (zenuwbanen met een relatief grote diameter), zonder activatie van de zenuwvezels die verantwoordelijk zijn voor nocisensorische informatie (de Aδ en C vezels; deze hebben een kleinere diameter, en daardoor een hogere prikkeldrempel). Theoretisch kan deze selectieve activatie het beste bereikt worden met laag‐frequente elektrische pulsen (10 – 200 Hz) van Uitwendige elektrotherapie bij chronische pijn

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lage intensiteit met een pulsduur van 50 – 500 µs (Johnson, 2008, p. 260). Er zijn vele varianten op deze klassieke vorm van TENS, waaronder Acupuncture‐Like TENS (AL‐TENS, toepassing van uitwendige elektrische stroom op acupunctuurpunten), hoge‐intensiteit TENS (TENS die ook de Aδ en C zenuwbanen activeert en daardoor een pijnsensatie teweeg brengt), lage intensiteit TENS (TENS waarmee getracht wordt zenuwvezels fysiologische te simuleren, ook wel Action Potential Simulation of APS genoemd), en percutane stimulatie van zenuwvezels (PENS) (Johnson, 2008, p. 262‐3). TENS wordt zowel door de beroepsgroep (voornamelijk fysiotherapeuten) als door patiënten als een belangrijke optie beschouwd in de behandeling van chronische pijn (Scudds et al, 2009; Johnson et al, 1991). Uit een survey, uitgevoerd onder patiënten die TENS hadden voorgeschreven gekregen in verband met chronische pijn, bleek dat 47% van mening was dat TENS de pijnklachten minstens halveerde, dat 75% het apparaat dagelijks gebruikte, en dat een derde het apparaat minstens 60 uur per week gebruikte (Johnson et al, 1991). Uit een survey, uitgevoerd onder fysiotherapeuten in Engeland, bleek dat ca. 80%TENS toepast ter behandeling van chronische pijn (Scudds et al, 2009). In Nederland is het aandeel van de fysische verrichtingen (waaronder TENS1) in het totaal van geleverde paramedische zorg overigens in de afgelopen jaren gedaald. In 2003 bedroeg het aandeel fysische verrichtingen 13.9% van het totaal; in 2008 was dat 7.7% (bron: Landelijke Informatievoorziening Paramedische Zorg, LiPZ: www.nivel.nl/lipz). Evidence Er is veel onderzoek gedaan naar de effecten van uitwendige elektrotherapie op pijn en chronische pijn, zowel experimenteel (Sluka en Walsh, 2003) als klinisch (Khadilkar et al, 2008; Rutjes et al, 2009; Nnoaham en Kumbang, 2008). De literatuur op dit punt is niet eenduidig (Johnson en Walsh, 2010). Er zijn in de loop der jaren diverse publicaties verschenen die een klinisch relevante en statistisch significante verbetering van chronische pijn lieten zien als gevolg van uitwendige elektrotherapie (Johnson en Martinson, 2007). Er zijn echter ook diverse publicaties waarin deze effecten niet gereproduceerd konden worden (voor recente reviews, zie Khadilkar et al, 2008; Rutjes et al, 2009). Voor andere toepassingen van TENS werd de beschikbare literatuur ontoereikend bevonden om de meerwaarde ervan te kunnen beoordelen (Robb et al, 2008; Mulvey et al, 2010). De belangrijkste uitdaging op dit moment is om deze heterogeniteit tussen studies (met positieve en met negatieve resultaten) beter te verklaren. Hangt deze samen met methodologische kenmerken van de betreffende studies (studieopzet, wijze waarop pijn is 1

TENS neemt een belangrijke plaats in onder de fysische verrichtingen, maar het exacte percentage is niet bekend. Uitwendige elektrotherapie bij chronische pijn

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gemeten e.d.), met de heterogeniteit in behandeling (type TENS, aard, duur, intensiteit en begeleiding van behandeling), met de heterogeniteit van de indicatie (adequate diagnostiek omtrent de oorzaak, duur en locatie van de pijn), of een combinatie van deze factoren? Doel van dit rapport is een systematisch overzicht te bieden van wat er over de effectiviteit van uitwendige elektrotherapie ter behandeling van chronische pijn bekend is uit de literatuur, en inzicht te bieden in de huidige praktijk van behandeling van chronische pijn in Nederland.


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2. Methodische verantwoording 2.1 Systematisch literatuuronderzoek

Bronnen Potentieel relevante, primaire studies werden gezocht in de literatuurbestanden PubMed, Embase, CINAHL, PEDRo (Physiotherapy Evidence Database), Scopus, en Web of Science, van 1980 – heden. De opbrengst van deze zoekstrategieën werd vergeleken met referenties van relevante overzichtsartikelen in de Cochrane Library, en waar nodig hiermee aangevuld. De zoekstrategieën zijn opgenomen in Bijlage 2. Selectie van potentieel relevante artikelen Typen studies: prospectieve, gerandomiseerde, placebogecontroleerde studies (RCTs), zowel met parallelle groepen als cross‐over designs. De eis van placebocontrole vloeit voort uit het feit dat dit type interventie een relatief groot placebo‐effect kan veroorzaken (Kaptchuk et al, 2000). Patiëntenpopulaties: ambulante patiënten met chronische, onbehandelbare pijn, gedefinieerd als persisterende pijn die minstens 3 maanden bestaat, ondanks optimale (medicamenteuze) behandeling, waarbij onderscheiden worden pijnklachten in het bewegingsapparaat (rug/been; nek/schouder) en bij zenuwletsels (postherpetisch, perifere posttraumatische letsels, plexus brachialis letsel, carpaal tunnel syndroom waar indicatie voor operatie ontbreekt of operatie niet tot het gewenste effect leidde), hoofdpijn, en pijn bij kanker. Interventies: uitwendig draagbare apparatuur waarmee d.m.v. elektroden op de huid elektrische stroomprikkels gegeven kunnen worden met als primair doel bestrijding van pijn, voorgeschreven door fysiotherapeut of arts, waaronder o.m. vallen Conventional TENS, burst‐TENS, acupuncture‐like TENS, en APS‐therapie. De elektrotherapie wordt als monotherapie aangeboden of als aanvulling op een andere behandeling, en vergeleken met placebo TENS.

Eindpunten: verandering van pijn, gemeten m.b.v. een pijnschaal (Visual Analogue Scale of VAS) of een gevalideerd meetinstrument (bv. McGill Pain Questionnaire). Taalrestricties: Artikelen in Engels, Nederlands, Duits, of Frans. Uitwendige elektrotherapie bij chronische pijn

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Selectie en methodologische beoordeling van artikelen Inclusiecriteria werden door twee onderzoekers onafhankelijk van elkaar toegepast op titel en abstract van alle studies in de zoekopbrengst. Studies die op basis van titel en abstract voldeden aan de inclusiecriteria werden full‐text geanalyseerd. In geval van discrepante beoordeling werd overeenstemming bereikt door middel van discussie. Van geïncludeerde studies werden gegevens verzameld over onderzoeksdesign, studiepopulatie (aantal, demografie, soort pijn, duur van de pijn), behandelkenmerken (type apparaat, stimulus frequentie en – intensiteit, duur en frequentie van de behandeling, co‐interventies), follow up, en resultaten, inclusief eventuele bijwerkingen (aard en frequentie). Methodologische kwaliteit van studies werd gescoord met behulp van de Jadad score (Jadad et al, 1996). Geëxtraheerde data werden weergegeven in tabelvorm. Voor de effectiviteit werd de gemiddelde pijn voor‐ en direct na afloop van behandelperiode gescoord, inclusief standaard deviaties, of de gemiddelde verandering in pijn met 95% betrouwbaarheidsinterval. Op basis hiervan werd de gemiddelde verandering in pijn (VAS) berekend voor de behandelde groep en de placebogroep. De standaard deviatie van het verschil werd berekend m.b.v. de correlatiecoëfficiënt r, die geschat kon worden op basis van de data van vijf geïncludeerde studies: Var(x‐y) = Var(x) + Var(y) – 2{Cov(x,y)} r(x,y) = Cov(x,y) / SD(x)*SD(y) De correlatiecoëfficiënt (r) bedroeg 0.72 ± 0.11 (gemiddelde en standaard deviatie). In de berekening is steeds een correlatiecoëfficiënt van 0.7 gehanteerd. Er werd geen sensitiviteitsanalyse uitgevoerd op deze parameter, omdat het effect van variatie binnen deze grenzen op de schatting van de standaarddeviatie verwaarloosbaar bleek te zijn. Statistische heterogeniteit tussen studies werd uitgedrukt in I2, het percentage van variatie tussen studies dat een gevolg is van heterogeniteit, en niet van toeval (Higgins en Thompson, 2002). Data van meerder studies werden gepoold middels een meta‐analyse met een random‐effect model. Hiertoe werd voor elke studie het gestandaardiseerde gemiddelde verschil berekend (Standardized Mean Difference, SMD). Als weegfactor werd de inverse van de variantie van elke studie gebruikt. Publicatie bias werd geanalyseerd m.b.v. een funnel plot (Egger et al, 1997). Subgroepanalyses werden uitgevoerd voor trials met een verschillend design (parallelle groepen vs. crossover), indicatie, methodologische kwaliteit (Jadad score) en voor verschillende typen interventies (conventionele TENS, AL‐ TENS, en PENS). De SMD werd gebruikt om de Odds Ratio te schatten, die de odds op respons in de experimentele groep uitdrukt ten opzichte van de odds op respons in de controlegroep (Chinn, 2000). De OR werd vervolgens gebruikt om de Number Needed to Treat (NNT) te berekenen: het gemiddeld aantal patiënten dat met uitwendige elektrotherapie behandeld moet worden om bij één patiënt extra een klinisch relevante vermindering in pijn te bewerkstelligen. Voor dit doel werd de gewogen gemiddelde Uitwendige elektrotherapie bij chronische pijn

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pijnscore in de controle groep berekend, uitgedrukt in standaard deviaties. Vervolgens werd ook de gewogen gemiddelde verandering in pijnscore in de experimentele groep berekend, uitgedrukt in standaard deviaties. De wegingsfactor was in beide gevallen de inverse van de variantie van de betreffende studie. Op basis hiervan werden de kans op een klinisch relevante verbetering in pijn in de controle groep en de NNT berekend. De analyses werden uitgevoerd m.b.v. het software pakket StatsDirect. Daarnaast werd ook een sequentiële meta‐analyse uitgevoerd voor de studies die betrekking hadden op TENS (n = 18). In de sequentiële meta‐analyse werd de cumulatieve Z‐score uitgezet tegen het percentage van het in totaal benodigde aantal patiënten. Voor dit laatste werd een groepsgrootte berekening uitgevoerd voor de volgende aannames: percentage patiënten met een klinisch relevante verbetering (> 30%) in pijn in de controle groep: 30%; percentage patiënten met een klinisch relevante verbetering (> 30%) in pijn in de behandelde groep: 45%; α = 0,05, β = 0,10, tweezijdig. De benodigde aantallen werden gecorrigeerd voor de geobserveerde heterogeniteit (I2) onder de studies (Brok et al, 2009). De O’Brien‐Flemming α‐spending functie werd gebruikt om de grenzen van het 95% betrouwbaarheidsinterval te berekenen (O’Brien en Flemming, 1979). 2.2. Inventarisatie huidige behandelpraktijk in Nederland Om inzicht te krijgen in de behandelingen die toegepast worden in Nederland bij patiënten met chronische pijn werd een enquête ontwikkeld (Bijlage 8). Een oproep werd verspreid via de elektronische nieuwsbrief van relevante beroepsgroepen. Respondenten konden een hyperlink aanklikken, waardoor ze toegang kregen tot de vragenlijst. Gegevens werden anoniem verzameld en verwerkt.


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3. Resultaten

3.1. Opbrengst zoekstrategie De zoekstrategie leverde, na ontdubbelen, 1181 treffers op. Hiervan werden 34 artikelen geïncludeerd, die in totaal 1519 patiënten met chronische pijn onderzochten (zie Bijlage 4). De belangrijkste redenen voor exclusie van studies waren indicatie (geen chronische pijn: 36%), design (geen RCT: 23%, geen sham controle: 10%), behandeling (invasieve, neurochirurgische behandeling: 12%; geen elektrotherapie: 8%), en data rapportage (geen data extractie mogelijk: 5%). Van een beperkt aantal artikelen (1%) kon de volledige tekst niet achterhaald worden. Het betreft hier 12 artikelen die niet full text of in hard copy via eigen bibliotheek of andere bibliotheek in Nederland beschikbaar waren, en die evenmin via internationaal bibliothecair leenverkeer te achterhalen waren. Naar verwachting gaat het om artikelen die van hooguit matige kwaliteit zijn, en die, mede vanwege het geringe aantal, geen noemenswaardige impact zouden hebben op de overall conclusies van het rapport. De referenties van geëxcludeerde artikelen met reden voor exclusie zijn opgenomen in Bijlage 8. De referenties van geïncludeerde studies zijn opgenomen in Bijlage 6. Van deze studies hadden er 16 betrekking op TENS, 9 op PENS2, en 7 op AL‐TENS. In de overige studies werden microcurrent elektrostimulatie (2), TSE (1), noxious level ES (1), NMES (1), en PES (1) onderzocht.3 Het merendeel van de studies had betrekking op behandeling van chronische (lage) rugpijn (16). Overige indicaties waren artrose van de knie (4), overige pijn in arm of been (4), diabetische neuropathie (3), nek‐ of schouderpijn (2), hoofdpijn (1), fibromyalgie (1), reumatoïde artritis (1), bekkenpijn (1), en pijn gerelateerd aan kanker (1). De meest gerapporteerde stimulusintensiteit is LF (15), gevolgd door HF (10) en MF (6); de overige studies rapporteerden alternerende frequenties. De samenvattingen van de geïncludeerde studies zijn opgenomen in Bijlage 7. Omdat uitsluitend placebo‐gecontroleerde, gerandomiseerde studies zijn geïncludeerd, was de kwaliteit van de studies redelijk tot goed. Van de studies had 76% een Jadad score van 3 of lager, 6% had een score van 4, en 18% had een score van 5. Hoewel de meeste studies in opzet enkelblind waren, werd slechts in twee studies (Deyo et al, 1990; 2

PENS (Percutaneous Electrical Nerve Stimulation) is strikt genomen niet een uitwendige vorm van elektrotherapie. Zoals de aam aangeeft, worden de naaldelektroden door de huid aangebracht. Om deze reden mag de behandeling uitsluitend door artsen uitgevoerd worden. Vanwege de grote gelijkenis met TENS (Transcutaneous Electrical Nerve Stimulation) is in overleg met de opdrachtgever besloten de literatuur over PENS wel in dit overzicht op te nemen. Verderop in het rapport zullen de resultaten met PENS apart worden gepresenteerd. 3

TENS = Transcutaneous Electrical Nerve Stimulation, PENS = Percutaneous Electrical Nerve Stimulation, AL‐ TENS = Acupuncture‐like Transcutaneous Electrical Nerve Stimulation, TSE = Trans Spinal Electrostimulation, ES = Electrostimulation, NMES = NeuroMuscular Electrostimulation, PES = Periosteal Electrostimulation. In totaal betreft het 38 vergelijkingen in 34 trials; in sommige trials werden meerdere behandelmodaliteiten onderzocht. Uitwendige elektrotherapie bij chronische pijn

15

Oosterhof et al, 2006) een check op het succes van blindering uitgevoerd. In beide gevallen bleek de blindering succesvol te zijn geweest. Het merendeel van de studies (n = 23) had een design met parallelle groepen; de overige 11 studies hadden een crossover design. De omvang van de trials (aantal geïncludeerde patiënten) varieerde van 8 tot 163 (mediaan: 30; bovenste en onderste kwartielscore: 64, respectievelijk 23). 3.2. Meta‐analyse Van elke studie werd de gemiddelde pijnscore voorafgaand aan de behandeling en na afloop van de behandeling bepaald, inclusief de spreiding (standaard deviatie), zowel voor de behandelde groep als de placebogroep. Op basis hiervan werd per studie het gestandaardiseerde gemiddelde verschil berekend (Standardized Mean Difference, SMD), het gemiddelde verschil in pijnvermindering tussen beide groepen, gedeeld door de gezamenlijke standaard deviatie. Met behulp van een random effects model werd een overall effect van uitwendige elektrotherapie op chronische pijn berekend. De resultaten staan vermeld in Figuur 1. In de figuur staan sommige studies meer dan één keer vermeld; de reden hiervan is dat in deze studies het effect van uitwendige elektrotherapie bij meerdere indiacties werd onderzocht. Deze resultaten zijn separaat, per indicatie, in de analyse opgenomen. In het merendeel van de studies zijn de effecten van TENS, AL‐TENS, of PENS onderzocht. In de studies van Koopman, Naeser, Thompson, Nourbakhsh, Moore en Garland werden varianten van de standaard TENS onderzocht, die allen voldeden aan de definitie zoals gehanteerd in deze studie, namelijk “uitwendig draagbare apparatuur waarmee d.m.v. elektroden op de huid

elektrische stroomprikkels gegeven kunnen worden met als primair doel bestrijding van pijn, voorgeschreven door fysiotherapeut of arts”.


16

Effect size meta-analysis plot [random effects] Deyo et al, 1990 Topuz et al, 2004 Topuz et al, 2004 Machin et al, 1988 Bennett et al, 2010 Boggio et al, 2009 Moore & Shurman, 1997 Cheing & Hui-Chan, 1999 Ghoname et al, 1999a Ghoname et al, 1999b Cheing et al, 2002 Al-Smadi et al, 2003 Al-Smadi et al, 2003 Kumar et al, 1998 Forst et al, 2004 Oosterhof et al, 2006 Kofotolis et al, 2008 Vitiello et al, 2007 Chan et al, 2009 Lee and Lee, 2009 Tam et al, 2007 Deluze et al, 1992 Sangdee et al, 2002 Weng et al, 2005a Weng et al, 2005a Weng et al, 2005b Weng et al, 2005b Ghoname et al, 1999a Ghoname et al, 1999c Ghoname et al, 1999c Ghoname et al, 1999c Ghoname et al, 1999b Ahmed et al, 2000 Ahmed et al, 2000 Ahmed et al, 2000 Hamza et al, 2000 Weiner et al, 2008 Weiner et al, 2008 Weiner et al, 2003 Weiner et al, 2007 Topuz et al, 2004 Koopman et al, 2009 Naeser et al, 2002 Thompson et al, 2008 Nourbakhsh and Fearon, 2008 Moore & Shurman, 1997 Garland et al, 2007

-2

0

2

4

6

DL pooled effect size = 1,149531 (95% CI = 0,822103 to 1,476959)

8

Figuur 1. Schatting van effect van uitwendige elektrotherapie op chronische pijn.


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Uit de figuur blijkt dat de grootte van het effect van uitwendige elektrotherapie op chronische pijn, berekend over alle geïncludeerde studies, 1.14 bedraagt (95% Betrouwbaarheidinterval: 0.82 – 1.48). Dit suggereert dat uitwendige elektrotherapie een groot, klinisch relevant effect kan hebben op chronische pijn (normwaarden: 0.2 = klein effect; 0.5 = middelgroot effect; > 0.8 = groot effect. Cohen, 1992). In de literatuur over pijn en behandeling van pijn wordt een vermindering van pijn met 30% of meer doorgaans als klinisch relevant beschouwd (Ostelo et al, 2008). Op basis van bovenstaande gegevens zal gemiddeld ongeveer 40% van de patiënten die een placebobehandeling hebben ondergaan een dergelijke verbetering laten zien. Op basis van de resultaten van de meta‐ analyse bedraagt de odds ratio (OR) voor een klinisch relevante verandering in pijn (uitwendige elektrotherapie in vergelijking tot placebo) ca. 3.7. De Number Needed to Treat (NNT) bedraagt daarmee 3.2: gemiddeld moeten ongeveer 3 patiënten worden behandeld met uitwendige elektrotherapie om bij één extra patiënt een verbetering van de pijn met minimaal 30% te realiseren. 3.3. Kanttekeningen Bij deze analyse moet een aantal belangrijke kanttekeningen geplaatst worden. Heterogeniteit Ten eerste is de heterogeniteit onder de studies zeer groot (I2 = 92.7%). Dit betekent dat de verschillen tussen studies voor slechts een zeer klein deel toegeschreven kunnen worden aan toeval, en dat het merendeel van de verschillen berust op werkelijke verschillen in de gevonden effecten van uitwendige elektrotherapie. Bronnen van heterogeniteit omvatten onder meer type van uitwendige elektrotherapie (TENS, AL‐TENS, PENS, en overige vormen van uitwendige elektrotherapie, en variaties binnen deze modaliteiten, zoals stimulusfrequentie en stimulusintensiteit, behandelduur enz.), indicatie (aard, duur en lokalisatie van de pijn) en studiekenmerken (met name kwaliteit van blindering, wat samenhangt met design: parallelle groepen vs. crossover). Om die reden is een aantal aanvullende subgroepanalyses uitgevoerd (zie hieronder). Publicatie bias Ten tweede zijn er op basis van de funnel plot (Figuur 2) sterke aanwijzingen voor publicatie bias (Egger test, p = 0.04). Dat betekent dat er sprake is van een oververtegenwoordiging van trials in de literatuur waarin positieve effecten van behandeling worden gerapporteerd, en dat de overall schatter van het effect van uitwendige elektrotherapie op chronische pijn een overschatting is. Uitwendige elektrotherapie bij chronische pijn

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Bias assessment plot Standard error 0,0

0,2

0,4

0,6

0,8

1,0 -2

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6 Effect size

Figuur 2. Funnel plot waarin voor alle geïncludeerde studies, per studie de standaard fout (verticale as) wordt uitgezet tegen de gerapporteerde grootte van het behandeleffect (horizontale as). Voor interpretatie van de funnel plot, zie tekst. 3.4. Subgroepanalyses 3.4.1. Subgroepanalyse naar type elektrotherapie: TENS, AL‐TENS en PENS In onderstaande figuren staan de resultaten van de meta‐analyse weergegeven, uitgesplitst naar type van uitwendige elektrotherapie. Sommige studies (bv. Topuz 2004; Ghoname 1999 a en b) zijn in meer dan één subgroepanalyse opgenomen. De reden hiervoor is dat in deze studies meerdere typen van uitwendige elektrotherapie zijn onderzocht. De resultaten daarvan zijn separaat geanalyseerd. TENS In totaal werden 16 studies geïncludeerd waarin een TENS werd vergeleken met placebo (18 vergelijkingen). De overall effect size binnen deze groep was aanzienlijk lager (0.50; 95% betrouwbaarheidsinterval 0.27 – 0.74) dan in de totale groep, wat duidt op een hooguit middelmatig effect van TENS op chronische pijn (zie Figuur 3). De heterogeniteit binnen deze studies was weliswaar lager, maar nog steeds 60%. Deze heterogeniteit is mogelijk toe te schrijven aan verschillen binnen deze modaliteit (gebruik van verschillende frequenties, en duur van de Uitwendige elektrotherapie bij chronische pijn

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behandeling, variërend van een eenmalige behandeling van 30 minuten tot een totale behandelduur van meer dan 3600 minuten over 4 weken), indicatie, en onderzoeksdesign. Er zijn minder aanwijzingen voor publicatiebias binnen deze groep (Egger’s test, p = 0.12). Effect size meta-analysis plot [random effects] Deyo et al, 1990 Topuz et al, 2004 Topuz et al, 2004 Machin et al, 1988 Bennett et al, 2010 Boggio et al, 2009 Moore & Shurman, 1997 Cheing & Hui-Chan, 1999 Ghoname et al, 1999a Ghoname et al, 1999b Cheing et al, 2002 Al-Smadi et al, 2003 Al-Smadi et al, 2003 Kumar et al, 1998 Forst et al, 2004 Oosterhof et al, 2006 Kofotolis et al, 2008 Vitiello et al, 2007

-2

0

2

4


Figuur 3. Resultaten random effects meta‐analyse, subgroep: TENS. AL‐TENS In totaal werden 7 studies geïncludeerd waarin een AL‐TENS werd vergeleken met placebo (9 vergelijkingen). De overall effect size binnen deze groep was lager (0.64; 95% betrouwbaarheidsinterval 0.28 – 1.01) dan in de totale groep, wat duidt op een middelmatig effect van AL‐TENS op chronische pijn (zie Figuur 4). De heterogeniteit binnen deze studies bedroeg 70.6%. Er zijn geen aanwijzingen voor publicatiebias binnen deze groep (Egger’s test, p = 0.81).


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Effect size meta-analysis plot [random effects]

Chan et al, 2009 Lee and Lee, 2009 Tam et al, 2007 Deluze et al, 1992 Sangdee et al, 2002 Weng et al, 2005a Weng et al, 2005a Weng et al, 2005b Weng et al, 2005b

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Figuur 4. Resultaten random effects meta‐analyse, subgroep: AL‐TENS. PENS In totaal werden 9 studies geïncludeerd waarin een PENS werd vergeleken met placebo (14 vergelijkingen). De overall effect size binnen deze groep was aanzienlijk hoger (2.5; 95% betrouwbaarheidsinterval 1.7 – 3.3) dan in de totale groep, wat duidt op een groot effect van PENS op chronische pijn (zie Figuur 5). De heterogeniteit binnen deze studies was zeer groot (96.2%). Er zijn sterke aanwijzingen voor publicatiebias binnen deze groep (Egger’s test, p = 0.05).


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Effect size meta-analysis plot [random effects] Ghoname et al, 1999a Ghoname et al, 1999c Ghoname et al, 1999c Ghoname et al, 1999c Ghoname et al, 1999b Ahmed et al, 2000 Ahmed et al, 2000 Ahmed et al, 2000 Hamza et al, 2000 Weiner et al, 2008 Weiner et al, 2008 Weiner et al, 2003 Weiner et al, 2007 Topuz et al, 2004

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Figuur 5. Resultaten random effects meta‐analyse, subgroep: PENS. 3.4.2. Subgroepanalyse naar indicatie De resultaten van de subgroepanalyses per indicatie staan weergegeven in Tabel 1. De subgroepanalyses zijn uitsluitend uitgevoerd voor indicaties waarvoor minimaal 3 studies beschikbaar waren (rugpijn, artrose van de knie, bewegingsapparaat – overig, en diabetische neuropathie). Uit de tabel blijkt dat er wel enige verschillen zijn tussen de indicaties, maar dat er in alle gevallen sprake is van een middelmatig (0.5 – 0.8) tot groot (> 0.8) effect. Uitwendige elektrotherapie bij chronische pijn

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Indicatie

Aantal studies

Aantal Pooled vergelijkingen effect size (95% BI)

Heterogeniteit Publicatie bias (I2) (Egger’s test)

Rugpijn

15

25

94.9%

0.33

61.6%

0.35

095.1%

0.17

1.10 (0.61 – 1.58)

Knie OA

13

14

0.62 (0.35 – 0.89)

Bewegingsapparaat, 4 overig

4

0.76 (0.51 – 1.01)

Diabetische neuropathie

3

3

1.69

- (niet te berekenen)

(1.14 – 2.24) Tabel 1. Resultaten subgroep‐analyse naar indicatie. 3.4.3. Subgroepanalyse naar design (parallelle groepen vs. crossover) Wat betreft onderzoeksopzet kunnen de geïncludeerde studies in twee groepen verdeeld worden: studies met parallelle groepen, en studies met en crossover design. In de eerste worden patiënten gerandomiseerd over actieve behandeling (elektrostimulatie) of placebo (sham‐elektrostimulatie). In studies met een crossover design krijgen alle patiënten zowel de actieve behandeling als de sham‐ behandeling; de volgorde waarin patiënten de behandelingen ondergaan wordt gerandomiseerd. Het onderscheid is van belang omdat de blindering in geval van parallelle groepen waarschijnlijk beter werkt dan in geval van crossover. In het laatste geval ondergaat elke patiënt zowel actieve behandeling als placebo; vrijwel elke patiënt zal onderscheid kunnen maken tussen beiden, waardoor het placebo‐effect –althans gedeeltelijk‐ teniet wordt gedaan (Kaptchuk et al, 2000). Uitwendige elektrotherapie bij chronische pijn

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Studies met parallelle groepen In totaal werden 23 studies geïncludeerd waarin een design met parallelle groepen werd gehanteerd (28 vergelijkingen). De overall effect size binnen deze groep bedroeg 0.65 (95% betrouwbaarheidsinterval 0.42 – 0.87), wat duidt op een middelgroot effect van uitwendige elektrotherapie op chronische pijn (zie Figuur 6). De heterogeniteit binnen deze studies bedroeg 72.1%. Ook binnen deze subgroep zijn er duidelijke aanwijzingen voor publicatiebias (Egger’s test, p = 0.01). Effect size meta-analysis plot [random effects] Deyo et al, 1990 Topuz et al, 2004 Topuz et al, 2004 Machin et al, 1988 Cheing et al, 2002 Al-Smadi et al, 2003 Al-Smadi et al, 2003 Kumar et al, 1998 Forst et al, 2004 Oosterhof et al, 2006 Cheing & Hui-Chan, 1999 Kofotolis et al, 2008 Chan et al, 2009 Lee and Lee, 2009 Tam et al, 2007 Deluze et al, 1992 Sangdee et al, 2002 Weng et al, 2005 Weng et al, 2005 Weiner et al, 2008 Weiner et al, 2008 Weiner et al, 2003 Weiner et al, 2007 Topuz et al, 2004 Thompson et al, 2008 Nourbakhsh and Fearon, 2008 Garland et al, 2007 Vitiello et al, 2007

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Figuur 6. Resultaten random effects meta‐analyse, subgroep: trials met parallelle groepen.


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Studies met crossover design In totaal werden 11 studies geïncludeerd waarin een crossover design werd gehanteerd (19 vergelijkingen). De overall effect size binnen deze groep bedroeg 1.88 (95% betrouwbaarheidsinterval 1.21 – 2.55), wat duidt op een groot effect van uitwendige elektrotherapie op chronische pijn (zie Figuur 7). De heterogeniteit binnen deze studies was zeer hoog (95.8%). Er zijn geen duidelijke aanwijzingen voor publicatiebias binnen deze subgroep (Egger’s test, p = 0.16). Effect size meta-analysis plot [random effects] Bennett et al, 2010 Boggio et al, 2009 Moore & Shurman, 1997 Moore & Shurman, 1997 Ghoname et al, 1999a Ghoname et al, 1999b Weng et al, 2005a Weng et al, 2005a Ghoname et al, 1999a Ghoname et al, 1999c Ghoname et al, 1999c Ghoname et al, 1999c Ghoname et al, 1999b Ahmed et al, 2000 Ahmed et al, 2000 Ahmed et al, 2000 Hamza et al, 2000 Koopman et al, 2009 Naeser et al, 2002

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Figuur 7. Resultaten random effects meta‐analyse, subgroep: trials met crossover design. De verschillen tussen beide typen van studies komen tot uitdrukking in de schatting van de gemiddelde verschillen in verandering van pijn; deze bedroeg voor studies met parallelle groepen 22.5% (95% BI: 14.2 – 30.8), en voor studies met een crossover design 36.6% (95% BI: 18.6 – 54.6). Dit verschil was een gevolg van verschillen in zowel de groep met actieve behandeling als met sham‐ behandeling (zie Tabel 2). Uitwendige elektrotherapie bij chronische pijn

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Studies met parallelle groepen (n = 26) (gemiddelde en 95% BI)

Studies met crossover design (n = 17) (gemiddelde en 95% BI)

Gemiddelde verbetering in pijnscore in groep met actieve behandeling

32.9 (24.5 – 41.3)

43.0 (27.6 – 58.3)

Gemiddelde verbetering in pijnscore in placebogroep

10.4 (4.3 – 16.5)

6.4 (-0.4 – 13.1)

Gemiddeld verschil in verbetering, actieve behandeling - placebogroep

22.5 (14.2 – 30.8)

36.6 (18.6 – 54.6)

Tabel 2. Gemiddelde veranderingen in pijn in placebogroep en groep met actieve behandeling, in trials met parallelle groepen en in trials met crossover design. 3.4.4. Subgroepanalyse naar methodologische kwaliteit Tevens is een subgroepanalyse uitgevoerd van studies met een hoge methodologische kwaliteit (Jadad score van 3 of hoger) en studies met een lage methodologische kwaliteit (Jadad score van 1 of 2). De resultaten van de meta‐analyse van de studies met een Jadad score van 3 of hoger staan weergegeven in Figuur 8. De gepoolde effect size voor deze studies bedraagt 0.75 (0.41 – 1.09).


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Effect size meta-analysis plot [random effects] Topuz et al, 2004 Topuz et al, 2004 Bennett et al, 2010 Boggio et al, 2009 Moore & Shurman, 1997 Al-Smadi et al, 2003 Al-Smadi et al, 2003 Forst et al, 2004 Oosterhof et al, 2006 Vitiello et al, 2007 Chan et al, 2009 Lee and Lee, 2009 Tam et al, 2007 Weiner et al, 2003 Topuz et al, 2004 Koopman et al, 2009 Naeser et al, 2002 Thompson et al, 2008 Nourbakhsh and Fearon, 2008 Moore & Shurman, 1997 Garland et al, 2007

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Figuur 8. Resultaten random effects meta‐analyse, subgroep: trials met hoge methodologische kwaliteit (Jadad score van 3 of hoger). Ter vergelijking is hieronder de forrest plot weergegeven van de studies met een Jadad score van 1 of 2 (Figuur 9); de gepoolde effect size van deze studies is twee maal zo hoog als de gepoolde effect size van de methodologisch sterke studies (1.44; 0.96 ‐ 1.92).


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Effect size meta-analysis plot [random effects] Deyo et al, 1990 Machin et al, 1988 Cheing & Hui-Chan, 1999 Ghoname et al, 1999a Ghoname et al, 1999b Cheing et al, 2002 Kumar et al, 1998 Kofotolis et al, 2008 Deluze et al, 1992 Sangdee et al, 2002 Weng et al, 2005a Weng et al, 2005a Weng et al, 2005b Weng et al, 2005b Ghoname et al, 1999a Ghoname et al, 1999c Ghoname et al, 1999c Ghoname et al, 1999c Ghoname et al, 1999b Ahmed et al, 2000 Ahmed et al, 2000 Ahmed et al, 2000 Hamza et al, 2000 Weiner et al, 2008 Weiner et al, 2008 Weiner et al, 2007

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1,5

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6,5


Figuur 9. Resultaten random effects meta‐analyse, subgroep: trials met lage methodologische kwaliteit (Jadad score van 1 of 2). 3.5. Sequentiële meta‐analyse Voor de studies waarin TENS werd vergeleken met placebo (n = 18) werd een sequentiële meta‐ analyse uitgevoerd. De resultaten hiervan staan weergegeven in Figuur 8. Op de horizontale as staan de trials in chronologische volgorde uitgezet, beginnend met Machin et al (1988) en eindigend met Uitwendige elektrotherapie bij chronische pijn

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Bennett (2010). De intervallen geven het percentage van het totaal aantal benodigde patiënten (de optimal information size) weer dat tot en met de betreffende studie is geïncludeerd. Op de verticale as staan de cumulatieve Z‐score en de grenzen van het cumulatieve betrouwbaarheidsinterval. In de grafiek is te zien dat vanaf de achtste studie (Cheing et al, 2002) het betrouwbaarheidsinterval blijvend wordt overschreden. Dit is een indicatie dat er vanaf de publicatie van die studie er voldoende cumulatief bewijs was dat TENS een klinisch relevante meerwaarde heeft ten opzichte van placebo. Uit de grafiek valt op te maken dat uitvoering van kleine studies naar TENS in de toekomst de conclusies niet wezenlijk zullen beïnvloeden.

Figuur 10. Sequentiële meta‐analyse van RCTs van TENS vs. placebo ter behandeling van chronische pijn (n = 18). Cumulatieve Z‐score (verticale as) staat uitgezet tegen het percentage van het totaal aantal benodigde patiënten om een verschil in responspercentage van 15% (30 vs. 45%) aan te kunnen tonen (n1 + n2 = 1150; α = 0,05, β = 0,10, tweezijdig, I2 = 60%). Grenzen van bovenste en onderste betrouwbaarheidsinterval gebaseerd op de O’Brien‐Flemming α‐spending functie. 3.6. Lopend onderzoek Uit trial registers valt op te maken dat in Europa op dit moment één trial gaande is naar TENS bij chronische pijn(UK; tenniselleboog; ISRCTN87141084). In de VS zijn drie trials gaande naar TENS bij chronische pijn (fybromyalgie ‐ NCT00932360, lage rugpijn ‐ NCT00709748, en pijn bij kanker ‐ NCT01194466). Volgens de gegevens uit de registers zal bij de universiteit van Maastricht nog een studie van start gaan naar TENS bij lage rugpijn (NCT00885859). Uitwendige elektrotherapie bij chronische pijn

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3.6. Enquête De vragenlijst werd door 174 respondenten ingevuld, voor het merendeel fysiotherapeuten (89%), en enkele anesthesiologen (6.7%), revalidatieartsen, neurochirurgen, en (ortho)manueel therapeuten (overige 4.3%). Respondenten waren in meerderheid werkzaam in de eerste lijn (74.1%), in pijnbehandelcentra in niet‐academische ziekenhuizen (9.9%), in eerstelijns gezondheidscentra (6.8%), in pijnbehandelcentra in academische ziekenhuizen (4.9%) en in revalidatiecentra (4.3%). Het merendeel van de respondenten (83.3%) gaf aan wel eens uitwendige hulpmiddelen te gebruiken ter behandeling van chronische pijn. Het mediane aantal patiënten met chronische pijn dat respondenten in de voorgaande maand onder behandeling hadden gehad bedroeg 8 (25‐percentiel: 4, 75% percentiel: 20). Van de respondenten gaf 68% aan TENS te gebruiken in de behandeling van chronische pijn. Van hen gaf 65% aan dat het daarbij om maximaal 2 patiënten per maand gaat; voor 27% waren dit 3 – 10 patiënten per maand, en voor 8% waren dit meer dan 10 patiënten per maand. 27.8% Van de respondenten gaf aan (ook) andere vormen van uitwendige elektrotherapie toe te passen voor deze indicatie, waaronder APS, interferentiestroom, en combinaties van elektrotherapie en ultrageluidsgolven. Het gebruik van braces ter behandeling van chronische pijn werd gerapporteerd door 49.3% van de respondenten, tapes door 56.6%, prothesen door 8.6%, bandages door 24.3%, en spalken door 15.3%. In al deze gevallen ging het doorgaans om ca. 2 tot maximaal 10 patiënten per maand. Andere behandelingen werden gerapporteerd door 22.8% van de respondenten, en omvatten o.m. acupunctuur, aangepast schoeisel, bindweefselmassage, hydrotherapie, diverse loopmiddelen, en elastische kousen. De belangrijkste indicatie vormde pijn van het bewegingsapparaat (95.7% van de respondenten), gevolgd door zenuwletsels (66.2% van de respondenten) en pijn bij kanker (36% van de respondenten). Overige pijnsyndromen die hierbij werden gerapporteerd omvatten o.m. bekkenbodempijn, chronische spanningshoofdpijn, complex regionaal pijnsyndroom, fantoompijn, fibromyalgie, littekenpijn, myofasciaal syndroom, oedemen en pijn na mamma‐amputaties. Van de respondenten gaf 82.8% aan het betreffende hulpmiddel zelf voor te schrijven. In andere gevallen betrof het de huisarts (53.3%), revalidatiearts (20%) of anesthesioloog (26.7%). Het gebruik van het hulpmiddel werd in het merendeel van de gevallen (82.2%) door de respondent zelf begeleid; in andere gevallen betrof het een (collega) fysiotherapeut (63.6%), een pijnconsulent (9.1%), of verpleegkundige of assistent (18.2%). In veruit de meeste gevallen (70.7%) was het gebruik van het hulpmiddel niet permanent; in 14.1% was dit wel het geval, en in 15.2% van de gevallen was dit niet bekend bij de respondent. In 67.7% van de gevallen was er een achterwachtfunctie geregeld; in 21.2% van de gevallen was dit niet het geval, en in 11.1% was dit onbekend bij de respondent. Vervanging van het hulpmiddel geschiedt in 62.6% van de gevallen door de respondent zelf; in 27.3% door een ander, en in 10.1% was dit onbekend. Wanneer vervanging door een ander geschiedde, was dit doorgaans de fabrikant (36%), een (collega) fysiotherapeut (32%), en, incidenteel, een arts (huisarts, pijnconsulent, specialist), een nurse practitioner, of de verzekeraar.


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4. Interpretatie Wanneer de resultaten van alle geïncludeerde studies samen worden genomen, lijkt uitwendige elektrostimulatie een vermindering van chronische pijn te bewerkstelligen die, ten opzichte van een placebo behandeling, zowel klinisch relevant is als statistisch significant. Deze conclusie moet echter om diverse redenen genuanceerd worden: 1. Er is sprake van grote heterogeniteit tussen de studies. Tegenover 23 vergelijkingen die een statistisch significant verschil lieten zien, staan even zoveel (n = 24) vergelijkingen die geen statistisch significant verschil lieten zien. Onder de laatste bevinden zich de grootste studies met de hoogste methodologische kwaliteit (Deyo et al, 1990; Oosterhof et al, 2006). Deze heterogeniteit kon voor een deel herleid worden tot type elektrostimulatie, indicatie, methodologische kwaliteit, en onderzoeksdesign. De gepoolde effect size voor studies met een hoge methodologische kwaliteit (Jadad van 3 of hoger) was aanmerkelijk lager (0.75; 95% BI 0.41 – 1.09) dan voor studies met een lage methodologische kwaliteit (Jadad score van 1 of 2) (1.44; 95% BI 0.96 ‐ 1.92). Dit suggereert dat de kwalitatief mindere studies een overschatting geven van het effect van behandeling. 2. Er is vrijwel zeker sprake van publicatiebias: de asymmetrie in de funnel plots suggereert dat er studies zijn uitgevoerd met een negatief resultaat die niet in de literatuur verschenen zijn. Dit leidt tot een overschatting van het effect van uitwendige elektrostimulatie op chronische pijn. 3. Adequate blindering is een essentiële voorwaarde voor het optreden van een placebo‐effect. Blindering is in geval van apparatieve behandeling die een duidelijk voelbaar effect sorteert moeilijk te realiseren. Er zijn slechts twee studies (beide met parallelle groepen) waarin het succes van blindering is gecontroleerd (Deyo et al, 1990; Oosterhof et al, 2006). In beide studies bleek de blindering succesvol; geen van beide studies liet een statistisch significant voordeel van actieve behandeling (TENS) ten opzichte van placebo zien. Crossover designs zijn voor dit doel niet adequaat, en leiden tot een overschatting van het behandeleffect. Dit zou met name de (onrealistisch) grote behandeleffecten in de studies naar PENS voor een deel kunnen verklaren, aangezien deze studies oververtegenwoordigd waren in de groep met crossover designs (47% van de crossover design studies, vs. slechts 14% van de studies met parallelle groepen). De studies die werden geïncludeerd in dit onderzoek verschilden van elkaar wat betreft duur van de behandeling. Er zijn geen aanwijzingen dat langdurig gebruik tot een groter effect leidt dan kort gebruik. In de studie van Deyo et al (1990) werd TENS langdurig gebruikt (enkele weken), zonder dat dit tot een verschil leidde met placebo‐behandeling. Als eindpunt is de verandering in pijn gehanteerd, direct na afloop van de behandeling ten opzichte van pijn bij het begin van behandeling. Er zijn weinig gegevens over het effect op langere termijn na afloop van de behandeling. Echter, indien TENS op korte termijn geen klinisch relevante verbetering laat zien t.o.v. placebo (zoals in het geval van het onderzoek van Deyo et al, 1999, en Oosterhof et al, 2006), is er geen reden om aan te nemen dat dit bij langere follow up wel het geval zal zijn. Uitwendige elektrotherapie bij chronische pijn

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Als uitwendige elektrotherapie een effect heeft op chronische pijn dat onderscheiden kan worden van placebo, dan zal dat effect minder groot zijn dan in de overall analyse wordt gesuggereerd, zal het niet gelijk zijn voor alle behandelmodaliteiten, en zal het niet gelijk zijn voor alle typen van pijn. De vraag of uitwendige elektrotherapie een specifiek effect kan hebben op chronische pijn dat te onderscheiden is van het aspecifiek effect dat via sham‐behandeling tot stand komt, kan daarom op grond van de beschikbare literatuur niet zonder meer bevestigend worden beantwoord. Deze conclusie is in overeenstemming met recente reviews over uitwendige elektrostimulatie voor specifieke vormen van chronische pijn en voor chronische pijn in het algemeen (Khadilkar et al,

2008; Rutjes et al, 2009; Nnoaham en Kumbang, 2008; Robb et al, 2008; Mulvey et al, 2010). De gevonden effecten voor TENS en AL‐TENS zijn vergelijkbaar met die van andere behandelmodaliteiten voor chronische pijn, zoals gedragstherapie (Henschke et al, 2010), oefentherapie (Hayden et al, 2005), en massage (Forlan et al, 2008). De conclusie van het huidige onderzoek is ook in overeenstemming met richtlijnen, uitgebracht door het Koninklijk Nederlands Genootschap voor Fysiotherapie (KNGF), die terughoudendheid adviseert m.b.t. het gebruik van elektrotherapie bij chronische lage rugpijn (KNGF‐richtlijn Lage‐rugpijn, 2005, p. 5). Voor patiënten met reumatoïde artritis en voor patiënten met artrose van de heup of knie wordt TENS noch aanbevolen, noch afgeraden (KNGF‐richtlijn Reumatoïde artritis, 2008, p. 13; KNGF‐ richtlijn Artrose heup – knie, 2010, p. 11). Ten aanzien van behandeling van patiënten met knieartrose, lage‐rugpijn, en Reumatoïde artritis luiden de aanbevelingen van het KNGF als volgt:

Knieartrose: Op basis van de huidige evidentie kan TENS noch worden aanbevolen, noch afgeraden bij de behandeling van mensen met knieartrose ter vermindering van de pijn op de korte termijn. Gezien het mogelijke korte termijn effect van TENS is de werkgroep van mening dat deze interventie in individuele gevallen kan worden overwogen als sprake is van knieartrose en veel pijnklachten. TENS dient dan ter ondersteuning van het oefenen. Ter verbetering van pijn en fysiek functioneren kan ook de combinatie van TENS en oefentherapie worden overwogen. Dit is echter niet de behandeling van eerste keus. Lage rugpijn: Tractie en biofeedback zijn niet zinvol bij chronische lage-rugpijn. Het is onbekend of massage, elektrotherapie (inclusief TENS), ultrageluid en laser al dan niet zinvol zijn bij patiënten met lage-rugpijn. Met betrekking tot de praktijk wordt geadviseerd terughoudend te zijn met het hanteren van deze verrichtingen. Reumatoïde artritis: het apparatief toedienen van elektrische energie door middel van wisselstroom (zowel interferentie als TENS) wordt noch aanbevolen, noch afgeraden;


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In de richtlijnen van het National Institute for Health and Clinical Excellence (NICE) wordt het gebruik van TENS bij patiënten met lage rugpijn ontraden (NICE Clinical Guideline Low back pain 2009, Nr.88, p. 11), terwijl het gebruik van TENS bij patiënten met artrose overwogen kan worden als aanvullende behandeling (NICE Clinical Guideline Osteoarthritis 2010, Nr.59, p. 10). Ondanks deze terughoudendheid van de kant van de beroepsvereniging, blijkt op grond van de enquête uitwendige elektrotherapie ter behandeling van chronische pijn een wezenlijk onderdeel van het behandelrepertoire te zijn. Circa tweederde van de respondenten gaf aan TENS toe te passen; bij 65% van hen betrof het maximaal 2 patiënten per maand, terwijl het bij 27% van de respondenten om 3 – 10 patiënten per maand ging, en bij 8% om meer dan 10 patiënten per maand. Pijn van het bewegingsapparaat is daarbij veruit de belangrijkste indicatie, gevolgd door zenuwletsels en pijn bij kanker. Uit de enquête blijkt dat TENS daarnaast nog bij diverse typen van pijn wordt toegepast, waaronder fantoompijn, pijn na operaties, en hoofdpijn. De vraag, welke vorm van uitwendige elektrotherapie, voor welke patiënt, in welke fase van de ziekte, onder welke voorwaarden therapeutische meerwaarde heeft, blijft in wezen onbeantwoord. Dat is onbevredigend. Chronische pijn is, zowel voor de individuele patiënt als voor de samenleving als geheel, uitermate belastend. Ook een relatief geringe vermindering van pijn kan zich vertalen in een verbetering van welbevinden en in functioneren, met als gevolg o.m. verminderd arbeidsverzuim. Veel patiënten menen baat te hebben bij enige vorm van uitwendige elektrotherapie. Waarschijnlijk komt dit voor een deel via suggestie tot stand (Marchand et al, 1993; Kaptchuk et al, 2000). Anderzijds heeft experimenteel onderzoek, uitgevoerd bij mensen of proefdieren, overtuigend laten zien dat uitwendige stroom de sensatie van pijn op specifieke wijze kan onderdrukken (Sluka en Walsh, 2003). De discrepantie met bevindingen uit klinisch onderzoek en met ervaringen uit de praktijk kan wellicht voor een deel verklaard worden door de complexiteit van chronische pijn, en het feit dat we de factoren die van invloed zijn op het ontstaan en onderhouden van chronische pijn onvoldoende kennen, voor zover we ze kennen onvoldoende controleren in onderzoek, en voor zover we ze controleren, onvoldoende beschrijven in publicaties. Vooruitgang kan vermoedelijk het beste worden bereikt door een in te stellen behandeling te baseren op inzicht in de onderliggende mechanismen van pijn en pijnbehandeling, en hierover meer gedetailleerd te rapporteren (Priest en Hoggart, 2002). De veronderstelde onderliggende mechanismen dienen daarbij gebaseerd te zijn op een adequate multi‐dimensionele diagnostiek. Men dient zich hierbij echter te realiseren dat geen enkele monodisciplinaire behandeling van chronische pijn een voldoende hoog succes percentage zal hebben omdat er in de dagelijkse praktijk altijd bijkomende interacterende mechanismen een (on)bedoelde rol kunnen spelen. Het CVZ staat, als pakketbeheerder, voor de principiële keuze of het bereid is positief te adviseren over de vergoeding van een behandeling die in de praktijk aanzienlijke pijnverlichting kan bewerkstelligen, maar waarvan in onderzoek het effect voor een mogelijk belangrijk deel aspecifiek lijkt te zijn (zie ook Sullivan, 1993, en Kaptchuk, 2002). Het CVZ zou hier op grond van pragmatische Uitwendige elektrotherapie bij chronische pijn

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overwegingen toe kunnen besluiten (vermindering van ziektelast ten gevolge van chronische pijn). Hier zijn echter twee argumenten tegen in te brengen: 1. Het zet de deur open naar vergoeding van allerlei interventies waarvan het effect vermoedelijk langs aspecifieke weg tot stand komt; 2. Het is de vraag of dit effect voor TENS en andere vormen van uitwendige elektrotherapie in de toekomst nog wel benut kan worden. Daartoe moeten immers zowel behandelaars als patiënten voldoende vertrouwen hebben in een specifiek behandeleffect. Op grond van de beschikbare literatuur en huidige richtlijnen vanuit de beroepsvereniging is dat, zeker voor behandelaars, in feite niet meer reëel. Om die reden ligt het wellicht meer voor de hand om nieuwe, effectieve manieren te zoeken om de mechanismen waarlangs patiënten zelf controle kunnen uitoefenen over hun pijnsensatie te activeren (Benedetti et al, 2010; Stiles en Wright, 2008). Tot die tijd mag in ieder geval verwacht worden dat behandeling altijd deel uitmaakt van een omvattender, multidisciplinaire aanpak, waaronder adequate (multidimensionele) diagnostiek, een goede evaluatie van effect van de therapie en algemene behandelprincipes van de patiënt met chronische pijn (KNGF, 2010).

5. Geciteerde literatuur Benedetti F, Carlino E, Pollo A, How placebos change the patient’s brain. Neuropscychopharmacology Rev 2010; 1 – 16. Brok J, Thorlund K, Wetterslev J, Gluud C, Apparently conclusive meta‐analyses may be inconclusive. Trial sequential analysis adjustment of random error risk due to repetitive testing of accumulating data in apparently conclusive neonatal meta‐analyses. Int J Epidemiol 2009; 38: 287 – 98. Chinn S, A simple method for converting an odds ratio to effect size for use in meta‐analysis. Stat Med 2000; 19: 3127 – 31. Cohen J, A power primer. Psychol. Bull. 1992; 112 (1): 155 – 9. Egger M, et al. Bias in meta‐analysis detected by a simple, graphical test. British Medical Journal 1997;315:629‐634. Furlan AD, Imamura M, Dryden T, Irvin E. Massage for low‐back pain. Cochrane Database Syst Rev. 2008 Oct 8;(4). Gilron I, Johnson AP. Economics of chronic pain: How can science guide health policy? Can J Anaesth. 2010; 57 (6) :530‐8. Hayden JA, van Tulder MW, Malmivaara A, Koes BW. Exercise therapy for treatment of non‐specific low back pain. Cochrane Database Syst Rev. 2005 Jul 20;(3) Hedges LV, Olkin I, Statistical methods for meta‐analysis. London: Academic Press 1985. Henschke N, Ostelo RW, van Tulder MW, Vlaeyen JW, Morley S, Assendelft WJ, Main CJ. Behavioural treatment for chronic low‐back pain. Cochrane Database Syst Rev. 2010 Jul 7; 7. Higgins JPT, Thompson SG. Quantifying heterogeneity in a meta‐analysis. Statistics in Medicine 2002;21:1539‐1558. Uitwendige elektrotherapie bij chronische pijn

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Jadad AR, Moore RA, Carroll D, Jenkinson C, Reynolds DJ, Gavaghan DJ, McQuay HJ. Assessing the quality of reports of randomized clinical trials: is blinding necessary? Control Clin Trials. 1996; 17(1):1‐12.

Johnson M, Martinson M. Efficacy of electrical nerve stimulation for chronic musculoskeletal pain: a meta‐analysis of randomized controlled trials. Pain. 2007; 130 (1‐2):157‐65. Johnson M, Transcutaneous electrical nerve stimulation (TENS). In: Electrotherapy: Evidence‐ Based Practice. T Watson (Ed), 12the Edition, pp. 254 – 5. Johnson MI, Walsh DM, Pain: continued uncertainty of TENS’ effectiveness for pain relief. Nature Rev Rheumatology 2010; 6: 314 – 6. Kaptchuk TJ, Goldman P, Stone DA, Stason WB. Do medical devices have enhanced placebo effects? J Clin Epidemiol. 2000; 53 (8): 786‐92. Kaptchuk TJ, The placebo effect in alternative medicine: Can the performance of a healing ritual have clinical significance? Ann Int Med 2002: 136: 817 – 25.

Khadilkar A, Odebiyi DO, Brosseau L, Wells GA. Transcutaneous electrical nervestimulation (TENS) versus placebo for chronic low‐back pain. Cochrane Database Syst Rev. 2008 Oct 8;(4). Marchand S, Charest J, Li J, Chenard J‐R, Lavignolle B, Laurencelle L, Is TENS purely a placebo effect? A controlled study on chronic low back pain. Pain 1993; 54: 99 – 106. Melzack R, Wall P, Pain mechanisms: A new theory. Science 1965; 150: 971 – 9. Mulvey MR, Bagnall AM, Johnson MI, Marchant PR. Transcutaneous electrical nerve stimulation (TENS) for phantom pain and stump pain following amputation in adults. Cochrane Database Syst Rev. 2010 May 12;5. Nnoaham KE, Kumbang J. Transcutaneous electrical nerve stimulation (TENS) for chronic pain. Cochrane Database Syst Rev. 2008 Jul 16;(3). O’Brien PC, Fleming TR, A multiple testing procedure for clinical trials. Biometrika 1979; 35: 549 – 56. Ostelo RWJG, Deyo RA, Stratford P, et al, Interpreting change scores for pain and functional status in low back pain. Spine 2008; 33 (1): 90 – 4. Priest TD, Hoggart B. Chronic pain: mechanisms and treatment. Curr Opin Pharmacol. 2002; 2 (3):310‐5.

Robb KA, Bennett MI, Johnson MI, Simpson KJ, Oxberry SG. . Transcutaneous electric nerve stimulation (TENS) for cancer pain in adults. Cochrane Database Syst Rev. 2008. Uitwendige elektrotherapie bij chronische pijn

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Robinson AJ, Snyder‐Mackler L, Clinical Electrophysiology. Electrotherapy and Electrophysiologic Testing. Baltimore, Williams & Wilkins, 1995 (2nd Edition) Rutjes AW, Nüesch E, Sterchi R, Kalichman L, Hendriks E, Osiri M, Brosseau L, Reichenbach S, Jüni P. Transcutaneous electrostimulation for osteoarthritis of the knee. Cochrane Database Syst Rev. 2009 Oct 7;(4):CD002823. SjogrenP, Ekholm O, Peuckmann V, Gronbek M, Epidemiology of chronic pain in Denmark: an update. Eur J of Pain 2009; 13: 287 – 92. Sluka KA, Walsh D. Transcutaneous electrical nerve stimulation: basic science mechanisms and clinical effectiveness. J Pain. 2003 Apr;4(3):109‐21. Stiles TC, Wright D, Cognitive‐behavioural treatment of chronic pain conditions. Nord J Psychiatry 2008; 62: 30 – 6. Sullivan MD, Placebo controls and epistemic control in orthodox medicine. J Med Philos 1993; 18: 213 – 31.

Wall PD, Sweet WH, Temporary abolition of pain in man. Science 1967; 155: 108 – 9. Wood L, 2008, Physiology of pain. In: Electrotherapy: Evidence‐Based Practice. T Watson (Ed), 12the Edition, p. 92.


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Bijlage 1: Samenstelling projectgroep en geraadpleegde deskundigen

Projectgroep prof. dr. G. J. van der Wilt, hoogleraar HTA, Afdeling Epidemiologie, Biostatistiek & HTA dr. R.T.M. van Dongen, anesthesioloog, Afdeling Anesthesiologie, Pijn en Palliatieve Geneeskunde. J. Oosterhof, fysiotherapeut, Afdeling Orthopedie, subafdeling Fysiotherapie Centraal dr.ir. R.P.B. Reuzel, HTA deskundige, Afdeling Epidemiologie, Biostatistiek & HTA prof. dr. M.W.G. Nijhuis, hoogleraar paramedische wetenschappen, Afdeling IQ Health Care dr. J.B. Staal, fysiotherapeut / epidemioloog, Afdeling IQ Health Care Drs. L.H.M. Boerboom, junior onderzoeker, Afdeling IQ Health Care Drs. N.M. de Vries, onderzoeksassistent, Afdeling IQ Health Care Secretariële ondersteuning: F. Westerweel, Afdeling Epidemiologie, Biostatistiek & HTA Geraadpleegde deskundigen: Drs. J.H.M. Groenewoud, Afdeling Epidemiologie, Biostatistiek & HTA Prof. dr. R.A.B. Oostendorp, emeritus hoogleraar Paramedische Wetenschappen Dr. P.G.M. Peer, Afdeling Epidemiologie, Biostatistiek & HTA E. Peters, Bibliotheek Allen van de Radboud Universiteit Nijmegen, Medisch Centrum


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Bijlage 2: Zoekstrategieën PubMed, sensitieve search: (Pain AND “electrical nerve stimulation”) OR (“Pain”[Mesh] AND “Electric Stimulation Therapy”[MESH]) Aantal treffers: 659 PubMed, specifieke search: ((((TENS OR Transcutaneous electric nerve stimulation OR Transcutaneous electrical nerve stimulation OR Electronic nerve stimulation OR Electronical nerve stimulation OR Electric nerve stimulation OR Electrical nerve stimulation OR Electric stimulation therapy OR Electrical stimulation therapy OR Percutaneous electric nerve stimulation OR Percutaneous electrical nerve stimulation OR Transcutaneous electrostimulation OR Percutaneous electrostimulation OR Electric stimulation OR Electrical stimulation OR Electroacupuncture OR Electro‐acupuncture OR Electrostimulation therapy OR Electro‐stimulation therapy OR Electroanalgesic OR Electroanalgesia OR Nerve stimulation OR Nerve stimulations OR Electric therapy OR Electrical therapy OR Analgesic Cutaneous Electrostimulation OR Transdermal electrostimulation[Title/Abstract])) OR (Transcutaneous electric nerve stimulation[MeSH Terms])) AND ("Chronic Disease"[Mesh] AND "Pain"[Mesh] OR "chronic pain")) Aantal treffers:: 110 Embase: (TENS or Transcutaneous electric nerve stimulation or Transcutaneous electrical nerve stimulation or Electronic nerve stimulation or Electronical nerve stimulation or Electric nerve stimulation or Electrical nerve stimulation or Electric stimulation therapy or Electrical stimulation therapy or Percutaneous electric nerve stimulation or Percutaneous electrical nerve stimulation or Transcutaneous electrostimulation or Percutaneous electrostimulation or Electric stimulation or Electrical stimulation or Electroacupuncture or Electro‐acupuncture or Electrostimulation therapy or Electro‐stimulation therapy or Electroanalgesic or Electroanalgesia or Nerve stimulation or Nerve Uitwendige elektrotherapie bij chronische pijn

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stimulations or Electric therapy or Electrical therapy or Analgesic Cutaneous Electrostimulation or Transdermal electrostimulation).ab. OR exp electrostimulation therapy/ or exp transcutaneous nerve stimulation/ AND chronic pain.mp. or exp chronic pain/ AND randomized controlled trial/ Aantal treffers: 121

PEDro: ‐ TENS or elect nerv stimul or electrostimul or electro‐stim [title or abstract fields] ‐ clinical trial [method field] ‐ electrotherapies, heat and cold [intervention field] ‐ pain [problem field] Aantal treffers: 283 Scopus:

((((TITLE-ABS-KEY(chronic pain)) AND (((TITLE-ABS-KEY(tens OR transcutaneous electric nerve stimulation OR transcutaneous electrical nerve stimulation OR electronic nerve stimulation OR electronical nerve stimulation OR electric nerve stimulation OR electrical nerve stimulation OR electric stimulation therapy)) OR (TITLE-ABS-KEY(electrical stimulation therapy OR percutaneous electric nerve stimulation OR percutaneous electrical nerve stimulation OR transcutaneous electrostimulation OR percutaneous electrostimulation OR electric stimulation OR electrical stimulation)) OR (TITLE-ABSKEY(electroacupuncture OR electro‐acupuncture OR electrostimulation therapy OR electro‐ stimulation therapy OR electroanalgesic OR electroanalgesia OR nerve stimulation OR nerve stimulations OR electric therapy)) OR (TITLE-ABS-KEY(electrical therapy OR analgesic cutaneous electrostimulation OR transdermal electrostimulation)))))) AND (TITLE-ABSKEY(randomized controlled trial))) Aantal treffers: 123


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Cinahl: TI ( TENS OR Transcutaneous electric nerve stimulation OR Transcutaneous electrical nerve stimulation OR Electronic nerve stimulation OR Electronical nerve stimulation OR Electric nerve stimulation OR Electrical nerve stimulation OR Electric stimulation therapy OR Electrical stimulation therapy OR Percutaneous electric nerve stimulation OR Percutaneous electrical nerve stimulation OR Transcutaneous electrostimulation OR Percutaneous electrostimulation OR Electric stimulation OR Electrical stimulation OR Electroacupuncture OR Electro‐acupuncture OR Electrostimulation therapy OR Electro‐stimulation therapy OR Electroanalgesic OR Electroanalgesia OR Nerve stimulation OR Nerve stimulations OR Electric therapy OR Electrical therapy OR Analgesic Cutaneous Electrostimulation OR Transdermal electrostimulation ) or AB ( TENS OR Transcutaneous electric nerve stimulation OR Transcutaneous electrical nerve stimulation OR Electronic nerve stimulation OR Electronical nerve stimulation OR Electric nerve stimulation OR Electrical nerve stimulation OR Electric stimulation therapy OR Electrical stimulation therapy OR Percutaneous electric nerve stimulation OR Percutaneous electrical nerve stimulation OR Transcutaneous electrostimulation OR Percutaneous electrostimulation OR Electric stimulation OR Electrical stimulation OR Electroacupuncture OR Electro‐acupuncture OR Electrostimulation therapy OR Electro‐stimulation therapy OR Electroanalgesic OR Electroanalgesia OR Nerve stimulation OR Nerve stimulations OR Electric therapy OR Electrical therapy OR Analgesic Cutaneous Electrostimulation OR Transdermal electrostimulation ) OR (MH "Transcutaneous Electric Nerve Stimulation") AND (TI chronic pain or AB chronic pain OR MH Chronic pain) Aantal treffers: 172

Web of Science: Topic=(TENS or Transcutaneous electric nerve stimulation or Transcutaneous electrical nerve stimulation or Electronic nerve stimulation or Electronical nerve stimulation or Electric nerve stimulation or Electrical nerve stimulation or Electric stimulation therapy or Electrical stimulation therapy or Percutaneous electric nerve stimulation or Percutaneous electrical nerve stimulation or Transcutaneous electrostimulation or Percutaneous electrostimulation or Electric stimulation or Electrical stimulation or Electroacupuncture or Electro‐acupuncture or Electrostimulation therapy or Electro‐stimulation therapy or Electroanalgesic or Uitwendige elektrotherapie bij chronische pijn

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Electroanalgesia or Nerve stimulation or Nerve stimulations or Electric therapy or Electrical therapy or Analgesic Cutaneous Electrostimulation or Transdermal electrostimulation) AND topic=(Chronic pain) AND topic=(Randomized controlled trial) OR topic = randomized controlled trial Aantal treffers: 176 Cochrane Database of Systematic Reviews: (TENS OR Transcutaneous electric* nerve stimulation OR Electron* nerve stimulation OR Electric* nerve stimulation OR Electric* stimulation therap* OR Percutaneous electric* nerve stimulation OR Transcutaneous electrostimulation OR Electric* stimulation OR Electroacupuncture OR Electro‐ acupuncture OR Electrostimulation therap* OR Electro‐stimulation therap* OR Electroanalgesi* OR Electro‐analgesi* OR Nerve stimulat* OR Electric* therap* OR Analges* Cutaneous Electrostimulation OR Transdermal electrostimulation):ti,ab,kw AND pain:ti,ab,kw AND chronic:ti,ab,kw Aantal treffers: : 35


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Bijlage 3: Formulier beoordeling methodologische kwaliteit (Jadad)

Jadad Score Calculation Item

Score

Was the study described as randomized (this includes words such as randomly, random, and randomization)?

0/1

Was the method used to generate the sequence of randomization described and appropriate (table of random numbers, computer-generated, etc)?

0/1

Was the study described as double blind?

0/1

Was the method of double blinding described and appropriate (identical placebo, active placebo, dummy, etc)?

0/1

Was there a description of withdrawals and dropouts?

0/1

Deduct one point if the method used to generate the sequence of randomization was 0/-1 described and it was inappropriate (patients were allocated alternately, or according to date of birth, hospital number, etc). Deduct one point if the study was described as double blind but the method of blinding was inappropriate (e.g., comparison of tablet vs. injection with no double dummy).

0/-1

Total score


42

Bijlage 4. Opbrengst zoekstrategie Search:

Totale opbrengst:

Opbrengst na ontdubbeling:

Waarvan geïncludeerd:

PubMed sensitieve search

659

659

25

Pedro

283

120

4

Web of Science

176

137

0

Cinahl

172

131

0

Scopus

123

53

2

Embase

120

50

0

PubMed, specifieke search

110

29

1

Handmatig

2

2

2

Totaal

1181

34


43

Bijlage 5: Redenen voor exclusie Reden

Aantal

-

Geen chronische pijn

428

-

geen RCT

273

-

Invasieve behandeling

143

-

Geen sham controle groep

123

-

Geen elektrotherapie

99

-

Data extractie niet mogelijk

59

-

Niet beschikbaar

12

-

Geen primaire data

6

-

Geen gegevens over duur van de pijn

4

Totaal:

1147


44

Bijlage 6: Referenties geïncludeerde studies

Auteur

Titel

1

Ahmed 2000

Use of percutaneous electrical nerve stimulation (PENS) in the short‐term management of headache

2

Al‐Smadi

A pilot investigation of the hypoalgesic effects of transcutaneous electrical nerve stimulation upon low back pain in people with multiple sclerosis

3

Bennett 2010

Feasibility study of Transcutaneous Electrical Nerve Stimulation (TENS) for cancer bone pain

4

Boggio 2009

Transcranial DC stimulation coupled with TENS for the treatment of chronic pain: a preliminary study

5

Chan 2009

Electrical acustimulation of the wrist for chronic neck pain: a randomized, sham‐controlled trial using a wrist‐ankle acustimulation device

6

Cheing 1999

Transcutaneous electrical nerve stimulation: nonparallel antinociceptive effects on chronic clinical pain and acute experimental pain.

7

Cheing 2002

Does four weeks of TENS and/or isometric exercise produce cumulative reduction of osteoarthritic knee pain?

8

Deluze 1992

Electroacupuncture in fibromyalgia: results of a controlled trial.

9

Deyo 1990

A controlled trial of transcutaneous electrical nerve stimulation (TENS) and exercise for chronic low back pain.

10

Forst 2004

Impact of low frequency transcutaneous electrical nerve stimulation on symptomatic diabetic neuropathy using the new Salutaris device

11

Garland 2007

A 3‐month, randomized, double‐blind, placebo‐controlled study to evaluate the safety and efficacy of a highly optimized, capacitively coupled, pulsed electrical stimulator in patients with osteoarthritis of the knee

12

Ghoname 1999 Percutaneous electrical nerve stimulation for low back pain: a randomized percutaneous crossover study

13

Ghoname 1999 Percutaneous electrical nerve stimulation: an alternative to TENS in the management of sciatica

14

Ghoname 1999 The effect of stimulus frequency on the analgesic response to percutaneous electrical nerve stimulation in patients with chronic low back pain.


45

15

Hamza 2000

Percutaneous electrical nerve stimulation: a novel analgesic therapy for diabetic neuropathic pain.

16

Kofotolis 2008

Sequentially allocated clinical trial of rhythmic stabilization exercises and TENS in women with chronic low back pain.

17

Koopman 2009 Efficacy of microcurrent therapy in the treatment of chronic nonspecific back pain: a pilot study.

18

Kumar 1998

Diabetic peripheral neuropathy. Effectiveness of electrotherapy and amitriptyline for symptomatic relief

19

Lee and Lee 2009

Electroacupuncture relieves pain in men with chronic prostatitis/chronic pelvic pain syndrome: three‐arm randomized trial.

20

Machin 1988

Pain Measurement in Randomized Clinical‐Trials ‐ A Comparison of 2 Pain Scales

21

Moore 1997

Combined neuromuscular electrical stimulation and transcutaneous electrical nerve stimulation for treatment of chronic back pain: a double‐ blind, repeated measures comparison.

22

Nourbakhsh 2008

An alternative approach to treating lateral epicondylitis. A randomized, placebo‐controlled, double‐blinded study.

23

Naeser 1997

Carpal tunnel syndrome pain treated with low‐level laser and microamperes transcutaneous electric nerve stimulation: A controlled study.

24

Oosterhof 2006 Outcome of transcutaneous electrical nerve stimulation in chronic pain: shortterm results of a double-blind, randomised, placebo-controlled trial

25

Sangdee 2002

Electroacupuncture versus diclofenac in symptomatic treatment of osteoarthritis of the knee: a randomized controlled trial.

26

Tam 2007

Acupuncture in the treatment of rheumatoid arthritis: a double‐blind controlled pilot study.

27

Thompson 2008

A double blind randomised controlled clinical trial on the effect of transcutaneous spinal electroanalgesia (TSE) on low back pain.

28

Topuz 2004

Efficacy of transcutaneous electrical nerve stimulation and percutaneous neuromodulation therapy in chronic low back pain.

29

Vitiello 2007

The effectiveness of ENARÂ® for the treatment of chronic neck pain in Australian adults: A preliminary single‐blind, randomised controlled trial.

30

Weiner 2008

Efficacy of percutaneous electrical nerve stimulation and therapeutic exercise for older adults with chronic low back pain: a randomized controlled


46

trial. 31

Weiner 2003

Efficacy of percutaneous electrical nerve stimulation for the treatment of chronic low back pain in older adults.

32

Weiner 2007

Efficacy of periosteal stimulation therapy for the treatment of osteoarthritis‐ associated chronic knee pain: an initial controlled clinical trial.

33

Weng 2005

The evaluation of two modulated frequency modes of acupuncture‐like TENS on the treatment of tennis elbow pain.

34

Weng 2005

The treatment of upper back pain by two modulated frequency modes of acupuncture‐like TENS.


47

Bijlage 7: Resultaat beoordeling methodologische kwaliteit geïncludeerde studies


48

Use of percutaneous electrical nerve stimulation (PENS) in the short‐term management of headache Ahmed 2000 (1) Country

USA

What compared to what?

PENS vs. sham‐Pens

Patient characteristics

Tension headache; pain > 6 months, 7 female/6 male, age 38 ± 11

Fulfills inclusion criteria?

Yes

N

13

Groups

Crossover design

Drop‐outs

Not mentioned

Outcome measure

Vas (pain) 10 cm, three measurements per week prior to each treatment session

Instrument

0,5 ms of alternating 15/30 Hz, 10 acupuncture needles into soft tissue of back of neck (C2, C5, C7 and T4). Intensity adjusted to produce tolerable “tapping” sensation without muscle contraction.

Interventions

30 minutes, 3 times a week, for 2 weeks with one week between treatments.

Placebo

Non functioning PENS, identical needle placing.

Results

VAS

Baseline

Sham‐PENS

PENS

48 hours before first treatment

48 hours after treatment


7.1 ± 1.0

6.3 ± 0.9

3.1 ± 0.7

Pain relief

48 hours after treatment.

Follow up

No

Jadad score

1

Industry sponsored

No


49


USA




Migraine pain > 6 months; 8 female/4 male; mean age 38 ± 13


Yes

N

12

Groups

Crossover design

Drop‐outs

Not mentioned

Outcome measure


Instrument

0,5 ms of alternating 15/30 Hz, 10 acupuncture needles into soft tissue of back of neck (C2, C5, C7 and T4). Intensity adjusted to produce highest tolerable “tapping” sensation without muscle contraction.

Interventions


Placebo


Results

Baseline(48 hours before first treatment)

Sham‐PENS (48 hours after treatment)

PENS (48 hours after treatment)

VAS

7.6 ± 1.1

6.5 ± 0.9

3.0 ± 0.7

Pain relief


Follow up

No

Jadad score

1

Industry sponsored

No


50


USA




Posttraumatic headache; pain > 6 months; 3 f /2 m; age 41 ± 12


Yes

N

5

Groups

Crossover design

Drop‐outs

Not mentioned

Outcome measure


Instrument

0,5 ms of alternating 15/30 Hz, 10 acupuncture needles into soft tissue of back of neck (C2, C5, C7 and T4). Intensity adjusted to produce highest tolerable “tapping” sensation without muscle contraction.

Interventions


Placebo


Results

VAS

Baseline

Sham‐PENS

PENS

48 hours before first treatment



7.3 ± 1.0

5.7 ± 0.9

3.1 ± 0.6

Pain relief


Follow up

No

Jadad score

1

Industry sponsored

No

A pilot investigation of the hypoalgesic effects of transcutaneous electrical nerve stimulation


51

upon low back pain in people with multiple sclerosis – Al‐Smadi 2003 Country

Northern Ireland


TENS and TENS placebo


Low back pain > 3 months; 34‐65 yrs.


Yes

N

N = 15

Drop‐outs

One dropout: Tens 2; lost to follow‐up

Groups

TENS 1 (n = 5) TENS 2 (n = 5, n=4 for follow up) Placebo (n = 5)

Outcome measure

VAS (pain), McGill PRI, 4 measurements per person.

Instrument

200us/4 Hz (TENS group 1) and 200us/110Hz (TENS group 2), two electrodes on lumbar and sacral nerve roots (L1‐S2).

Interventions

45 minutes, three times per week for six weeks.

Placebo

Non functioning TENS, identical electrode placing & procedure.

Results

Mean (sem)

Week 1 (prior to first treatment)

Week 6 (after last treatment)

Week 10

Mean (sem)

Mean (sem)

Mean (sem)

Tens 1

16.7 (1.0)

10 (2.3)

14.2 (2.2)

Tens 2

18.2 (1.8)

15.6 (1.9)

13.7 (2.9)

Sham ‐ TENS

16.4 (1.4)

15 (2.5)

17 (1.6)

(follow‐up)

Pain relief

Directly after last treatment and four weeks after last treatment

Follow up

Yes, in week 10

Jadad score

5

Industry sponsored

Not mentioned


52

Feasibility Study of Transcutaneous Electrical Nerve Stimulation (TENS) for Cancer Bone Pain ‐ Bennett 2010 Country

United Kingdom


TENS vs. sham TENS


Painful bone metastases of any primary cancer; age 72.0 ± 11.1


y

N

N=24

Drop‐outs

Five drop‐outs N=19

Groups

Crossover design with different treatment orders: Active TENS > Placebo (n =12) Placebo > active TENS (n =12)

Outcome measure

Pain intensity measures: 5 measurements per patient: at rest, on movement; measured with Numeral Rating Scale

Instrument

200ms/80Hz, placed between 5 and 10 cm apart on an area of skin in good condition and without signs of altered sensation

Interventions

Single session of 60 minutes, three days between applications.

Placebo


Baseline

After treatment

NRS rest TENS

2.95 ± 2.95

2.11 ± 2. 42

NRS rest sham‐ TENS

3.95 ± 2.59

1.79 ± 2.18

NRS mov. TENS

5.16 ± 2.17

2.84 ± 2.17

NRS mov. sham‐TENS

5.05 ± 2.53

3.05 ± 2.46

Pain relief

1 hour

Follow up

No

Jadad score

3

Industry sponsored

Not mentioned


53

Transcranial DC Stimulation Coupled With TENS for the Treatment of Chronic Pain, A Preliminary Study ‐ Boggio 2009 Country

Italy


transcranial Direct Current Stimulation (tCDS)/TENS vs. tDCS/sham‐ TENS


Localized neurogenic pain of the arms > 3 months; 2 male/6 female; age 63.3 ± 15.9


Yes

N

N = 8

Drop‐outs

One drop‐out from tDCS/TENS for the third session

Groups

Crossover design

Outcome measure

VAS (pain) 10 cm

Instrument

150us/4 Hz The electrodes were positioned at a distance of 6 cm apart and centred over the site that elicited most pain on palpation during examination. Intensity decreased just below sensation treshold.

Interventions

Single session of 30 minutes with 48 hours wash out interval.

Placebo

Non functioning TENS

Results

Pretreatment

Posttreatment

VAS tDCS/TENS

7.8 ± 1.8

5.25 ± 2.66

VAS tDCS/sham‐TENS

7.5 ± 1.9

6.4 ± 1.9

Pain relief

Directly after treatment

Follow up

No

Jadad score

3

Industry sponsored

Not mentioned


54

Electrical acustimulation of the wrist for chronic neck pain: a randomized, sham‐controlled trial using a wrist‐ankle acustimulation device – Chan 2009 Country

Hong Kong, China


Electroacupuncture vs. Sham‐Electroacupuncture


Neck pain > 3 months, 18 male/31 female, average age +/‐ 52


Yes

N

N = 49

Drop‐outs

8 (not all patients completed NRS)

Groups

Electroacupuncture (n = 18 ) 2) sham‐Electroacupuncture (n = 23 )

Outcome measure

Numeral Rating Scale (NRS), 3 measurements per patient.

Instrument

Wrist‐ankle acustimulator, alternating 2 and 100 Hz every 3 seconds, six electrodes attached to dorsal aspect of wrist, three inches above crease of the wrist. Patients instructed to increase pulse amplitude until they experienced “strong but non‐painful sensation” with no visible muscle contraction and maintain this during treatment. Every treatment session: simultaneous 30 minutes program of standardized neck exercises. Patients told stimulation may or may not produce tingling sensation during treatment.

Interventions

30 minutes, two times a week for four weeks.

Placebo

Non‐functioning acustimulation; identical electrode placing and procedure.

Results

Baseline

End of intervention

Follow up

(four weeks)

(four weeks after end of intervention)

NRS Acustimulation

6.50 ± 1.98

3.61 ± 1.98

3.50 ± 1.82

NRS Sham

5.87 ± 1.29

5.35 ± 2.15

5.26 ± 2.20

Pain relief

After four week treatment period, and four weeks after intervention.

Follow up

Yes, four weeks after intervention.

Jadad score

3


55

Transcutaneous electrical nerve stimulation: nonparallel antinociceptive effects on chronic clinical pain and acute experimental pain – Cheing and Chan 1999 Country

Canada & China


TENS and TENS placebo


Lumbar back pain > 6 months; 21 male/9 female; 18‐50 yrs.


Yes

N

30

Drop‐outs

Not mentioned

Groups

TENS (n =15) Placebo (n =15)

Outcome measure

VAS (pain), 20 cm, 9 measurements per patient

Instrument

140ms/80 Hz, two electrodes on lumbosacral region (L4‐S2) paraspinally.

Interventions

Single session of 60 min TENS. Intensity of TENS adjusted to produce tingling sensation, 2/3 x pain threshold. All patients told they might/might not feel stimulation.

Placebo


Results

Baseline (40 min before treatment)

During treatment (60 min)

After session (60 min)

TENS

100 ± 0

72.06 ± 25.9

63.11 ± 31.2

TENS‐placebo

100 ± 0

96.62 ± 15.2

96.72 ± 23.1

Pain relief

During treatment & after treatment (60 min)

Follow up

Yes, 60 minutes after treatment.

Jadad score

1

Industry sponsored

No


56

Does four weeks of TENS and/or isometric exercise produce cumulative reduction of osteoarthritic knee pain? ‐ Cheing 2002 Country

Hong Kong, China


TENS vs. sham‐TENS


Osteoarthritic knee pain > 6 months; age 50‐75


Yes

N

34

Drop‐outs

Two from placebo group

Groups

1) TENS (n=16) 2) placebo TENS (n=16)

Outcome measure

Vas (pain) 10 cm; 2 measurements per patiënt.

Instrument

140µ/80Hz, 4 surface electrodes on 5 acupuncture points (spleen 9, stomach 35, extra 31,32 and gallbladder) Intensity 3/4 times subject’s sensory threshold. All patients told they might or might not feel stimulation.

Interventions

60 minutes, 5 days a week for 4 weeks.

Placebo

Non functioning TENS, identical electrode placement and procedure.

Results

Baseline

Follow up

(before session 1)

(four weeks after last session)

TENS

100 ± 0

51.5 ± 32.9

TENS‐placebo

100 ± 0

67.9 ± 78.6

Pain relief

Four weeks after last session

Follow up

Yes, four weeks after last session.

Jadad score

2

Industry sponsored

Not mentioned


57

Electroacupuncture in fibromyalgia: results of a controlled trial ‐ Deluze 1992 Country

Switzerland


Electroacupuncture vs. Sham‐Electroacupuncture


Fibromyalgia; disease duration >6 years; 16 m/54 f; 42‐53 yrs


Yes

N

N = 70

Drop‐outs

N = 15

Groups

Electroacupuncture (n = 28) Control group (n = 27)

Outcome measure

Regional pain score (1‐105 where 105 was worst): VAS (pain) 100 mm; 2 measurements per person

Instrument

250ms (every 250ms interval of 250 ms) /1‐99Hz, four to ten stain needles. Four needles on first dorsal intereosseous muscle of the hand and the anterior tibial muscle on both sides, six other needles placed depending on patient’s symptoms and pain pattern. Intensity just below pain threshold with muscle contractions.

Interventions

Six sessions spread over three weeks.

Placebo

Non functioning electroacupuncture, needles were put 20 mm away from points chosen for intervention group. No increase after threshold of perception was reached; no muscular contraction.

Results

Before treatment

After treatment

Means(SE)

Means(SE)

VAS (pain): interv.

56.61 (3.19)

39.89 (4.97)

VAS (pain): control

60.89 (4.07)

53.78 (4.37)

RPS: interv.

43.43 (3.28)

26.46 (3.82)

RPS: control

36.96 (2.53)

36.26 (3.94)

Pain relief

After last session

Follow up

No

Jadad score

2

Industry sponsored

Not mentioned


58

A controlled trial of transcutaneous electrical nerve stimulation (TENS) and exercise for chronic low back pain ‐ Deyo 1990 Country

USA


TENS vs. Sham‐TENS


Low back pain > 3 months; +/‐ 60% female ; age M 51.4


Yes

N

72

Drop‐outs

20

Groups

Group 1: TENS (n= 31) Group 2: Sham TENS (n=29)

Outcome measure

‐ VAS (improvement) 100 mm 3 measurements per patient.

Instrument

Conventional TENS/Acupuncture‐like TENS

Interventions

Two weeks of conventional TENS (80‐100 pulses per second, high frequency) then instructed in acupuncture like TENS (2‐4 pulses per second) After instruction patient selects preferred mode for remaining two weeks. Four electrodes on back initially placed on area of most severe pain, then moved as necessary to optimize pain relief. (for sciatica electrodes also on leg) All patients told they might or might not feel stimulation. Self administered 45 minutes three days a week for four weeks. (The treatments were administered for four weeks, during which the subjects were asked to make twice‐weekly visitis. At these visits, all the subjects received moist‐heat treatment (hot packs) We also loaned the subjects electric heating pads for home use, advised 10 minutes twice a day.)

Placebo

Non functioning TENS, identical procedure and electrode placing.


59

Results

Difference is the score with true Tens minus the score with sham‐ TENS

Difference (95 % confidence limits) at 4 week follow‐up

VAS (improvement) Pain relief

Four weeks after last treatment

Follow up

Yes, after one month.

Jadad score

2

Industry sponsored

No

5.2 (‐6.6 , 16.9)


60

Impact of low frequency transcutaneous electrical nerve stimulation on symptomatic diabetic neuropathy using the new Salutaris device – Forst 2004 Country

Germany




Diabetic neuropathy, duration of illness > M 15 years


Yes

N

24

Drop‐outs

5

Groups

TENS (n=12) sham‐TENS (n=7)

Outcome measure

VAS (pain) 20 cm 3 measurements per patient.

Instrument

280µ/4Hz, intensity adjusted to highest tolerable level with pain. Skin electrodes over peroneal nerve.

Interventions

Patient advised to stimulate both legs at least half hour per day for twelve weeks. No upper limit to duration of stimulation.

Placebo

Non functioning TENS, no additional information.

Results

Baseline

Six weeks

12 weeks

(after sixth week of treatment)

(after 12th/last week of treatment)

VAS TENS

19.8 ± 5.0

14.4 ± 9.7

17.8 ± 8.8

VAS sham‐TENS

15.3 ± 8.5

14.0 ± 8.7

15.0 ± 11.8

Pain relief

After six weeks of treatment and after 12 weeks of treatment.

Follow up

No

Jadad score

5

Industry sponsored

Not mentioned


61

A 3‐month, randomized, double‐blind, placebo‐controlled study to evaluate the safety and efficacy of a highly optimized, capacitively coupled, pulsed electrical stimulator in patients with osteoarthritis of the knee – Garland 2007 Country

USA


PES (Pulsed Electric Stimulator) vs. sham‐PES; 20 male/38 female; mean age 66.1 ± 10.9


Osteoarthritis, years diagnosed > 8 years; 20male/38female; age 66.1 ± 10.9

Fulfils inclusion criteria?

Yes

N

58

Drop‐outs

Two patients dropped out, in both cases missing outcomes at 3 months imputed by last observation carried forward.

Groups

PES (n=39) sham‐PES (n=19)

Outcome measure

Patient pain and symptoms measured on 100 mm VAS WOMAC pain measured on 100 mm VAS Four measurements per patient.

Instrument

100 Hz negative pulsed signal; negative electrode on skin over patella and positive electrode over anterior distal thigh. Turned on and intensity increased until tingling sensation felt over knee of thigh, then reduction until sensation disappeared.

Interventions

Patient asked to wear device 6h or more (6‐14 h) a day (al devices contained timer) every day for 12 weeks.

Placebo

Non functioning PES, similar electrode placing, device shut off after intensity was reduced.

Results

Baseline

After

(before first treatment)

(after last treatment)

Patient pain PES

50.9 ± 17.99

36.2 ± 26.05

Patient pain sham

48.1 ± 16.76

45.7 ± 21.76

WOMAC pain PES

50.6 ± 14.20

37.4 ± 23.60


62

WOMAC pain sham Pain relief

After last treatment

Follow up

No

Jadad score

4

Industry sponsored

Not mentioned

44.9 ± 12.47

41.8 ± 16.59


63

Percutaneous electrical nerve stimulation for low back pain ‐ A randomized crossover study ‐ Ghoname 1999b Country

USA


PENS vs. sham‐PENS


Low back pain > 3 months of medication; 29 male/31 female, age 43 ± 19 yrs


Yes

N

60

Groups

Crossover design

Dropouts

Not mentioned

Outcome measure

VAS (pain) 10 cm, 72 measurements per patient

Instrument

0,5 ms/4Hz; 10 acupuncture points lower back region

Interventions

30 min PENS of TENS, 3 times a week, for 3 weeks.

Placebo

Non functioning PENS, identical acupuncture points.

Results

Baseline

24h After treatment

Sham‐PENS

5.7 ± 1.8

5.5 ± 1.9

PENS

6.3 ± 1.5

3.4 ± 1.4

Pain relief


Jadad score

1

Industry sponsored

Not mentionded


64

Percutaneous electrical nerve stimulation: an alternative to TENS in the management of sciatica – Ghoname 1999c Country

USA




Sciatia pain due to lumbar disc hernation > 6 months ;30 male/34 female; age 43 ± 19


Yes

N

64

Groups

Crossover design

Drop‐outs

Not mentioned

Outcome measure

VAS (10 cm), 6 measurements per patient; VAS measurements prior and immediately after each treatment.

Instrument

0.1 s/4 Hz, 10 acupuncture needles, in symptomatic leg. Intensity of electrical stimulation adjusted to produce the highest tolerable electrical `tapping' sensation without muscle contractions.

Interventions

30 minutes, 3 times per week, for 3 weeks with one week in between treatment blocks.

Placebo


Results

Before (24 hours before first treatment)

After (24 hours after last treatment)

PENS

7.2 ± 1.8

4.1 ± 1.4

sham‐PENS

6.6 ± 1.9

6.1 ± 1.9

Pain relief


Follow up

No

Jadad score

1

Industry sponsored

Not mentioned

The effect of stimulus frequency on the analgesic response to percutaneous electrical nerve


65

stimulation in patients with chronic low back pain ‐ Ghoname 1999a Country

USA


Pens vs. Sham‐PENS


Low back pain > 3 months; age 46 ± 21 yr


Yes

N

68

Dropouts

Not mentioned

Groups

Crossover design

Outcome measure

VAS (pain), 10 cm, 12 measurements per person.

Instrument

0,5 ms/ 4Hz, alternating 15‐30 Hz or 100 Hz, 10 lumbar acupuncture sites

Interventions

30 min PENS, three days week for two weeks. With one week of in between treatment modalities.

Placebo

Non functioning PENS, identical acupuncture sites.

Results

Pre treatment 1

Pre treatment 6

PENS 4 Hz

6.4 ± 1.6

4.7 ± 1.6

PENS 15/30 Hz

6.0 ± 1.7

4.0 ± 1.4

PENS 100 Hz

5.7 ± 1.6

4.5 ± 1.5

Sham

5.8 ± 1.5

5.7 ± 1.7

Pain reduction

5‐10 minutes after treatment.

Jadad score

2

Industry sponsored

Not mentioned

Percutaneous electrical nerve stimulation: a novel analgesic therapy for diabetic neuropathic pain – Hamza 2000 Uitwendige elektrotherapie bij chronische pijn

66

Country

USA




Peripheral neuropathic pain > 6 months, 28 female, 22 male. Age 34‐ 71 yrs


Yes

N

50

Groups

Crossover design

Drop‐outs

Not mentioned

Outcome measure

VAS (pain) 10 cm, 9 measurements per patient.

Instrument

10 acupuncture points, alternating 15/30 Hz every 3s. Needles in soft tissue and/or muscle in the leg and foot (L 3‐4‐5 S 1‐2) Intensity adjusted to highest tolerable level without muscle contractions.

Interventions

30 minutes; two periods of three times a week for three weeks with one week in between.

Placebo

Non functioning PENS, identical acupuncture points.

Results

Baseline

Week 1

Week 2

Week 3

VAS PENS

6.2 ± 1.3

3.8 ± 1.2

3.5 ± 1.0

2.6 ± 0.9

VAS Sham‐ PENS

5.2 ± 1.6

4.6 ± 1.5

4.6 ± 1.4

4.8 ± 1.2

Pain relief

End of every week of intervention.

Follow up

No

Jadad score

1

Industry sponsored

No

Sequentially allocated clinical trial of rhythmic stabilization exercises and TENS in women with chronic low back pain – Kofotolis 2008


67

Country

Greece




Low back pain > 6 months; 46 female; age 40.5 ± 6.7


Yes

N

46

Drop‐outs

Yes, 2 in sham‐TENS

Groups

TENS (n=23 ) sham‐TENS (n= 21)

Outcome measure

Pain severity with Borg verbal rating pain scale (0 = normal to 10 = emergency); 4 measurements per patient

Instrument

200µs/4Hz, strong but comfortable level of stimulation. Four rubber electrodes on fascia thoracolambaliis and approx. 10 cm proximal to this along middle of the muscle (e.g. directly over the site of pain).

Interventions

40‐45 minutes, five times per week for four weeks.

Placebo


Results

Post 2

Post 3

Baseline

After

(Prior to treatment)

(immediately (Four after last weeks after treatment) last treatment)

(Eight weeks after last treatment)

Borg TENS

2.3 ± 0.4

2.2 ± 0.4

2.1 ± 0.6

2.0 ± 0.6

Borg sham‐ TENS

2.1 ± 0.7

2.0 ± 0.4

2.0 ± 0.4

1.9 ± 0.5

Pain relief

After last treatment, four weeks after last treatment and six weeks after last treatment.

Follow up

four weeks after last treatment and six weeks after last treatment.

Jadad score

2

Industry sponsored

Not mentioned


68

Efficacy of microcurrent therapy in the treatment of chronic nonspecific back pain: a pilot study – Koopman 2009 Country

Netherlands


Microcurrent therapy (MCT) vs. sham‐Microcurrent therapy


Low back pain > 3 months; 4 male/6 female; age 50 ± 9.2


Yes

N

9

Drop‐outs

No

Groups

Crossover design

Outcome measure

VAS (average pain), VAS (worst pain), 4 measurements per patient.

Instrument

Patch applied to most painful spot with positive electrode closest to the spine, microcurrent below sensory threshold.

Interventions

24 h daily patch; 9 day baseline period/washout period followed by 5 day treatment period.

Placebo

Non functioning MCT, identical patch placement and procedure.

Results

Baseline

After

VAS average MCT

6.23 ± 1.45

6.14 ± 1.42

VAS average sham‐MCT

5.99 ± 1.37

6.33 ± 1.43

VAS worst MCT

7.36 ± 0.68

6.71 ± 1.58

VAS worst sham‐MCT

6.71 ± 1.48

7.12 ± 1.28

Pain relief

After treatment period

Follow up

No

Jadad score

5

Industry sponsored

Yes, third author received compensation for manufacturer.


69

Diabetic peripheral neuropathy. Effectiveness of electrotherapy and amitriptyline for symptomatic relief – Kumar 1998 Country

USA




Patients with peripheral neuropathy who failed to respond to treatment with amitriptyline, pain > 21 months; 10male/13 female; average age +/‐ 58.5


Yes

N

23 (including three who could not take amitriptyline)

Drop‐outs

No

Groups

Electrotherapy (n=14) Sham‐Electrotherapy (n=9)

Outcome measure

Pain and discomfort level graded on scale 0‐5 (0 = no symptoms, 5 = extremely intense burning pain). Two measurements per patient.

Instrument

4ms/2‐70 Hz on lower extremties. Patients told they might or might not feel electrical stimulation.

Interventions

12 weeks, self‐administration.

Placebo

Non functioning electrotherapy, identical electrode placing and procedure.

Results

Before

After

Mean(SEM)

Mean(SEM)

Pain Electrotherapy

3.2 (0.2)

1.4 (0.4)

Pain sham

2.8 (0.3)

1.9 (0.5)

Pain relief

Directly after last treatment

Follow up

No

Jadad score

1

Industry sponsored

Not mentioned

Electroacupuncture relieves pain in men with chronic prostatitis/chronic pelvic pain syndrome: three‐arm randomized trial – Lee and Lee 2009 Uitwendige elektrotherapie bij chronische pijn

70

Country

South Korea


Electroacupuncture (EA) plus advice and excercise (A&E) vs. sham‐ Electroacupuncture (SEA) plus advice and excercise (A&E)


Chronic prostatitis/chronic pelvis pain syndrome > 3 months; average age +/‐ 37


Yes

N

26

Drop‐outs

Yes, 1 from each treatment group.

Groups

EA plus A&E (n=12) SEA plus A&E (n=12)

Outcome measure

NIH‐CPSI pain subscore range 0‐21 3 measurements per patient.

Instrument

Continuous stimulation/4Hz, 6 acupuncture points at bilateral BL32, BL33 and GB30. Stimulated at both right and left acupuncture points. Sounds of pulse generator heard by participants.

Interventions

20 minutes, twice a week for 6 weeks.

Placebo

Non functioning EA, identical needle placing.

Results

Baseline

3 weeks

6 weeks

(after 3 weeks of treatment)

(after six weeks of treatment)

Net change from baseline Pain EA

12.2 ± 5.2

‐3.7 ± 2.6

‐5.2 ± 1.9

Pain SEA

11.8 ± 2.7

‐1.4 ± 3.5

‐1.6 ± 1.8

Pain relief

After three and after end of treatment.

Follow up

No

Jadad score

3

Industry sponsored

Not mentioned


71

Pain Measurement in Randomized Clinical‐Trials ‐ A Comparison of 2 Pain Scales – Machin 1988 Country

United Kingdom


Tens vs. sham‐TENS


Low back pain

Fulfills inclusion criteria

‐

N

30

Dropouts

One drop‐out after week 1 for sham‐TENS

Groups

Tens (n=15) sham‐Tens (n=15, n=14 after week 1)

Outcome measure

VAS (pain) 7 cm 23 measurements per patient.

Instrument

100 µs/32‐50 Hz to cutaneous electrodes placed around painful area

Interventions

20 minutes, for three weeks

Placebo

Non functioning TENS, identical electrode placing

Results

Pre‐treatment

Week 3

Post‐treatment

(one week before treatment)

(after last treatment session)

(1 week after last treatment)

VAS TENS

2.911 ± 1.172

1.347 ± 1.372

1.884 ± 0.752

VAS sham‐ TENS

3.008 ± 1.392

1.629 ± 1.365

1.763 ± 1.242

Pain reduction

After each week of treatment and one week after treatment.

Jadad score

2

Industry sponsored

Not mentioned

Combined neuromuscular electrical stimulation and transcutaneous electrical nerve stimulation Uitwendige elektrotherapie bij chronische pijn

72

for treatment of chronic back pain: A double‐blind, repeated measures comparison – Moore 1997 Country

USA




Back pain > 6 months; 16 female/8male; mean age 51.67


Yes

N

28

Drop‐outs

4 male dropouts, N = 24

Groups

Crossover design

Outcome measure

Vas (pain relief): 10 cm; 4 measurements per patient PPI: 1 mild to 4 horrible; 8 measurements per patient

Instrument

100 µs/100 Hz; patients instructed to place four electrodes directly over area of the back where pain was most intense, and to use same placement throughout study. Subjects told they might or might not feel stimulation.

Interventions

Self‐administered, 5 hours a day, 2 consecutive days with 2 days hiatus between treatments

Placebo

Non functioning TENS, identical electrode placement instructions.

Results

TENS

Placebo

Pretreatment

Posttreatment

VAS‐r

46.23 ± 26.88

40.58 ± 27.55

PPI

2.58 ± 1.03

2.27 ± 1.13

VAS‐r

50.56 ± 29.13

44.81 ± 30.67

PPI

2.79 ± 1.07

2.42 ± 1.15

Pain relief


Jadad score

4

Industry sponsored

Not mentioned

Carpal tunnel syndrome pain treated with low‐level laser and microamperes transcutaneous electric nerve stimulation: A controlled study – Naeser 1997 Uitwendige elektrotherapie bij chronische pijn

73

Country

USA


Microampère TENS vs. sham‐TENS


Carpal Tunnel Syndrome pain > 3 months; 9male/2female; 40‐68 years.


Yes

N

11

Drop‐outs

Patients who reported greater than 50 % pain reduction after sham‐ TENS were removed from statistical analyses.

Groups

Crossover design

Outcome measure

McGill Pain Questionnaire 3 measurements per patient.

Instrument

Microamps TENS 292Hz for 2 mintues followed by 0.3 Hz for 18 minutes. One electrode applied to skin, centered over acupoint PC 7 at center of wrist crease. Grounding pad applied to skin and centered over acupoint TW 4, on dorsum of wrist. Intensity decreased to subtrehsold level at which patient reported no sensation. Audible click heard with adjustment of Hz.

Interventions

Serie of nine‐twelve treatments, 20 minutes, three times a weeks for three‐four weeks

Placebo

Non functioning TENS, identical needle placement and procedure. Audible click with adjustment of Hz.

Results

Patient received either TENS treatment first and sham second or sham‐treatment first and TENS second. TENS 1st treatment

Pretest

Posttest

(month before first treatment; also posttest 1 served as pretest for posttest 2)

(week after end of each treatment session)

21.3 ± 5.69

.33 ± .58 (posttest 1)

TENS 2nd treatment 21.87 ± 9.06

3.75 ± 6.52 (posttest 2 )


74

Sham 1st treatment 18.00 ± 8.40

22.00 ± 11.28 (posttest 1)

Sham 2nd treatment 11.38 ± 11.14

14.00 ± 14.17 (posttest 2)

Pain relief

Week after end of each treatment session

Jadad score

3

Industry sponsored

No


75

An alternative approach to treating lateral epicondylitis. A randomized, placebo‐controlled, double‐blinded study ‐ Nourbakhsh 2008 Country

USA


Noxious level electrical stimulation (ES) vs. sham‐ES


Lateral epicondylitis pain > 3 months; 10male/8female; age 24‐72


Yes

N

18

Drop‐outs

No

Groups

Treatment (n=10) Control (n=8)

Outcome measure

NRS pain intensity Measurement per patient: unknown

Instrument

Interrupted DC current/4Hz. Arm resting on treatment, after palpatation of painful area on lateral epicdonyle while subject was holding ground electrode in affected hand, therapist located tender point on this area with probe electrode. All identifief points stimulated three times each treatment session.

Interventions

Six sessions over 2‐3 week period ; intensity adjusted to subject’s pain tolerance level. Beeping tone to be heard during treatment.

Placebo

Non functioning ES, identical procedure.

Results

Pretest

Posttest

Pain ES

4.2 ± 2.4

1.1 ± 1.5

Pain sham‐ES

3.85 ± 2.8

4.0 ± 2.8

Pain relief

Unknown

Jadad score

5

Industry sponsored

No


76

Outcome of transcutaneous electrical nerve stimulation in chronic pain: short‐term results of a double‐blind, randomised, placebo‐controlled trial – Oosterhof 2006 Country

Netherlands


TENS vs. Sham‐TENS


Chronic pain > 6 months; 66 male/97 female; age 50.2 ± 1.1


Yes

N

165

Drop‐outs

Yes, 2 from TENS

Groups

TENS (n=81) sham‐TENS (n=82)

Outcome measure

VAS (pain) 100 mm Patient rated pain for 14 days.

Instrument

50 µs/80Hz, electrodes applied over supericial cutaneous nerves in painful segments, determined by physiotherapist. Stimulation set at level at which patient did not experience sensation.

Interventions

Ten days of self‐administration.

Placebo

Non functioning TENS, identical electrode placing and procedure.

Results

Baseline

After

(week before treatment)

(after 10 days of treatment)

TENS

62.2 ± 18.5

53.2 ± 26.4

sham‐TENS

61.9 ± 18.3

57.1 ± 26.5

Pain relief

After last day of treatment

Jadad score

5

Industry sponsored

No


77

Electroacupuncture versus diclofenac in symptomatic treatment of osteoarthritis of the knee: a randomized controlled trial – Sangdee 2002 Country

Thailand


Electroacupuncture (EA) vs. sham‐EA (SEA)


Osteoarthritis pain > 3 months; 10male/39 female; age 61.84 ± 8.96


Yes

N

186 knees

Drop‐outs

Yes, 2 patients from SEA 1 patients from EA

Groups

EA (n=91 knees) SEA (n=89 knees)

Outcome measure

VAS (pain) 100 mm; Two measurements per patient.

Instrument

2 Hz; four superficially placed needles in acupuncture points around affected knee. First pair connected to Dubi and neares adjacent point, second pair to trigger point and Ququan. Stimulation applied until it reached maximum level of pain.

Interventions

20 minutes, three times a week for four weeks.

Placebo

Non functioning EA, similar acupuncture points on affected knee, identical procedure.

Results

Baseline

After (after last treatment) Change to baseline score

VAS (pain) EA

66.78 ± 22.34

‐48.24 ± 3.59

VAS (pain) SEA

63.49 ± 22.36

‐22.86 ± 4.02

Pain relief


Jadad score

2

Industry sponsored

No

Acupuncture in the treatment of rheumatoid arthritis: a double‐blind controlled pilot study – Tam 2007 Uitwendige elektrotherapie bij chronische pijn

78

Country

Hong Kong, China


Electroacupuncture (EA) vs. sham‐Electroacupuncture (SEA)


Rheumatoid arthritis, diseasure duration > 9 years;age 58 ± 10


Yes

N

24

Drop‐outs

Yes, 3 from SEA did not complete 10 week study.

Groups

EA (n=12) SEA (n=12, n=9 after drop‐outs)

Outcome measure

VAS (pain) 10 cm 5 measurements per patient

Instrument

Dense wave 4Hz, disperse wave 20 Hz. Six acupuncture points in hand including LI11, TE5, LI4, ST36, GB34 and GB39. intermittent non‐specific manual twirling

Interventions

30 minutes, two times a week for ten weeks.

Placebo

Non functioning electroacupuncture, skin punctured in identical points but needles quickly withdrawn. Intermittent non‐specific manual twirling

Results

Baseline

Week 10 (after last treatment session)

VAS (pain) EA

6.0 ± 2.1

5.7 ± 2.3

VAS (pain) SEA

6.5 ± 2.0

5.1 ± 1.9

Pain relief

After last treatment session, ten weeks.

Jadad score

3

Industry sponsored

No

A double blind randomised controlled clinical trial on the effect of transcutaneous spinal electroanalgesia (TSE) on low back pain – Thompson 2008


79

Country

United Kingdom


Transcutaneous Spinal Electroanalgesia (TSE) vs. sham‐TSE


Low back pain > 1 year ; 26male/32female ; age 46.2 ± 12.3


Yes

N

58

Drop‐outs

No

Groups

TSE (n=29) sham‐TSE (n=29)

Outcome measure

VAS (pain) 10 cm 4 measurements per patient

Instrument

4µs/10kHz, pair of electrodes applied to back; one on skin overlying spinous process of 1st thoracic verterbra and other to skin overlying 12th thoraric vertebra.

Interventions

Single session, 20 minutes.

Placebo

Non functioning TSE, identical electrode placement and procedure.

Results

VAS TSE

Mean of VAS immediately before treatment

Mean of VAS immediately after treatment

Mean of VAS in week before treatment

Mean of VAS in week after treatment

5.008 ± 2.062 4.216 ± 1.870 5.398 ± 1.768

5.225 ± 1.757

VAS 5.520 ± 2.152 4.679 ± 2.066 5.037 ± sham‐TSE 2.188

5.057 ± 2.361

Pain relief

Immediately after treatment and during week after treatment

Jadad score

5

Industry sponsored

Not mentioned

Efficacy of transcutaneous electrical nerve stimulation and percutaneous neuromodulation therapy in chronic low back pain ‐ Topuz 2004 Uitwendige elektrotherapie bij chronische pijn

80

Country

Turkey


TENS, low‐frequency TENS and PENS vs. sham‐TENS


Patients with low back pain > 3 months, 19‐70 yrs. 19male/41female


Yes

N

45

Drop‐outs

Yes, 3 from placebo TENS, N = 42

Groups

Placebo TENS (n=12) Conventional‐TENS (n=15) Low‐TENS (n=15)

Outcome measure

VAS (pain intensity=Cur) 10 cm, 2 x per patient VAS (activity pain=Act) 10 cm, 2 measurements per patient.

Instrument

Four electrodes standard dermatomal pattern over most painful lumbar region. C‐TENS: 100 µs/80 Hz; Low‐TENS: 100 µs/4 Hz.

Interventions

20 min, five times a week for two weeks.

Placebo

Non functioning TENS, similar electrode placing

Results

Pre‐treatment

Post‐treatment (directly after)

Placebo

Cur

5.75 ± 1.35

5.91 ± 1.37

Act

6.75 ± 1.13

6.58 ± 0.99

Cur

6.53 ± 1.18

3.73 ± 1.62

Act

7.40 ± 1.18

4.86 ± 1.68

Low‐

Cur

6.86 ± 1.24

4.26 ± 2.05

TENS

Act

7.46 ± 1.92

5.33 ± 2.09

PENS

Cur

7.00 ± 1.47

3.38 ± 2.66

Act

8.15 ± 1.21

4.07 ± 2.49

C‐TENS

Pain relief


Follow up

No

Jadad score

3

Industry sponsored

Not mentioned.


81

The effectiveness of ENARÂ® for the treatment of chronic neck pain in Australian adults: A preliminary single‐blind, randomised controlled trial – Vitiello 2007 Country

Australia


TENS vs. sham‐ENAR


Neck pain > 6 weeks ;10male/14female; age M 40.5


No

N

17

Drop‐outs

No

Groups

TENS (n= 9) sham‐ENAR (n=8)

Outcome measure

VAS (pain) 5 measurements per patient.

Instrument

Electrodes applied to skin overlying the posterior surface of neck and upper thorax regions. Dosage set to comfortable tolerance level below muscle fasciulation response. All patients told they might not feel electrotherapy.

Interventions

10 minutes; six week schedule of treatment.

Placebo

Non functioning ENAR, identical placement and procedure.

Results (mean ± SE)

Baseline

6 weeks

(after last treatment)

12 weeks 18 weeks 24 weeks follow‐ follow‐ follow‐ up up up

VAS (pain) TENS

3.243 ± .844

3.643 ± .887

3.214 ± 1.049

VAS (pain) sham

3.250 ± .789

4.500 ± .869

3.250 ± .829

3.438 ± .981

4.063 ± .813

Pain relief

After last treatment (six weeks), after 12/18/24 weeks.

Jadad score

3


4.429 ± .958

4.063 ± .896

82

Industry sponsored

Yes


83

Efficacy of percutaneous electrical nerve stimulation and therapeutic exercise for older adults with chronic low back pain: a randomized controlled trial – Weiner 2008 (1) Country

USA




Low back pain, pain > 3 months; age > 65 years


Yes

N

100

Drop‐outs

3 from PENS, 5 from sham‐PENS

Groups

1) PENS (n=47) 2) sham‐PENS (n=45)

Outcome measure

Pain intensity with McGill Pain Questionnaire short form 3 measurements per patient.

Instrument

10 acupuncuture points, placed bilaterally at dermatomal, myotomal, scleratomal, and sympathetic levels corresponding to T12, L3, L5 and S2 and the motor point for the piriformis muscle. Two extra needles on T12 dermatome with electrical stimulation.

Interventions

12 sessions of 30 minutes PENS, frequency adjusted to previous session; maintained stimulus of moderate intensity.


84

Placebo

Non functioning PENS on similar acupuncture points, electrical stimulation delivered to T12 dermatome. 100 Hz, electrostimulator turned off after 5 minutes.

Results

Baseline


Follow up (6 months)

MPQ total PENS

13.4 ± 8.5

‐2.9 ± 9.2

‐3.4 ± 7.4

MPQ total sham‐ PENS

10.7 ± 6.2

‐2.3 ± 6.3

‐3.3 ± 7.4

Pain relief

After last treatment and after 6 months.

Follow up

Yes, 6 months.

Jadad score

2

Industry sponsored

No

Efficacy of percutaneous electrical nerve stimulation and therapeutic exercise for older adults with chronic low back pain: a randomized controlled trial – Weiner 2008 (2)


85

Country

USA


PENS as add on to general conditioning and aerobic exercise (GCAE) vs. Sham‐PENS as add on to GCAE

Patient characteristics Low back pain, pain > 3 months; age > 65 years Fulfills inclusion criteria?

Yes

N

100

Drop‐outs

PENS + GCAE: 5 drop‐outs, Sham‐PENS + GCAE: 6 drop‐outs

Groups

1) PENS +GCAE (n=45) 2)sham‐PENS + GCAE (n=44)

Outcome measure

Pain intensity with McGill Pain Questionnaire short form 3 measurements per patient.

Instrument

10 acupuncuture points, placed bilaterally at dermatomal, myotomal, scleratomal, and sympathetic levels corresponding to T12, L3, L5 and S2 and the motor point for the piriformis muscle. Two extra needles on T12 dermatome with electrical stimulation.

Interventions

12 sessions of 30 minutes PENS, frequency adjusted to previous session; maintained stimulus of moderate intensity.


86

Placebo

Non functioning PENS on similar acupuncture points, electrical stimulation solely delivered to T12 dermatome. 100 Hz, electrostimulator turned off afer 5 minutes.

Results

Baseline


Follow up (6 months)

PENS + CGAE

12.2 ± 6.6

‐4.1 ± 8.2

‐3.8 ± 8.9

Sham + GCAE

12.0 ± 8.0

‐3.1 ± 7.9

‐3.1 ± 7.1

Pain relief

After last treatment and after 6 months.

Follow up

Yes, 6 months.

Jadad score

2

Industry sponsored

No

Efficacy of percutaneous electrical nerve stimulation for the treatment of chroniclow back pain in older adults ‐ Weiner 2003 Uitwendige elektrotherapie bij chronische pijn

87

Country

USA


PENS + PT (physical therapy) vs. sham PENS + PT


Patients with chronic low back pain > 3 months; 17 male/17female; > 65 yrs


Yes

N

34

Drop‐outs

One subject each in the PENS plus PT group and the sham PENS plus PT group dropped out of treatment, and one subject in the PENS plus PT group was lost to follow‐up. A conservative approach was followed and used their pretreatment scores in the data analyses, thus assuming they were treatment failures

Groups

PENS + PT (17) Sham PENS + PT (17)

Outcome measure

McGill Pain Questionnaire (MPQ) & Pain Severity scale of Multidimensional Pain Inventory (MPI) 3 measurements per patient.

Instrument


88

Interventions

30 minutes, twice a week for six weeks.

Placebo

Non functioning PENS, identical acupuncture sites

Results

Pre

Standard error of mean

PENS

Sham

Post

Follow‐up

(within 1 week of completion of intervention)

(three months after completion of intervention)

MPQ

13.06 ± 1.31 (= standard error of mean)

6.66 ± 0.87

6.19 ± 0.88

MPI

3.21 ± 0.25

2.00 ± 0.20

2.16 ± 0.30

MPQ

12.24 ± 1.69

12.47 ± 2.04

11.82 ± 1.90

MPI

3.28 ± 0.28

3.22 ± 0.23

3.10 ± 0.16

Pain relief

Directly after treatment, 3 months after treatment

Jadad score

3

Industry sponsored

Not mentioned

Efficacy of periosteal stimulation therapy for the treatment of osteoarthritis‐associated chronic knee pain: an initial controlled clinical trial – Weiner 2007 Country

USA




Knee pain > 3 months; 44male/44 female


Yes

N

88

Drop‐outs

5 from PENS and 4 from sham‐PENS, none excluded from analysis.

Groups

1) PENS (n=44) 2 sham‐PENS (n=44)

Outcome measure

WOMAC Pain, 3 measurements per person.

Instrument

30 min/100 Hz, 4 acupuncture points: medial femoral condyle, lateral femoral condyle, flare of tibia, head of fibula. 1 minute stimulation on


89

two additional needles on either side of upper third of tibial shaft. Interventions

6 treatments, 30 min. Once a week for 6 weeks.

Placebo

Non functioning PENS on identical acupuncture sites. 1 min stim on two additional needles on either side of upper third of tibial shaft.

Results

Baseline

Posttreatment Follow up (after last treatment)

(3 months after treatment)

WOMAC PENS

9.25 ± 3.14

6.17 ± 3.72

8.32 ± 3.93

WOMAC sham‐PENS

9.06 ± 3.32

8.04 ± 3.25

7.79 ± 3.94

Pain relief

Directly after treatment and 3 months after treatment

Follow up

Yes, 3 months after treatment.

Jadad score

1

Industry sponsored

No

The evaluation of two modulated frequency modes of acupuncture‐like TENS on the treatment of tennis elbow pain – Weng 2005 Country

Taiwan


Acupuncture‐like TENS (AL‐TENS) vs. sham AL‐TENS


Tennis elbow pain > 3 months; age 20‐30


Yes

N

20

Drop‐outs

Not mentioned

Groups

Crossover design

Outcome measure

VAS (pain) 10 cm; Two measurements per patient.

Instrument

‐5 KHz modulated by 2 Hz (LF);‐5 KHz modulated by 100 (HF); Four electrodes on LI10 and L11 in area of the elbow. Two electrodes on two right acupoints and two electrodes on two left acupoints.


90

Intensity at tolerable level. Interventions

15 minutes, three times a week for two weeks.

Placebo

Non functioning TENS, no additional information.

Results VAS (pain)

Before

After (two weeks)

VAS (pain) LF

4.40 ± 2.16

3.70 ± 2.00

VAS (pain) HF

4.16 ± 2.37

3.42 ± 2.01

VAS (pain) sham

4.80 ± 1.93

4.95 ± 2.01

Pain relief

Two weeks after treatmetn

Follow up

No

Jadad score

1

Industry sponsored

Not mentioned

The Treatment of Upper Back Pain by Two Modulated Frequency Modes of Acupuncture‐like TENS ‐ Weng 2005 Country

Taiwan, Republic of China


Al‐TENS (Low frequency/High frequency) and AL‐TENS placebo


Upper back pain < 3 months, 20‐30 yrs, M 25.3 ± 5.1; all male


Yes

N

30

Drop‐outs

None mentioned.

Groups

Crossover design

Outcome measure

VAS(pain) 10 cm, 12 measurements per person.

Instrument

Pulse duration: 0.1 ms. Either: 5 KHz modulated by 2 Hz or 5 KHz modulated by 200 Hz. Two electrodes placed on two acupuncture points on subject’s right and left sides of upper back. Intensity of stimulation adjusted a tolerable level.

Interventions

Every treatment for 20 min, three times a week for two weeks.


91

Placebo

Non functioning AL‐TENS, identical electrode placing.

Results VAS (pain)

Directly before treatment

Direcly after treatment

LF (2 Hz)

4.46 ± 1.85

3.81 ± 1.70

HF (200 Hz)

4.10 ± 2.09

3.49 ± 1.70

Placebo

4.40 ± 2.09

4.30 ± 2.07

Pain relief

Directly after treatment.

Follow up

No

Jadad score

1

Industry sponsored

Not mentioned


92

Bijlage 8. Enquête


93

Openingsscherm In opdracht van het College voor Zorgverzekeringen (CVZ) voert het UMC St Radboud een onderzoek uit naar het huidig gebruik van uitwendige hulpmiddelen ter bestrijding van chronische pijn*. Onder uitwendige hulpmiddelen moet u in dit verband bijvoorbeeld verstaan TENS, APS, braces, tapes, e.d. Het CVZ zal de resultaten gebruiken om te bepalen welke behandelingen voldoen aan de stand van de wetenschap en praktijk. Daartoe wordt een enquête uitgevoerd onder de beroepsgroep en wordt een systematisch onderzoek van de beschikbare literatuur uitgevoerd. Wij zouden het zeer op prijs stellen indien u onderstaande vragenlijst invult. Het invullen vergt niet meer dan 5 minuten van uw tijd, en de gegevens worden volstrekt anoniem verwerkt. *N.B.: Onder chronische pijn verstaan we pijn die langer aanhoudt dan 3 maanden Dr Robert van Dongen Prof dr Ria NijhuisvanderSanden Jan Oosterhof, fysiotherapeut Dr Ir Rob Reuzel Dr Bart Staal Prof dr Gert Jan van der Wilt Vraag 1

Maakt u bij de behandeling van de patiënten wel eens gebruik van uitwendige hulpmiddelen ter behandeling van chronische pijn?

Ja Nee

Vraag 2 (alleen indien Vraag 1 bevestigend is beantwoord)

Hoeveel patiënten met chronische pijn heeft u in de afgelopen maand ongeveer onder behandeling gehad?

Welke van de volgende uitwendige hulpmiddelen past u toe ter behandeling van chronische pijn: TENS

Ja

Nee Aantal patiënten per maand:

APS

Ja

Nee

Andere vormen van elektrotherapie

Ja

Nee Namelijk: Aantal patiënten per maand:

Braces (incl. halskraag)

Ja

Nee

Tapes

Ja


Prothesen

Ja

Nee

Bandages

Ja


Spalken

Ja

Nee

Anders

Ja

Nee Namelijk: Aantal patiënten per maand:


94

Vraag 3 (alleen indien Vraag 1 bevestigend is beantwoord en bij Vraag 2 een vorm van electrotherapie is aangevinkt)

U maakt gebruik van elektrotherapie Wie schrijft het hulpmiddel voor:

U zelf Een ander

Wie begeleidt het gebruik:

Namelijk:

U zelf Niemand Een ander

Is het gebruik van het hulpmiddel permanent?

Ja Nee Onbekend

Is er in geval van problemen een achterwachtfunctie geregeld?

Ja Nee Onbekend

Hoe geschiedt eventuele vervanging van het hulpmiddel? Door U zelf Onbekend Door een ander

Namelijk:


95

Vraag 4 (alleen indien Vraag 1 bevestigend is beantwoord en bij Vraag 2 een vorm van electrotherapie is aangevinkt)

Voor welke indicaties gebruikt u genoemde uitwendige hulpmiddelen ter behandeling van chronische pijn: Pijn van het bewegingsapparaat

Ja

Nee

Zenuwletsels

Ja

Nee

Pijn bij kanker

Ja

Nee

Overige pijnsyndromen

Ja

Nee

Namelijk:


96

Vraag 5

Wat is uw beroep: Fysiotherapeut Ergotherapeut Oefentherapeut Revalidatiearts Anesthesioloog Othopedisch chirurg Orthomanueel therapeut Reumatoloog Sportarts Anders

Namelijk:

In wat voor een instelling bent u werkzaam: Pijnbehandelcentrum verbonden aan academisch ziekenhuis Pijnbehandelcentrum verbonden aan niet-academisch ziekenhuis Eerstelijns gezondheidscentrum Eerstelijns praktijk Revalidatiecentrum


97

Bijlage 9. Referenties van geëxcludeerde studies, met reden voor exclusie. (geïncludeerde studies vet gedrukt) Reference List 1

"Controlling pain. Taming pain with TENS," Nursing 31(11), 84 (2001). No data on pain

2

"Philadelphia panel evidence-based clinical practice guidelines on selected rehabilitation interventions for knee pain," 81(10), 1675 (2001). no RCT

3

"Fibromyalgia: an enigmatic condition with no defined treatment," Drugs & Therapy Perspectives 18(9), 11 (2002). no RCT

4

"PENS returns as PNT for chronic low back pain -- still electrical stimulation of acupuncture needles (n=72)," Acupunct. Med. 20(2-3), 127 (2002). No TENS

5

"Management of chronic central neuropathic pain following traumatic spinal cord injury: executive summary of evidence report/technology assessment: number 45," Journal of Pain & Palliative Care Pharmacotherapy 17(2), 99 (2003). no RCT

6

"Percutaneous tibial nerve stimulation in chronic pelvic pain (n=33)," Acupunct. Med. 21 (3), 112 (2003). No TENS

7

"Longterm specific effect of acupuncture on chronic neck pain (n=24)," Acupunct. Med. 22 (3), 161 (2004). Acupuncture

8

"Chiropractic clinical practice guideline: evidence-based treatment of adult neck pain not due to whiplash," Journal of the Canadian Chiropractic Association 49(3), 158 (2005). no RCT

9

"Pediatric headache," Headache: The Journal of Head & Face Pain 45(8), 1098 (2005). no RCT

10

"Chronic cluster headache relieved by nerve stimulation," NHF Head Lines (157), 4 (2007). No data on pain

11

"PT bulletin digest," PT: Magazine of Physical Therapy 16(11), 79 (2008). No data on pain

12

"TENS and sham TENS have a similar impact on chronic pain levels -- what about patient satisfaction?," Lippincott's Bone & Joint Newsletter 14(8), 93 (2008). No data on pain


98

13

"Complex regional pain syndrome type 1: Some treatments assessed versus placebo, limited efficacy," Prescrire Int. 18(104), 267 (2009). No RCT

14

"Long term conditions," Nursing Times 105(47), 6 (2009). No data on pain

15

"Pain: hope through research," Journal of Pain & Palliative Care Pharmacotherapy 23(3), 307 (2009). no RCT

16

"New guidelines nix TENS for chronic back pain," Clinical Advisor for Nurse Practitioners 13(3), 13 (2010). no RCT

17

R. Aarskog, et al., "Is mechanical pain threshold after transcutaneous electrical nerve stimulation (TENS) increased locally and unilaterally? A randomized placebocontrolled trial in healthy subjects," Physiother. Res. Int. 12(4), 251 (2007). No chronic pain

18

E. Abdel-Moty, et al., "Functional electrical stimulation treatment of postradiculopathy associated muscle weakness," Arch. Phys. Med. Rehabil. 75(6), 680 (1994). No chronic pain

19

D. Abejon and C. A. Feler, "Is impedance a parameter to be taken into account in spinal cord stimulation?," Pain Phys. 10(4), 533 (2007). Invasive

20

K. Abelson, et al., "Transcutaneous electrical nerve stimulation in rheumatoid arthritis," N. Z. Med. J. 96(727), 156 (1983). Excluded after full text, no adequate data

21

A. P. Abernethy, "Randomized controlled trial of acupuncture for chronic neck pain," 22 (2), 145 (2008). No RCT

22

S. Aboseif, et al., "Sacral neuromodulation as an effective treatment for refractory pelvic floor dysfunction," Urology 60(1), 52 (2002). Invasive

23

S. E. Abram, A. C. Reynolds, and M. B. Chancellor, "A comparison of analgesic effects of electroacupuncture, placebo electroacupuncture and transcutaneous electrical stimulation," (1983). no RCT

24

J. Achterberg, P. McGraw, and G. F. Lawlis, "Rheumatoid arthritis: a study of relaxation and temperature biofeedback training as an adjunctive therapy," (1981). no TENS

25

C. Acton, "The holistic management of chronic wound pain," 3(1), 61 (2007). No RCT

26

J. E. Adams, "Naloxone reversal of analgesia produced by brain stimulation in the human," Pain 2(2), 161 (1976). No RCT


99

27

M. L. Adams and G. J. Arminio, "Non-pharmacologic pain management intervention," Clinics in Podiatric Medicine & Surgery 25(3), 409 (2008). no RCT

28

N. Adams and J. Sim, "An overview of fibromyalgia syndrome: mechanisms, differential diagnosis and treatment approaches," 84(7), 304 (1998). no RCT

29

R. A. Adedoyin, M. O. B. Olaogun, and A. L. Oyeyemi, "Transcutaneous electrical nerve stimulation and interferential current combined with exercise for the treatment of knee osteoarthritis: a randomised controlled trial," (2005). No sham control group

30

H. E. Ahmed, et al., "Percutaneous electrical nerve stimulation: an alternative to antiviral drugs for acute herpes zoster," Anesth. Analg. 87(4), 911 (1998). No chronic pain

31

H. E. Ahmed, et al., "Use of percutaneous electrical nerve stimulation (PENS) in the short-term management of headache," Headache 40(4), 311 (2000). Included

32

E. Ahonen, et al., "Effectiveness of acupuncture and physiotherapy on myogenic headache: a comparative study," (1984). no RCT

33

N. Aigner, et al., "(Acupuncture versus laser acupuncture in the treatment of whiplash injury -a prospective randomized study) [German]," (1999). no TENS

34

O. Airaksinen and P. J. Pontinen, "Effects of the electrical stimulation of myofascial trigger points with tension headache," Acupunct. Electrother. Res. 17(4), 285 (1992). No chronic pain

35

O. Airaksinen, et al., "Chapter 4 - European guidelines for the management of chronic nonspecific low back pain," 15, S192-S300 (2006). No RCT

36

C. B. Aiyejusunle, T. A. Kola-Korolo, and O. A. Ajiboye, "Comparison of the effects of tens and sodium salicylate iontophoresis in the management of osteoarthritis of the knee," Nig. Q. J. Hosp. Med. 17(1), 30 (2007). No RCT

37

G. Akyuz, et al., "Transcutaneous electrical nerve stimulation (TENS) in the treatment of postoperative pain and prevention of paralytic ileus," (1993). no chronic pain

38

E. A. Al-Badawi, et al., "Efficacy of pulsed radio frequency energy therapy in temporomandibular joint pain and dysfunction," Cranio. 22(1), 10 (2004). Excluded after full text, no data extraction possible

39

J. Al-Smadi, et al., "A pilot investigation of the hypoalgesic effects of transcutaneous electrical nerve stimulation upon low back pain in people with multiple sclerosis," Clin. Rehabil. 17(7), 742 (2003). Included

40

J. Albright, et al., "Philadelphia panel evidence-based clinical practice guidelines on selected rehabilitation interventions for low back pain," 81(10), 1641 (2001). No RCT


100

41

L. Alcidi, et al., "Low power radiofrequency electromagnetic radiation for the treatment of pain due to osteoarthritis of the knee," Reumatismo. 59(2), 140 (2007). No sham control group

42

V. Alfieri, et al., "Parameters of electrical multistimulation for the treatment of radicular pain," (1987). Excluded after full text, no adequate sham control group

43

D. Alimi, et al., "Analgesic effect of auricular acupuncture for cancer pain: a randomized, blinded, controlled trial," J. Clin. Oncol. 21(22), 4120 (2003). Excluded after full text, no chronic pain

44

G. Allais, et al., "Non-pharmacological approaches to chronic headaches: Transcutaneous electrical nerve stimulation, lasertherapy and acupuncture in transformed migraine treatment," Neurol. Sci. 24(SUPPL. 2) (2003). Excluded after full text, no sham control group

45

M. Allegri, et al., "Prospective study of the success and efficacy of spinal cord stimulation," Minerva Anestesiol. 70(3), 117 (2004). Invasive

46

R. J. Allen, "Physical agents used in the management of chronic pain by physical therapists," Physical Medicine & Rehabilitation Clinics of North America 17(2), 315 (2006). no RCT

47

W. A. Alm, M. L. Gold, and L. S. Weil, "Evaluation of transcutaneous electrical nerve stimulation (TENS) in podiatric surgery," J. Am. Podiatry. Assoc. 69(9), 537 (1979). No chronic pain

48

T. F. Almeida, et al., "The effect of combined therapy (ultrasound and interferential current) on pain and sleep in fibromyalgia," Pain 104(3), 665 (2003). Electromagnetic

49

J. Alves-Guerreiro , et al., "The effect of three electrotherapeutic modalities upon peripheral nerve conduction and mechanical pain threshold," Clin. Physiol 21(6), 704 (2001). No chronic pain

50

J. J. Ambler, D. A. Zideman, and C. D. Deakin, "The effect of prophylactic topical steroid cream on the incidence and severity of cutaneous burns following external DC cardioversion," Resuscitation 65(2), 179 (2005). No chronic pain

51

J. J. Ambler and C. D. Deakin, "A randomised controlled trial of the effect of biphasic or monophasic waveform on the incidence and severity of cutaneous burns following external direct current cardioversion," Resuscitation 71(3), 293 (2006). No chronic pain

52

F. Ambrosio, et al., "SIAARTI recommendations for chronic non-cancer pain," 72(11), 859 (2006). No RCT

53

C. Ammendolia, et al., "Evidence-informed management of chronic low back pain with needle acupuncture," 8(1), 160 (2008). No RCT

54

R. Ammer, et al., "Pain threshold for low energy intracardiac cardioversion of atrial fibrillation with low or no sedation," Pacing Clin. Electrophysiol. 20(1 Pt 2), 230 (1997). No chronic pain


101

55

C. Andersen and P. Hole, "Long-term home treatment with epidural analgesia does not affect later spinal cord stimulation in patients with otherwise intractable angina pectoris," Clin. J. Pain 14(4), 315 (1998). No chronic pain

56

T. Andersen, et al., "The effect of electrical stimulation on lumbar spinal fusion in older patients: a randomized, controlled, multi-center trial: part 1: functional outcome," Spine (Phila Pa 1976. ) 34(21), 2241 (2009). No chronic pain

57

A. F. Anderson and A. B. Lipscomb, "Analysis of rehabilitation techniques after anterior cruciate reconstruction," (1989). No chronic pain

58

R. U. Anderson, "Traditional therapy for chronic pelvic pain does not work: what do we do now?," 3(3), 145 (2006). No RCT

59

S. I. Anderson, et al., "Chronic transcutaneous electrical stimulation of calf muscles improves functional capacity without inducing systemic inflammation in claudicants," 27(2), 201 (2004). No chronic pain

60

W. S. Anderson, et al., "Implantation of a responsive neurostimulator device in patients with refractory epilepsy," Neurosurg. Focus. 25(3), E12 (2008). Invasive

61

P. Andrell, et al., "Cost-effectiveness of spinal cord stimulation versus coronary artery bypass grafting in patients with severe angina pectoris--long-term results from the ESBY study," Cardiology 99(1), 20 (2003). Invasive

62

P. Andrell, et al., "White matter disease in magnetic resonance imaging predicts cerebral complications after coronary artery bypass grafting," Ann. Thorac. Surg. 79(1), 74 (2005). No chronic pain

63

D. L. Angulo and C. W. Colwell, Jr., "Use of postoperative TENS and continuous passive motion following total knee replacement," (1990). no chronic pain

64

N. Annal, et al., "Introduction of transcutaneous, low-voltage, non-pulsatile direct current (DC) therapy for migraine and chronic headaches. A comparison with transcutaneous electrical nerve stimulation (TENS)," (1992). No sham control group

65

M. Anselmino, et al., "Spinal cord stimulation and 30-minute heart rate variability in refractory angina patients," Pacing Clin. Electrophysiol. 32(1), 37 (2009). Excluded after full text, no chronic pain

66

A. Antal, et al., "Anodal Transcranial Direct Current Stimulation of the Motor Cortex Ameliorates Chronic Pain and Reduces Short Intracortical Inhibition," J. Pain Symptom Manage. 39(5), 890 (2010). Excluded after full text, no data extraction possible

67

F. Ardic, M. Sarhus, and O. Topuz, "Comparison of two different techniques of electrotherapy on myofascial pain," (2002). No sham control group


102

68

S. Arner and B. A. Meyerson, "Lack of analgesic effect of opioids on neuropathic and idiopathic forms of pain," Pain 33(1), 11 (1988). No TENS

69

W. S. Aronow, "Management of atrial fibrillation in the elderly," 100(1), 3 (2009). No RCT

70

I. Arvidsson and E. Eriksson, "Postoperative TENS pain relief after knee surgery: objective evaluation," Orthopedics 9(10), 1346 (1986). No chronic pain

71

H. Ashton, et al., "Effects of acupuncture and transcutaneous electrical nerve stimulation on cold-induced pain in normal subjects," J. Psychosom. Res. 28(4), 301 (1984). No chronic pain

72

N. P. Assefi, et al., "A Randomized clinical trial of acupuncture compared with sham acupuncture in Fibromyalgia," 143(1), 10 (2005). No TENS

73

C. Atalay and K. B. Yilmaz, "The effect of transcutaneous electrical nerve stimulation on postmastectomy skin flap necrosis," Breast Cancer Res. Treat. 117(3), 611 (2009). No chronic pain

74

M. Ather, et al., "Spinal cord stimulation does not change peripheral skin blood flow in patients with neuropathic pain," Eur. J. Anaesthesiol. 20(9), 736 (2003). Invasive

75

M. Atkinson, "A new way to tackle pain," SportEX Medicine (8), 9 (2001). No data on pain

76

L. E. Augustinsson, T. Eliasson, and C. Mannheimer, "Spinal cord stimulation in severe angina pectoris," Stereotact. Funct. Neurosurg. 65(1-4), 136 (1995). Invasive

77

F. Avraham, et al., "The efficacy of treatment of different intervention programs for patellofemoral pain syndrome: a single blinded randomized clinical trial. Pilot study," (2007). No sham control group

78

M. J. az Arribas, et al., "Effectiveness of the physical therapy Godelive Denys-Struyf method for nonspecific low back pain: primary care randomized control trial," Spine (Phila Pa 1976. ) 34(15), 1529 (2009). No sham control group

79

N. Azulay, et al., "A novel radiofrequency thermocoagulation method for treatment of lower back pain: Thermal conduction after instillation of saline solution into the nucleus pulposus - Preliminary results," 49(8), 934 (2008). No TENS

80

Z. D. Baghdadi, "A comparison of parenteral and electronic dental anesthesia during operative procedures in children," Gen. Dent. 48(2), 150 (2000). No chronic pain

81

M. M. Bala, et al., "Systematic review of the (Cost-)effectiveness of spinal cord stimulation for people with failed back surgery syndrome," 24 (9), 741 (2008). No RCT


103

82

S. Ballegaard, et al., "Acupuncture and transcutaneous electric nerve stimulation in the treatment of pain associated with chronic pancreatitis. A randomized study," Scand. J. Gastroenterol. 20(10), 1249 (1985). Excluded after full text, no adequate data

83

J. A. Balogun, "Pain complaint and muscle soreness associated with high-voltage electrical stimulation: effect of ramp time," Percept. Mot. Skills 62(3), 799 (1986). No data on pain

84

E. Barker, "Nerve pain: neuropathic pain is unique, in that not everyone with pain due to a specific etiology experiences it in the same way," RN 72(1), 32 (2009). No data on pain

85

K. L. Barker, et al., "Treatment of chronic back pain by sensory discrimination training. A Phase I RCT of a novel device (FairMed) vs. TENS," BMC. Musculoskelet. Disord. 9, 97 (2008). No sham control group

86

P. Barlas, et al., "Effects of intensity of electroacupuncture upon experimental pain in healthy human volunteers: a randomized, double-blind, placebo-controlled study," Pain 122(12), 81 (2006). No chronic pain

87

G. Barolat, "Experience with 509 plate electrodes implanted epidurally from C1 to L1," Stereotact. Funct. Neurosurg. 61(2), 60 (1993). Invasive

88

R. Baron, G. Wasner, and V. Lindner, "Optimal treatment of phantom limb pain in the elderly," Drugs & Aging 12(5), 361 (1998). No data on pain

89

J. O. Barr, S. A. Weissenbuehler, and C. K. Cleary, "Effectiveness and comfort of transcutaneous electrical nerve stimulation for older persons with chronic pain," (2004). Excluded after full text, no data extraction possible

90

Z. Baskurt, et al., "The immediate effects of heat and TENS on pressure pain threshold and pain intensity in patients with stage I shoulder impingement syndrome," (2006). No sham control group

91

N. Baum and L. Defidio, "Chronic testicular pain: a workup and treatment guide for the primary care physician," Postgraduate Medicine 98(4), 151 (1995). no RCT

92

S. Baumann, "A nursing approach to pain in older adults," MEDSURG Nursing 18(2), 77 (2009). no RCT

93

C. Bausewein, et al., "Non-pharmacological interventions for breathlessness in advanced stages of malignant and non-malignant diseases," Cochrane Database Syst Rev (2) (2008). No RCT

94

O. Bayindir, et al., "Use of transcutaneous electrical nerve stimulation in the control of postoperative chest pain after cardiac surgery," J. Cardiothorac. Vasc. Anesth. 5(6), 589 (1991). No chronic pain


104

95

E. bdel-Moty, et al., "Functional electrical stimulation treatment of postradiculopathy associated muscle weakness," Archives of Physical Medicine & Rehabilitation 75(6), 680 (1994). No RCT

96

T. Beems and R. T. van Dongen, "Minimally invasive placement of epidural plate electrodes under local anaesthesia in spinal cord stimulation," Acta Neurochir. Suppl 97 (Pt 1), 105 (2007). Invasive

97

M. K. H. Bement and K. A. Sluka, "Low-intensity exercise reverses chronic muscle pain in the rat in a naloxone-dependent manner," 86(9), 1736 (2005). Not human

98

S. J. Benbow and I. A. MacFarlane, "Painful diabetic neuropathy," 13(2), 295 (1999). No RCT

99

J. Bending, "TENS in a pain clinic," 75(5), 292 (1989). No data on pain

100

F. Benedetti, et al., "Control of postoperative pain by transcutaneous electrical nerve stimulation after thoracic operations," Ann. Thorac. Surg. 63(3), 773 (1997). No chronic pain

101

M. I. Bennett, et al., "Feasibility study of Transcutaneous Electrical Nerve Stimulation (TENS) for cancer bone pain," J. Pain 11(4), 351 (2010). Included

102

P. Berger, "Perspectives on physiotherapy guidelines for chronic low back pain," South African Journal of Physiotherapy 63(3), 15 (2007). no RCT

103

S. Berkovitz, et al., "High volume acupuncture clinic (HVAC) for chronic knee pain - audit of a possible model for delivery of acupuncture in the National Health Service," Acupunct. Med. 26(1), 46 (2008). No RCT

104

J. Berlin, W. Erdman, and E. David, "Psychosomatic correlations in chronic pain patients using electroacupuncture," Am. J. Chin Med. 17(1-2), 85 (1989). No chronic pain

105

N. O. Bernardes and L. Bahamondes, "Intravaginal electrical stimulation for the treatment of chronic pelvic pain," Journal of Reproductive Medicine 50(4), 267 (2005). Invasive

106

M. Bernateck, et al., "Adjuvant auricular electroacupuncture and autogenic training in rheumatoid arthritis: a randomized controlled trial. Auricular acupuncture and autogenic training in rheumatoid arthritis," Forsch. Komplementmed. 15(4), 187 (2008). No sham control group

107

A. Bertalanffy, et al., "Transcutaneous electrical nerve stimulation reduces acute low back pain during emergency transport," Acad. Emerg. Med. 12(7), 607 (2005). No chronic pain

108

B. Bettendorf, S. Shay, and F. Tu, "Dysmenorrhea: Contemporary perspectives," 63(9), 597 (2008). No RCT


105

109

H. J. Biedermann, et al., "Perceived and actual control in EMG treatment of back pain," (1987). no TENS

110

A. I. Binder, "Cervical spondylosis and neck pain," 334(7592), 527 (2007). No RCT

111

J. Binder, G. Rossbach, and A. van Ophoven, "The complexity of chronic pelvic pain exemplified by the condition currently called interstitial cystitis - Part 2: Treatment," 39(4), 289 (2008). No RCT

112

S. Blond, et al., "[Cost-benefit evaluation of spinal cord stimulation treatment for failed-back surgery syndrome patients]," Neurochirurgie 50(4), 443 (2004). Invasive

113

D. M. Bloodworth, et al., "Comparison of stochastic versus conventional transcutaneous electrical stimulation for pain modulation in patients with electromyographically documented radiculopathy," (2004). Excluded after full text, no data extraction possible

114

K. Blum, et al., "Repetitive H-wave device stimulation and program induces significant increases in the range of motion of post operative rotator cuff reconstruction in a double-blinded randomized placebo controlled human study," BMC. Musculoskelet. Disord. 10, 132 (2009). No chronic pain

115

K. Bo and M. Maanum, "Does vaginal electrical stimulation cause pelvic floor muscle contraction? A pilot study," Scand. J. Urol. Nephrol. Suppl 179, 39 (1996). No sham control group

116

A. P. Boezaart, J. F. De Beer, and M. L. Nell, "Early experience with continuous cervical paravertebral block using a stimulating catheter," Reg Anesth. Pain Med. 28(5), 406 (2003). Invasive

117

P. S. Boggio, et al., "Transcranial DC stimulation coupled with TENS for the treatment of chronic pain: a preliminary study," Clin. J. Pain 25 (8), 691 (2009). Included

118

R. Bonakdar, D. E. Bresler, and J. Borwick, "Do CAM therapies work for pain management?," Patient Care for the Nurse Practitioner , -9p (2004). no RCT

119

L. Boodhoo, et al., "Improving the acceptability of the atrial defibrillator: patient-activated cardioversion versus automatic night cardioversion with and without sedation (ADSAS 2)," Pacing Clin. Electrophysiol. 27(7), 910 (2004). No chronic pain

120

J. J. Borckardt, et al., "A pilot study investigating the effects of fast left prefrontal rTMS on chronic neuropathic pain," 10(5), 840 (2009). No RCT

121

G. Boriani, et al., "Mechanisms of pain associated with internal defibrillation shocks: results of a randomized study of shock waveform," Heart Rhythm. 2(7), 708 (2005). No chronic pain


106

122

M. Borjesson, et al., "Transcutaneous electrical nerve stimulation in unstable angina pectoris," Coron. Artery Dis. 8(8-9), 543 (1997). No chronic pain

123

E. K. Borud, et al., "The Acupuncture on Hot Flushes Among Menopausal Women (ACUFLASH) study, a randomized controlled trial," 16(3), 484 (2009). No chronic pain

124

L. Borup, et al., "Acupuncture as pain relief during delivery: a randomized controlled trial," Birth 36(1), 5 (2009). No chronic pain

125

E. S. Bracher, et al., "A combined approach for the treatment of cervical vertigo," J. Manipulative Physiol Ther. 23(2), 96 (2000). No chronic pain

126

K. Branco and M. A. Naeser, "Carpal tunnel syndrome: clinical outcome after low-level laser acupuncture, microamps transcutaneous electrical nerve stimulation, and other alternative therapies--an open protocol study," J. Altern. Complement Med. 5 (1), 5 (1999). No RCT

127

R. Breit and Wall H. Van der, "Transcutaneous electrical nerve stimulation for postoperative pain relief after total knee arthroplasty," J. Arthroplasty 19(1), 45 (2004). No chronic pain

128

F. Brighina, et al., "rTMS of the prefrontal cortex in the treatment of chronic migraine: a pilot study," J. Neurol. Sci. 227(1), 67 (2004). No TENS

129

G. Broggi, et al., "Italian multicentric study on pain treatment with epidural spinal cord stimulation," Stereotact. Funct. Neurosurg. 62(1-4), 273 (1994). Invasive

130

D. Brookoff, "Neurophysiological underpinnings of electronic analgesic neuromodulation for dummies," 7(s1), S103-S120 (2006). No data on pain

131

L. Brosseau, et al., "Efficacy of the transcutaneous electrical nerve stimulation for the treatment of chronic low back pain - A meta-analysis," 27(6), 596 (2002). No RCT

132

L. Brosseau, et al., "Transcutaneous electrical nerve stimulation (TENS) for the treatment of rheumatoid arthritis in the hand," Cochrane Database Syst Rev (3) (2003). No RCT

133

D. B. Bruzek and N. S. Geistfeld, "Clinical study to evaluate the use of electronic anesthesia during dental hygiene procedures," Northwest. Dent. 75(3), 21 (1996). No chronic pain

134

T. H. Budzynski, et al., "EMG biofeedback and tension headache: a controlled outcome study," (1973). no chronic pain

135

P. Bundsen, et al., "Pain relief in labor by transcutaneous electrical nerve stimulation. Testing of a modified stimulation technique and evaluation of the neurological and biochemical condition of the newborn infant," Acta Obstet. Gynecol. Scand. 61(2), 129 (1982). No chronic pain


107

136

M. Buonocore and N. Camuzzini, "Increase of the heat pain threshold during and after highfrequency transcutaneous peripheral nerve stimulation in a group of normal subjects," Eura. Medicophys. 43(2), 155 (2007). No chronic pain

137

F. X. Burch, et al., "Evaluating the benefits of patterned stimulation in the treatment of osteoarthritis of the knee: a multi-center, randomized, single-blind, controlled study with an independent masked evaluator," Osteoarthritis. Cartilage. 16(8), 865 (2008). No sham control group

138

K. J. Burchiel, et al., "Prospective, multicenter study of spinal cord stimulation for relief of chronic back and extremity pain," Spine (Phila Pa 1976. ) 21(23), 2786 (1996). Invasive

139

M. J. Callaghan, J. A. Oldham, and J. Winstanley, "A comparison of two types of electrical stimulation of the quadriceps in the treatment of patellofemoral pain syndrome. A pilot study," Clin. Rehabil. 15(6), 637 (2001). No sham control group

140

M. J. Callaghan and J. A. Oldham, "Electric muscle stimulation of the quadriceps in the treatment of patellofemoral pain," Arch. Phys. Med. Rehabil. 85(6), 956 (2004). Excluded after full text, no adequate sham control group

141

T. S. Campbell and B. Ditto, "Exaggeration of blood pressure-related hypoalgesia and reduction of blood pressure with low frequency transcutaneous electrical nerve stimulation," Psychophysiology 39(4), 473 (2002). No data on pain

142

F. Can, et al., "Rehabilitation of patellofemoral pain syndrome: TENS versus diadynamic current therapy for pain relief," (2003). No sham control group

143

S. Canavero, et al., "Low-rate repetitive TMS allays central pain," Neurol. Res. 25(2), 151 (2003). No RCT

144

R. O. Cannon, III , et al., "Imipramine in patients with chest pain despite normal coronary angiograms," N. Engl. J. Med. 330(20), 1411 (1994). No chronic pain

145

I. D. Capel, et al., "The amelioration of the suffering associated with spinal cord injury with subperception transcranial electrical stimulation," Spinal Cord. 41(2), 109 (2003). Excluded after full text, no adequate data

146

J. L. Capodice, et al., "Complementary and alternative medicine for chronic prostatitis/chronic pelvic pain syndrome," 2(4), 495 (2005). No RCT

147

C. P. Carlsson and B. H. Sjolund, "Acupuncture for chronic low back pain: a randomized placebo-controlled study with long-term follow-up," Clin. J. Pain 17(4), 296 (2001). Excluded after full text, no data extraction possible

148

J. Carlsson and U. Rosenhall, "Oculomotor disturbances in patients with tension headache treated with acupuncture or physiotherapy," (1990). no TENS


108

149

D. Carman and J. W. Roach, "Transcutaneous electrical nerve stimulation for the relief of postoperative pain in children," (1988). no chronic pain

150

J. A. Carrobles, A. Cardona, and J. Santacreu, "Shaping and generalization procedures in the EMG-biofeedback treatment of tension headaches," (1981). no TENS

151

D. Carroll, et al., "Motor cortex stimulation for chronic neuropathic pain: a preliminary study of 10 cases," Pain 84(2-3), 431 (2000). Invasive

152

N. J. Carter and G. M. Keating, "OROS hydromorphone prolonged release: A review of its use in the management of chronic, moderate to severe pain," 24(4), 337 (2010). No RCT

153

J. Cassuto, S. Liss, and A. Bennett, "The use of modulated energy carried on a high frequency wave for the relief of intractable pain," Int. J. Clin. Pharmacol. Res. 13(4), 239 (1993). No chronic pain

154

N. Cetin, et al., "Comparing hot pack, short-wave diathermy, ultrasound, and TENS on isokinetic strength, pain, and functional status of women with osteoarthritic knees: a single-blind, randomized, controlled trial," Am. J. Phys. Med. Rehabil. 87(6), 443 (2008). Excluded after full text, no adequate sham control group

155

C. Chabal, et al., "Long-term transcutaneous electrical nerve stimulation (TENS) use: Impact on medication utilization and physical therapy costs," 14(1), 66 (1998). Excluded after full text, no RCT

156

J. Chae and R. Hart, "Comparison of discomfort associated with surface and percutaneous intramuscular electrical stimulation for persons with chronic hemiplegia," Am. J. Phys. Med. Rehabil. 77(6), 516 (1998). Invasive

157

J. Chae, et al., "Intramuscular electrical stimulation for hemiplegic shoulder pain: a 12-month follow-up of a multiple-center, randomized clinical trial," Am. J. Phys. Med. Rehabil. 84(11), 832 (2005). Invasive

158

J. Chae, et al., "Intramuscular electrical stimulation for shoulder pain in hemiplegia: does time from stroke onset predict treatment success?," Neurorehabil. Neural Repair 21(6), 561 (2007). Invasive

159

D. K. Chan, et al., "Electrical acustimulation of the wrist for chronic neck pain: a randomized, sham-controlled trial using a wrist-ankle acustimulation device," Clin. J. Pain 25(4), 320 (2009). Included

160

A. Chantraine, et al., "Shoulder pain and dysfunction in hemiplegia: effects of functional electrical stimulation," Arch. Phys. Med. Rehabil. 80(3), 328 (1999). No sham control group

161

A. S. Chao, et al., "Pain relief by applying transcutaneous electrical nerve stimulation (TENS) on acupuncture points during the first stage of labor: a randomized double-blind


109

placebo-controlled trial," Pain 127(3), 214 (2007). No chronic pain 162

P. D. Chapman, et al., "Efficacy and safety of transcutaneous low-impedance cardiac pacing in human volunteers using conventional polymeric defibrillation pads," Ann. Emerg. Med. 21(12), 1451 (1992). No chronic pain

163

E. K. Chee and H. Walton, "Treatment of trigger points with microamperage transcutaneous electrical nerve stimulation (TENS)--(the Electro-Acuscope 80)," J. Manipulative Physiol Ther. 9(2), 131 (1986). No data on pain

164

G. L. Cheing and C. W. Hui-Chan, "Transcutaneous electrical nerve stimulation: nonparallel antinociceptive effects on chronic clinical pain and acute experimental pain," Arch. Phys. Med. Rehabil. 80(3), 305 (1999). Included

165

G. L. Cheing, C. W. Hui-Chan, and K. M. Chan, "Does four weeks of TENS and/or isometric exercise produce cumulative reduction of osteoarthritic knee pain?," Clin. Rehabil. 16(7), 749 (2002). Included

166

G. L. Cheing and C. W. Hui-Chan, "Analgesic effects of transcutaneous electrical nerve stimulation and interferential currents on heat pain in healthy subjects," J. Rehabil. Med. 35(1), 15 (2003). No chronic pain

167

G. L. Cheing, et al., "Optimal stimulation duration of tens in the management of osteoarthritic knee pain," J. Rehabil. Med. 35(2), 62 (2003). Excluded after full text, no data extraction possible

168

G. L. Cheing and M. L. Luk, "Transcutaneous electrical nerve stimulation for neuropathic pain," J. Hand Surg. Br. 30(1), 50 (2005). Excluded after full text, no data on duration of pain

169

G. L. Cheing, E. M. So, and C. Y. Chao, "Effectiveness of electroacupuncture and interferential eloctrotherapy in the management of frozen shoulder," J. Rehabil. Med. 40(3), 166 (2008). Excluded after full text, no adequate sham control group

170

G. L. Cheing and W. W. Chan, "Influence of choice of electrical stimulation site on peripheral neurophysiological and hypoalgesic effects," J. Rehabil. Med. 41(6), 412 (2009). Excluded after full text, no data on pain

171

G. L. Y. Cheing and C. W. Hui-Chan, "Would the addition of TENS to exercise training produce better physical performance outcomes in people with knee osteoarthritis than either intervention alone? [with consumer summary]," (2004). No data extraction possible

172

A. C. Chen, et al., "Mode and site of acupuncture modulation in the human brain: 3D (124-ch) EEG power spectrum mapping and source imaging," Neuroimage. 29(4), 1080 (2006). Pain not reported as outcome measure

173

C. C. Chen and M. I. Johnson, "An investigation into the effects of frequency-modulated transcutaneous electrical nerve stimulation (TENS) on experimentally-induced


110

pressure pain in healthy human participants," J. Pain 10(10), 1029 (2009). No chronic pain 174

C. C. Chen and M. I. Johnson, "An investigation into the hypoalgesic effects of high- and lowfrequency transcutaneous electrical nerve stimulation (TENS) on experimentallyinduced blunt pressure pain in healthy human participants," J. Pain 11(1), 53 (2010). No chronic pain

175

C. H. Chen, et al., "The effect of electroacupuncture on shoulder subluxation for stroke patients," Kaohsiung. J. Med. Sci. 16(10), 525 (2000). No chronic pain

176

D. Chen, et al., "Cardiac pacemaker inhibition by transcutaneous electrical nerve stimulation," Archives of Physical Medicine & Rehabilitation 71(1), 27 (1990). No RCT

177

L. Chen, et al., "The effect of location of transcutaneous electrical nerve stimulation on postoperative opioid analgesic requirement: acupoint versus nonacupoint stimulation," Anesth. Analg. 87(5), 1129 (1998). Excluded after full text, no chronic pain

178

L. Chen, et al., "Endogenous anandamide and cannabinoid receptor-2 contribute to electroacupuncture analgesia in rats," 10(7), 732 (2009). Not human

179

R. S. S. Cheng and B. Pomeranz, "Electrotheraphy of chronic musculoskeletal pain: Comparison of electroacupuncture and acupuncture-like transcutaneous electrical nerve stimulation," 2(3), 143 (1986). Excluded after full text, no sham control group

180

D. C. Cherkin, et al., "Physician views about treating low back pain: The results of a national survey," 20(1), 1 (1995). No RCT

181

L. S. Chesterton, et al., "Sensory stimulation (TENS): effects of parameter manipulation on mechanical pain thresholds in healthy human subjects," Pain 99(1-2), 253 (2002). No chronic pain

182

L. S. Chesterton, et al., "Effects of TENS frequency, intensity and stimulation site parameter manipulation on pressure pain thresholds in healthy human subjects," Pain 106(1-2), 73 (2003). No chronic pain

183

L. S. Chesterton, et al., "Transcutaneous electrical nerve stimulation for the management of tennis elbow: a pragmatic randomized controlled trial: the TATE trial (ISRCTN 87141084)," BMC. Musculoskelet. Disord. 10, 156 (2009). No primary data

184

O. Cheung and A. Wald, "Review article: the management of pelvic floor disorders," 19(5), 481 (2004). No RCT

185

Y. T. Chia, et al., "Effectiveness of transcutaneous electric nerve stimulator for pain relief in labour," Asia Oceania J. Obstet. Gynaecol. 16(2), 145 (1990). No adequate data


111

186

G. Chiarioni, et al., "Biofeedback is superior to electrogalvanic stimulation and massage for treatment of levator ani syndrome," Gastroenterology 138(4), 1321 (2010). Invasive

187

A. Chitsaz, et al., "Sensory complaints of the upper extremities in multiple sclerosis: relative efficacy of nortriptyline and transcutaneous electrical nerve stimulation," Clin. J. Pain 25(4), 281 (2009). No sham control group

188

J. H. Chiu, et al., "Effect of transcutaneous electrical nerve stimulation for pain relief on patients undergoing hemorrhoidectomy: prospective, randomized, controlled trial," Dis. Colon Rectum 42(2), 180 (1999). No chronic pain

189

T. T. Chiu, C. W. Hui-Chan, and G. Chein, "A randomized clinical trial of TENS and exercise for patients with chronic neck pain," Clin. Rehabil. 19(8), 850 (2005). Excluded after full text, no adequate sham control group

190

T. T. Chiu, C. W. Hui-Chan, and G. Chein, "A randomized clinical trial of TENS and exercise for patients with chronic neck pain [with consumer summary]," (2005). No sham control group

191

B. A. Chizh, et al., "The effect of intravenous infusion of adenosine on electrically evoked hyperalgesia in a healthy volunteer model of central sensitization," Anesth. Analg. 99(3), 816, table (2004). No chronic pain

192

S. Y. Cho, et al., "Effectiveness of electronic dental anesthesia for restorative care in children," Pediatr. Dent. 20(2), 105 (1998). No chronic pain

193

L. H. Chou, et al., "Intradiscal electrothermal annuloplasty," Am. J. Phys. Med. Rehabil. 84(7), 538 (2005). No RCT

194

R. Chou and L. H. Huffman, "Nonpharmacologic therapies for acute and chronic low back pain: a review of the evidence for an American Pain Society/American College of Physicians clinical practice guideline [corrected] [published erratum appears in ANN INTERN MED 2008 Feb 5;148(3):247]," 147(7), 492 (2007). no RCT

195

I. H. W. Chow and G. L. Y. Cheing, "Comparison of different energy densities of extracorporeal shock wave therapy (ESWT) for the management of chronic heel pain [with consumer summary]," (2007). no TENS

196

D. Christensen, et al., "Effect of gabapentin and lamotrigine on mechanical allodynia-like behaviour in a rat model of trigeminal neuropathic pain," Pain 93(2), 147 (2001). Not human

197

P. A. Christensen , et al., "Electroacupuncture and postoperative pain," Br. J. Anaesth. 62(3), 258 (1989). No chronic pain

198

P. A. Christensen , et al., "Electroacupuncture in anaesthesia for hysterectomy," Br. J. Anaesth. 71(6), 835 (1993). No chronic pain


112

199

J. Chu, et al., "The efficacy of automated/electrical twitch obtaining intramuscular stimulation (atoims/etoims) for chronic pain control: evaluation with statistical process control methods," Electromyogr. Clin. Neurophysiol. 42(7), 393 (2002). No RCT

200

J. Chu, et al., "Electrical twitch-obtaining intramuscular stimulation in lower back pain: a pilot study," Am. J. Phys. Med. Rehabil. 83(2), 104 (2004). Invasive

201

G. Cipriano, Jr., et al., "Short-term transcutaneous electrical nerve stimulation after cardiac surgery: effect on pain, pulmonary function and electrical muscle activity," Interact. Cardiovasc. Thorac. Surg. 7(4), 539 (2008). No chronic pain

202

L. G. Y. Claeys, "Improvement of microcirculatory blood flow under epidural spinal cord stimulation in patients with nonreconstructible peripheral arterial occlusive disease," Artif. Organs 21(3), 201 (1997). No chronic pain

203

M. S. Clark, et al., "An evaluation of the clinical analgesia/anesthesia efficacy on acute pain using the high frequency neural modulator in various dental settings," Oral Surg. Oral Med. Oral Pathol. 63(4), 501 (1987). No chronic pain

204

L. S. Claydon, et al., "Effects of simultaneous dual-site TENS stimulation on experimental pain," Eur. J. Pain 12(6), 696 (2008). No chronic pain

205

L. S. Claydon and L. S. Chesterton, "Does transcutaneous electrical nerve stimulation (TENS) produce 'dose-responses'? A review of systematic reviews on chronic pain," Physical Therapy Reviews 13(6), 450 (2008). no RCT

206

S. P. Cohen, P. J. Christo, and L. Moroz, "Pain management in trauma patients," 83(2), 142 (2004). No RCT

207

R. Coletta, F. Maggiolo, and Tizio S. Di, "Etofenamate and transcutaneous electrical nerve stimulation treatment of painful spinal syndromes," Int. J. Clin. Pharmacol. Res. 8(4), 295 (1988). No chronic pain

208

S. S. Colson, et al., "Neuromuscular electrical stimulation training: a safe and effective treatment for facioscapulohumeral muscular dystrophy patients," Arch. Phys. Med. Rehabil. 91(5), 697 (2010). No RCT

209

Ruiz B. Congregado, et al., "Peripheral afferent nerve stimulation for treatment of lower urinary tract irritative symptoms," Eur. Urol. 45(1), 65 (2004). No chronic pain

210

I. G. Conn, et al., "Transcutaneous electrical nerve stimulation following appendicectomy: the placebo effect," Ann. R. Coll. Surg. Engl. 68(4), 191 (1986). No chronic pain

211

T. M. Cook and R. H. Riley, "Analgesia following thoracotomy: a survey of Australian practice," Anaesth. Intensive Care 25(5), 520 (1997). No chronic pain


113

212

A. M. Cooperman, et al., "Use of transcutaneous electrical stimulation in the control of postoperative pain," Am. J. Surg. 133(2), 185 (1977). No chronic pain

213

P. E. Corrado, H. Gottlieb, and M. H. Abdelhamid, "The effect of biofeedback and relaxation training on anxiety and somatic complaints in chronic pain patients," (2003). no TENS

214

B. Cottingham, et al., "The effect of subcutaneous nerve stimulation (SCNS) on pain associated with osteoarthritis of the hip," (1985). Invasive

215

S. Cowan, et al., "An investigation of the hypoalgesic effects of TENS delivered by a glove electrode," J. Pain 10(7), 694 (2009). No chronic pain

216

P. J. Coyne, et al., "Transcutaneous electrical nerve stimulator for procedural pain associated with intravenous needlesticks," J. Intraven. Nurs. 18(5), 263 (1995). No chronic pain

217

J. A. Craig, et al., "Lack of effect of transcutaneous electrical nerve stimulation upon experimentally induced delayed onset muscle soreness in humans," Pain 67(2-3), 285 (1996). No chronic pain

218

F. L. Cramp, et al., "A controlled study on the effects of transcutaneous electrical nerve stimulation and interferential therapy upon the RIII nociceptive and H-reflexes in humans," Arch. Phys. Med. Rehabil. 81(3), 324 (2000). No chronic pain

219

D. A. Crane, K. M. Jaffee, and A. Kundu, "Intractable pruritus after traumatic spinal cord injury," Journal of Spinal Cord Medicine 32(4), 436 (2009). no chronic pain

220

D. J. Crockett, et al., "A comparison of treatment modes in the management of myofascial pain dysfunction syndrome," Biofeedback Self Regul. 11(4), 279 (1986). No adequate sham control

221

A. C. Crompton, et al., "Is transcutaneous electrical nerve stimulation of any value during cervical laser treatment?," Br. J. Obstet. Gynaecol. 99(6), 492 (1992). No chronic pain

222

F. B. Curcio, V. M. Tackney, and R. Berweger, "Transcutaneous electrical nerve stimulation in dentistry: a report of a double-blind study," J. Prosthet. Dent. 58(3), 379 (1987). No chronic pain

223

R. J. Cuschieri, C. G. Morran, and C. S. McArdle, "Transcutaneous electrical stimulation for postoperative pain," Ann. R. Coll. Surg. Engl. 67(2), 127 (1985). No chronic pain

224

R. J. Cuschieri, C. G. Morran, and J. G. Pollock, "Transcutaneous electrical stimulation for ischaemic pain at rest," Br. Med. J. (Clin. Res. Ed) 295(6593), 306 (1987). No chronic pain

225

G. D'Aleo, et al., "Nociceptive R3 reflex in relapsing-remitting multiple sclerosis patients," Funct. Neurol. 14(1), 43 (1999). No RCT


114

226

T. F. G. da Silva , et al., "Comparacao dos efeitos da estimulacao eletrica nervosa transcutanea e da hidroterapia na dor, flexibilidade e qualidade de vida de pacientes com fibromialgia (Comparison of transcutaneous electrical nerve stimulation and hydrotherapy effects on pain, flexibility and quality of life in patients with fibromyalgia) [Portuguese]," (2008). Wrong language

227

J. Dai and S. Liang, "A clinical observation on coronary heart disease treated by otopuncture at heart otopoint," J. Tradit. Chin Med. 18(1), 43 (1998). No chronic pain

228

N. Danziger, et al., "Depressive effects of segmental and heterotopic application of transcutaneous electrical nerve stimulation and piezo-electric current on lower limb nociceptive flexion reflex in human subjects," Arch. Phys. Med. Rehabil. 79(2), 191 (1998). No chronic pain

229

H. T. Davies, et al., "Audit in pain clinics: changing the management of low-back and nervedamage pain," Anaesthesia 51(7), 641 (1996). No RCT

230

J. R. Davies, "Ineffective transcutaneous nerve stimulation following epidural anaesthesia," (1982). no chronic pain

231

M. Y. Dawood and J. Ramos, "Transcutaneous electrical nerve stimulation (TENS) for the treatment of primary dysmenorrhea: a randomized crossover comparison with placebo TENS and ibuprofen," Obstet. Gynecol. 75(4), 656 (1990). No adequate data

232

C. de Angelis, et al., "Suppression of pelvic pain during hysteroscopy with a transcutaneous electrical nerve stimulation device," (2003). no chronic pain

233

N. O. de Bernardes, et al., "Use of intravaginal electrical stimulation for the treatment of chronic pelvic pain: a randomized, double-blind, crossover clinical trial," J. Reprod. Med. 55(1-2), 19 (2010). Invasive

234

M. J. De Jongste, et al., "Efficacy of spinal cord stimulation as adjuvant therapy for intractable angina pectoris: a prospective, randomized clinical study. Working Group on Neurocardiology," J. Am. Coll. Cardiol. 23(7), 1592 (1994). Invasive

235

O. A. de Leon-Casasola, "Spinal Cord and Peripheral Nerve Stimulation Techniques for Neuropathic Pain," J. Pain Symptom Manage. 38(2), S28-S38 (2009). No RCT

236

Bernardes N. de Oliveira and L. Bahamondes, "Intravaginal electrical stimulation for the treatment of chronic pelvic pain," J. Reprod. Med. 50(4), 267 (2005). Invasive

237

J. de Paiva Tosato, D. A. Biasotto-Gonzalez, and P. H. F. Caria, "Efeito da massoterapia e da estimulacao eletrica nervosa transcutanea na dor e atividade eletromiografica de pacientes com disfuncao temporomandibular (Effect of massage therapy and of transcutaneous electrical nerve stimulation on pain and electromyographic activity in patients with temporomandibular dysfunction) [Portuguese]," (2007). Wrong language


115

238

Andres J. De, "New advances in botulinum toxin therapy for pain," 2(6), 791 (2002). No RCT

239

Angelis C. De, et al., "Suppression of pelvic pain during hysteroscopy with a transcutaneous electrical nerve stimulation device," Fertil. Steril. 79(6), 1422 (2003). No chronic pain

240

Gennaro M. De, et al., "Percutaneous tibial nerve neuromodulation is well tolerated in children and effective for treating refractory vesical dysfunction," J. Urol. 171(5), 1911 (2004). No chronic pain

241

Tommaso M. de, et al., "High and low frequency transcutaneous electrical nerve stimulation inhibits nociceptive responses induced by CO2 laser stimulation in humans," Neurosci. Lett. 342(1-2), 17 (2003). No chronic pain

242

Vries J. de, et al., "The effect of electrical neurostimulation on collateral perfusion during acute coronary occlusion," BMC. Cardiovasc. Disord. 7, 18 (2007). No chronic pain

243

E. Deegan, "Use and effectiveness of transcutaneous electrical nerve stimulation (TENS) in chronic pain: patients' views," Physical Therapy Reviews 11(3), 225 (2006). No RCT

244

T. R. Deer, R. M. Levy, and E. L. Rosenfeld, "Prospective clinical study of a new implantable peripheral nerve stimulation device to treat chronic pain," 26(5), 359 (2010). Invasive

245

R. Defrin, E. Ariel, and C. Peretz, "Segmental noxious versus innocuous electrical stimulation for chronic pain relief and the effect of fading sensation during treatment," Pain 115(12), 152 (2005). Excluded after full text, no adequate sham control group

246

R. Defrin, et al., "The effect of a series of repetitive transcranial magnetic stimulations of the motor cortex on central pain after spinal cord injury," 88(12), 1574 (2007). Electromagnetic

247

C. Deluze, et al., "Electroacupuncture in fibromyalgia: results of a controlled trial," BMJ 305(6864), 1249 (1992). Included

248

F. Demirturk, et al., "Results of two different manual therapy techniques in chronic tensiontype headache," (2002). no TENS

249

C. R. Denegar and D. H. Perrin, "Effect of transcutaneous electrical nerve stimulation, cold, and a combination treatment on pain, decreased range of motion, and strength loss associated with delayed onset muscle soreness," (1992). No chronic pain

250

G. Deng, et al., "Randomized controlled trial of a special acupuncture technique for pain after thoracotomy," 136(6), 1464 (2008). No chronic pain

251

M. L. Denning, "Retrospective review of long-term transcutaneous nerve stimulation in the management of chronic back pain," 74(3), 149 (1988). no RCT


116

252

J. M. Desantana, et al., "Hypoalgesic effect of the transcutaneous electrical nerve stimulation following inguinal herniorrhaphy: a randomized, controlled trial," J. Pain 9(7), 623 (2008). No chronic pain

253

J. M. Desantana, K. A. Sluka, and G. R. Lauretti, "High and low frequency TENS reduce postoperative pain intensity after laparoscopic tubal ligation: a randomized controlled trial," Clin. J. Pain 25(1), 12 (2009). No chronic pain

254

J. Devulder, et al., "Infra-red thermographic evaluation of spinal cord electrostimulation in patients with chronic pain after failed back surgery," Br. J. Neurosurg. 10(4), 379 (1996). No TENS

255

R. A. Deyo, et al., "Prognostic variability among chronic pain patients: implications for study design, interpretation, and reporting," Arch. Phys. Med. Rehabil. 69(3 Pt 1), 174 (1988). No primary data

256

R. A. Deyo, et al., "Can trials of physical treatments be blinded? The example of transcutaneous electrical nerve stimulation for chronic pain," Am. J. Phys. Med. Rehabil. 69(1), 6 (1990). No data on pain

257

R. A. Deyo, et al., "A controlled trial of transcutaneous electrical nerve stimulation (TENS) and exercise for chronic low back pain," N. Engl. J. Med. 322(23), 1627 (1990). Included

258

P. di Benedetto, L. G. Iona, and V. Zidarich, "Clinical evaluation of S-adenosyl-L-methionine versus transcutaneous electrical nerve stimulation in primary fibromyalgia," (1993). No sham control group

259

Lazzaro Di, V, et al., "Direct demonstration of long latency cortico-cortical inhibition in normal subjects and in a patient with vascular parkinsonism," Clin. Neurophysiol. 113(11), 1673 (2002). No chronic pain

260

Massa A. Di, et al., "Electric nerve stimulation (ENS): 70 clinical cases of bi-block aided by an electric bipolar signal," Minerva Anestesiol. 63(10), 315 (1997). No RCT

261

A. Dickie, et al., "A preliminary investigation into the effect of coffee on hypolagesia associated with transcutaneous electrical nerve stimulation," Clin. Physiol Funct. Imaging 29(4), 293 (2009). No sham control group

262

M. Diers, "Functional Imaging in Chronic Pain: Implications for Therapy," 19(2), 86 (2009). No RCT

263

J. D. Dimitrakov and I. Dechev, "Pelvic floor electrical stimulation in the treatment of chronic pelvic pain syndrome: A randomized, sham-controlled trial," 179(4), 32 (2008). Excluded after full text, no data extraction possible

264

F. Dincer and K. Linde, "Sham interventions in randomized clinical trials of acupuncture - A review," Complement. Ther. Med. 11(4), 235 (2003). No RCT


117

265

J. Dirks, et al., "Gabapentin suppresses cutaneous hyperalgesia following heat-capsaicin sensitization," Anesthesiology 97(1), 102 (2002). No TENS

266

M. Domaille and B. Reeves, "TENS and pain control after coronary artery bypass surgery," (1997). no chronic pain

267

R. J. Dougherty, "Transcutaneous electrical nerve stimulation in the treatment of chronic pain," Hospital Formulary 16, 167 (1981). No data on pain

268

J. Downar, D. J. Mikulis, and K. D. Davis, "Neural correlates of the prolonged salience of painful stimulation," Neuroimage. 20(3), 1540 (2003). Pain not reported as outcome measure

269

W. I. Drechsler, J. F. Knarr, and L. Snyder-Mackler, "A comparison of two treatment regimens for lateral epicondylitis: a randomized trial of clinical interventions," (1997). no TENS

270

B. J. Drew, et al., "Pre-hospital synthesized 12-lead ECG ischemia monitoring with transtelephonic transmission in acute coronary syndromes: pilot study results of the ST SMART trial," J. Electrocardiol. 37 Suppl, 214 (2004). No chronic pain

271

X. Drouot, et al., "The antalgic efficacy of chronic motor cortex stimulation is related to sensory changes in the painful zone," Brain 125(Pt 7), 1660 (2002). No RCT

272

D. M. Duan, et al., "Efficacy evaluation for depression with somatic symptoms treated by electroacupuncture combined with Fluoxetine," J. Tradit. Chin Med. 29(3), 167 (2009). No chronic pain

273

D. Durmus, G. Alayli, and F. Canturk, "Effects of quadriceps electrical stimulation program on clinical parameters in the patients with knee osteoarthritis," Clin. Rheumatol. 26(5), 674 (2007). No sham control group

274

D. Durmus, et al., "Effects of electrical stimulation program on trunk muscle strength, functional capacity, quality of life, and depression in the patients with low back pain: a randomized controlled trial," Rheumatol. Int. 29(8), 947 (2009). Excluded after full text, no sham control group

275

D. Durmus, Y. Durmaz, and F. Canturk, "Effects of therapeutic ultrasound and electrical stimulation program on pain, trunk muscle strength, disability, walking performance, quality of life, and depression in patients with low back pain: a randomized-controlled trial," 30(7), 901 (2010). Excluded after full text, no sham control group

276

B. M. T. Durr, et al., "Bewertung des schmerzlindernden effeckts von TENS in verbindung mit kryotherapie (Evaluation of pain relief using a combination of TENS and cryotherapy) [German]," (2005). No sham control group

277

Y. Dusunceli, et al., "Efficacy of neck stabilization exercises for neck pain: a randomized controlled study," J. Rehabil. Med. 41(8), 626 (2009). No sham control group


118

278

L. E. Dyrehag, et al., "Effects of repeated sensory stimulation sessions (electro-acupuncture) on skin temperature in chronic pain patients," Scand. J. Rehabil. Med. 29(4), 243 (1997). Pain not reported as outcome measure

279

N. S. Ebneshahidi , et al., "The effects of laser acupuncture on chronic tension headache -- a randomised controlled trial [with consumer summary]," (2005). no TENS

280

S. Eckert and D. Horstkotte, "Management of Angina Pectoris The Role of Spinal Cord Stimulation," 9(1), 17 (2009). No RCT

281

S. Eddicks, et al., "Thoracic spinal cord stimulation improves functional status and relieves symptoms in patients with refractory angina pectoris: the first placebo-controlled randomised study," Heart 93(5), 585 (2007). Invasive

282

D. Ehrmann-Feldman, et al., "Physician referral to physical therapy in a cohort of workers compensated for low back pain," Phys. Ther. 76(2), 150 (1996). No data on pain

283

U. Eichenberger, et al., "Chronic phantom limb pain: The effects of calcitonin, ketamine, and their combination on pain and sensory thresholds," 106(4), 1265 (2008). No TENS

284

E. Eisenberg, H. Waisbrod, and H. U. Gerbershagen, "Long-term peripheral nerve stimulation for painful nerve injuries," Clin. J. Pain 20(3), 143 (2004). No RCT

285

E. Eisenberg, et al., "Quantitative sensory testing for spinal cord stimulation in patients with chronic neuropathic pain," Pain Pract. 6(3), 161 (2006). Invasive

286

A. Ekblom and P. Hansson, "Extrasegmental transcutaneous electrical nerve stimulation and mechanical vibratory stimulation as compared to placebo for the relief of acute orofacial pain," Pain 23(3), 223 (1985). No chronic pain

287

A. Ekblom and P. Hansson, "Thermal sensitivity is not changed by acute pain or afferent stimulation," J. Neurol. Neurosurg. Psychiatry 50(9), 1216 (1987). No chronic pain

288

A. Ekblom and P. Hansson, "Pain intensity measurements in patients with acute pain receiving afferent stimulation," J. Neurol. Neurosurg. Psychiatry 51(4), 481 (1988). No chronic pain

289

O. Ekre, et al., "Long-term effects of spinal cord stimulation and coronary artery bypass grafting on quality of life and survival in the ESBY study," Eur. Heart J. 23(24), 1938 (2002). Invasive

290

E. Eksioglu, et al., "Effects of Stanger bath therapy on fibromyalgia," Clin. Rheumatol. 26(5), 691 (2007). No sham control group

291

B. Ellis, "Transcutaneous electrical nerve stimulators: outpatient response to a temporary home-loan programme... BJTR pull-out physiotherapy supplement on electrotherapy,"


119

British Journal of Therapy & Rehabilitation 2(8), 419 (1995). No RCT 292

B. Ellis, "A retrospective study of long-term users of transcutaneous electrical nerve stimulators," British Journal of Therapy & Rehabilitation 3(2), 88 (1996). No RCT

293

B. Ellis, "Short report: transcutaneous electrical nerve stimulation for pain relief: recent research findings and implications for clinical use," Physical Therapy Reviews 3(1), 3 (1998). no RCT

294

M. Emmiler, et al., "Control of acute postoperative pain by transcutaneous electrical nerve stimulation after open cardiac operations: a randomized placebo-controlled prospective study," Heart Surg. Forum 11(5), E300-E303 (2008). No chronic pain

295

M. Erdogan, et al., "Prospective, Randomized, Placebo-controlled Study of the Effect of TENS on postthoracotomy pain and pulmonary function," World J. Surg. 29(12), 1563 (2005). No chronic pain

296

S. V. Eriksson, T. Lundeberg, and S. Lundeberg, "Interaction of diazepam and naloxone on acupuncture induced pain relief," Am. J. Chin Med. 19(1), 1 (1991). No RCT

297

R. Erkkola, P. Pikkola, and J. Kanto, "Transcutaneous nerve stimulation for pain relief during labour: a controlled study," Ann. Chir Gynaecol. 69(6), 273 (1980). No chronic pain

298

M. Escher, et al., "Pharmacokinetic and pharmacodynamic properties of buprenorphine after a single intravenous administration in healthy volunteers: a randomized, double-blind, placebo-controlled, crossover study," Clin. Ther. 29(8), 1620 (2007). No chronic pain

299

E. Escortell Mayor, et al., "Ensayo clinico aleatorizado en pacientes con cervicalgia mecanica en atencion primaria: terapia manual frente a electroestimulacion nerviosa transcutanea (Randomised clinical trial for primary care patients with neck pain: manual therapy versus electrical stimulation) [Spanish; with consumer summary]," (2008). Wrong language

300

C. J. Esposito, J. S. Shay, and B. Morgan, "Electronic dental anesthesia: a pilot study," Quintessence. Int. 24(3), 167 (1993). No chronic pain

301

A. B. Ettinger and C. E. Argoff, "Use of Antiepileptic drugs for nonepileptic conditions: psychiatric disorders and chronic pain," 4(1), 75 (2007). No RCT

302

A. Evanoff and W. P. Newton, "An alternative treatment for low back pain," J Fam Pract 48(6), 416 (1999). No RCT

303

K. Everaert, et al., "Patient satisfaction and complications following sacral nerve stimulation for urinary retention, urge incontinence and perineal pain: a multicenter evaluation," Int. Urogynecol. J. Pelvic. Floor. Dysfunct. 11(4), 231 (2000). Invasive


120

304

K. Everaert, et al., "The pain cycle: implications for the diagnosis and treatment of pelvic pain syndromes," Int. Urogynecol. J. Pelvic. Floor. Dysfunct. 12(1), 9 (2001). Invasive

305

J. Ezzo, et al., "Is acupuncture effective for the treatment of chronic pain? A systematic review," Pain 86(3), 217 (2000). No RCT

306

T. J. Fabian, et al., "Decreasing pain and anxiety associated with patient-activated atrial shock: a placebo-controlled study of adjunctive sedation with oral triazolam," J. Cardiovasc. Electrophysiol. 17(4), 391 (2006). No chronic pain

307

O. O. Fagade and T. O. Obilade, "Therapeutic effect of TENS on post-IMF trismus and pain," Afr. J. Med. Med. Sci. 32(4), 391 (2003). No RCT

308

O. O. Fagade, F. O. Oginni, and T. O. Obilade, "Comparative study of the therapeutic effect of a systemic analgesic and transcutaneous electrical nerve stimulation (TENS) on postIMF trismus and pain in Nigerian patients," Niger. Postgrad. Med. J. 12(2), 97 (2005). No sham control group

309

R. H. Falk and N. J. Battinelli, "External cardiac pacing using low impedance electrodes suitable for defibrillation: a comparative blinded study," J. Am. Coll. Cardiol. 22(5), 1354 (1993). No chronic pain

310

A. Fargas-Babjak, P. Rooney, and E. Gerecz, "Randomized trial of Codetron for pain control in osteoarthritis of the hip/knee," Clin. J. Pain 5(2), 137 (1989). No adequate data

311

A. Fargas-Babjak, "Acupuncture, transcutaneous electrical nerve stimulation, and laser therapy in chronic pain," 17(4), S105-S113 (2001). No RCT

312

A. M. Fargas-Babjak, B. Pomeranz, and P. J. Rooney, "Acupuncture-like stimulation with codetron for rehabilitation of patients with chronic pain syndrome and osteoarthritis," Acupunct. Electrother. Res. 17(2), 95 (1992). Excluded after full text, no data extraction possible

313

S. Farina, et al., "A randomized controlled study on the effect of two different treatments (FREMS and TENS) in myofascial pain syndrome," (2004). No sham control group

314

J. Farr, et al., "Pulsed electrical stimulation in patients with osteoarthritis of the knee: follow up in 288 patients who had failed non-operative therapy," Surg. Technol. Int. 15, 227 (2006). No RCT

315

K. E. Fasanella, et al., "Pain in Chronic Pancreatitis and Pancreatic Cancer," 36(2), 335 (2007). No RCT

316

J. Faucett, et al., "A test of two training interventions to prevent work-related musculoskeletal disorders of the upper extremity," (2002). no chronic pain


121

317

J. S. Feine and J. P. Lund, "An assessment of the efficacy of physical therapy and physical modalities for the control of chronic musculoskeletal pain," Pain 71(1), 5 (1997). No RCT

318

R. K. Fengler, et al., "Action potential simulation (APS) in patients with fibromyalgia syndrome (FMS): a controlled single subject experimental design," Clin. Rheumatol. 26(3), 322 (2007). Excluded after full text, no adequate data

319

B. W. Fenton, et al., "A preliminary study of transcranial direct current stimulation for the treatment of refractory chronic pelvic pain," 2(2), 103 (2009). Excluded after full text, no data extraction possible

320

F. S. Ferraz and C. M. C. Moreira, "Eletroanalgesia com utilizacao da TENS no pos-operatorio de cirurgia cardiaca (Electroanalgesia with TENS in postoperative of cardiac surgery) [Portuguese]," (2009). no chronic pain

321

V. Fialka, E. Preisinger, and A. Bohler, "Zur physikalischen diagnostik und physikalischer therapie der distorsio columnae vertebrailis cervicalis (Physical diagnosis and physical therapy of whiplash injury) [German]," (1989). no TENS

322

H. L. Fields, "Pain II: new approaches to management," Ann. Neurol. 9(2), 101 (1981). No RCT

323

M. Fink, et al., "Needle acupuncture in chronic poststroke leg spasticity," 85(4), 667 (2004). No chronic pain

324

V. Finsen, et al., "Transcutaneous electrical nerve stimulation after major amputation," J. Bone Joint Surg. Br. 70(1), 109 (1988). No chronic pain

325

G. Fischer, R. B. Pelka, and J. Barovic, "[Adjuvant treatment of knee osteoarthritis with weak pulsing magnetic fields. Results of a placebo-controlled trial prospective clinical trial]," Z. Orthop. Ihre Grenzgeb. 143(5), 544 (2005). No chronic pain

326

J. B. Fitzwater, T. J. Kuehl, and J. J. Schrier, "Electrical stimulation in the treatment of pelvic pain due to levator ani spasm," Journal of Reproductive Medicine 48(8), 573 (2003). Invasive

327

M. W. Flowerdew and J. G. Gadsby, "A review of the treatment of chronic low back pain with acupuncture-like transcutaneous electrical nerve stimulation and transcutaneous electrical nerve stimulation," Complement. Ther. Med. 5(4), 193 (1997). No RCT

328

B. Fodor-Sertl, K. Miller, and B. Hohenfellner, "(Transcutaneous electric nerve block in postoperative pain-therapy) [German]," (1990). No chronic pain

329

K. T. Foley, et al., "Randomized, prospective, and controlled clinical trial of pulsed electromagnetic field stimulation for cervical fusion," Spine J. 8(3), 436 (2008). Invasive

330

D. Fontaine, et al., "Safety and efficacy of deep brain stimulation in refractory cluster headache: a randomized placebo-controlled double-blind trial followed by a 1-year


122

open extension," 11(1), 23 (2010). Invasive 331

R. Forestier, et al., "[Are SPA therapy and pulsed electromagnetic field therapy effective for chronic neck pain? Randomised clinical trial First part: clinical evaluation]," Ann. Readapt. Med. Phys. 50(3), 140 (2007). No sham control group

332

R. Forestier, et al., "[Are SPA therapy and pulsed electromagnetic field therapy effective for chronic neck pain? Randomised clinical trial. Second part: medicoeconomic approach]," Ann. Readapt. Med. Phys. 50(3), 148 (2007). No sham control group

333

T. Forst, et al., "Impact of low frequency transcutaneous electrical nerve stimulation on symptomatic diabetic neuropathy using the new Salutaris device," Diabetes Nutr. Metab 17(3), 163 (2004). Included

334

E. L. Forster, et al., "Effect of TENS on pain, medications, and pulmonary function following coronary artery bypass graft surgery," Chest 106 (5), 1343 (1994). No chronic pain

335

N. Foster and J. Vas, "Acupuncture vs. placebo transcutaneous nerve stimulation for chronic neck pain: Commentary," 12(2), 113 (2007). No RCT

336

N. Foster and J. Vas, "Acupuncture vs. placebo transcutaneous nerve stimulation for chronic neck pain," Focus on Alternative & Complementary Therapies 12(2), 113 (2007). No TENS

337

N. E. Foster, et al., "Manipulation of transcutaneous electrical nerve stimulation variables has no effect on two models of experimental pain in humans," Clin. J. Pain 12(4), 301 (1996). No chronic pain

338

B. J. Freeman, et al., "A randomized, double-blind, controlled trial: intradiscal electrothermal therapy versus placebo for the treatment of chronic discogenic low back pain," Spine (Phila Pa 1976. ) 30(21), 2369 (2005). Invasive

339

F. Fregni, et al., "A randomized, sham-controlled, proof of principle study of transcranial direct current stimulation for the treatment of pain in fibromyalgia," Arthritis Rheum. 54(12), 3988 (2006). Invasive

340

F. Fregni, et al., "A sham-controlled, phase II trial of transcranial direct current stimulation for the treatment of central pain in traumatic spinal cord injury," Pain 122(1-2), 197 (2006). Excluded after full text, no chronic pain

341

F. Fregni and A. Pascual-Leone, "Technology Insight: noninvasive brain stimulation in neurology - perspectives on the therapeutic potential of rTMS and tDCS," 3(7), 383 (2007). No RCT

342

F. Fregni, et al., "Cortical stimulation of the prefrontal cortex with transcranial direct current stimulation reduces cue-provoked smoking craving: a randomized, sham-controlled


123

study," J. Clin. Psychiatry 69(1), 32 (2008). No chronic pain 343

M. E. Frey, et al., "Spinal Cord Stimulation for Patients with Failed Back Surgery Syndrome: A Systematic Review," Pain Phys. 12(2), 379 (2009). No RCT

344

T. Fried, R. Johnson, and W. McCracken, "Transcutaneous electrical nerve stimulation: its role in the control of chronic pain," Archives of Physical Medicine & Rehabilitation 65(5), 228 (1984). No primary data

345

Z. B. S. Frih, et al., "Efficacy and treatment compliance of a home-based rehabilitation programme for chronic low back pain: A randomized, controlled study," 52(6), 485 (2009). No TENS

346

L. M. Fu, J. T. Li, and W. S. Wu, "Randomized Controlled Trials of Acupuncture for Neck Pain: Systematic Review and Meta-Analysis," 15(2), 133 (2009). No RCT

347

C. J. Fuentes, et al., "Does amplitude-modulated frequency have a role in the hypoalgesic response of interferential current on pressure pain sensitivity in healthy subjects? A randomised crossover study," Physiotherapy. 96(1), 22 (2010). No chronic pain

348

A. D. Furlan, et al., "Massage for low-back pain: A systematic review within the framework of the Cochrane Collaboration Back Review Group," 27(17), 1896 (2002). No RCT

349

A. D. Furlan, et al., "Acupuncture and dry-needling for low back pain," (1) (2005). No RCT

350

A. D. Furlan, et al., "Acupuncture and dry-needling for low back pain: An updated systematic review within the framework of the Cochrane Collaboration," 30(8), 944 (2005). No RCT

351

C. A. Furnee, G. A. Pfann, and M. A. Kemler, "Treatment value of residual functional capacity improvement among disabled workers: Accounting for hedonic psychological biases," 151(2), 171 (2003). No RCT

352

L. Gabis, B. Shklar, and D. Geva, "Immediate influence of transcranial electrostimulation on pain and beta-endorphin blood levels: an active placebo-controlled study," Am. J. Phys. Med. Rehabil. 82(2), 81 (2003). Electromagnetic

353

L. Gabis, et al., "Pain reduction using transcranial electrostimulation: a double blind "active placebo" controlled trial," J. Rehabil. Med. 41(4), 256 (2009). Electromagnetic

354

J. Gadsby, et al., "Acupuncture-like transcutaneous electrical nerve stimulation within palliative care: a pilot study," (1997). Excluded after full text, no chronic pain

355

J. J. Gagnier, "Evidence-informed management of chronic low back pain with herbal, vitamin, mineral, and homeopathic supplements," 8(1), 70 (2008). No RCT


124

356

J. M. Gaines, Ph.D. Johns Hopkins University, 2002. Ref ID: 1193

357

J. M. Gaines, E. J. Metter, and L. A. Talbot, "The effect of neuromuscular electrical stimulation on arthritis knee pain in older adults with osteoarthritis of the knee," Appl. Nurs. Res. 17(3), 201 (2004). Excluded after full text, no adequate sham control group

358

N. Galanis, et al., "Postoperative pain management and acupuncture: a case report of meniscal cyst excision," Acupunct. Med. 27(2), 79 (2009). No chronic pain

359

G. D. Gale, P. J. Rothbart, and Y. Li, "Infrared therapy for chronic low back pain: a randomized, controlled trial," Pain Res. Manag. 11(3), 193 (2006). No TENS

360

D. Galley, et al., "Spinal cord stimulation for the treatment of peripheral vascular disease of the lower limbs. A multicenter study in 244 patients," J. MAL. VASC. 17(3), 208 (1992). Invasive

361

D. J. Galloway, et al., "A clinical assessment of electroanalgesia following abdominal operations," Surg. Gynecol. Obstet. 159(5), 453 (1984). No chronic pain

362

T. J. Gan, et al., "A randomized controlled comparison of electro-acupoint stimulation or ondansetron versus placebo for the prevention of postoperative nausea and vomiting," Anesth. Analg. 99(4), 1070, table (2004). No chronic pain

363

L. Garcia-Larrea, et al., "Electrical stimulation of motor cortex for pain control: a combined PET-scan and electrophysiological study," Pain 83(2), 259 (1999). Invasive

364

D. Garland, et al., "A 3-month, randomized, double-blind, placebo-controlled study to evaluate the safety and efficacy of a highly optimized, capacitively coupled, pulsed electrical stimulator in patients with osteoarthritis of the knee," Osteoarthritis Cartilage 15(6), 630 (2007). Included

365

A. L. Gejervall, et al., "Electro-acupuncture versus conventional analgesia: a comparison of pain levels during oocyte aspiration and patients' experiences of well-being after surgery," Hum. Reprod. 20(3), 728 (2005). No chronic pain

366

G. Gemignani, et al., "Transcutaneous electrical nerve stimulation in ankylosing spondylitis: a double-blind study," Arthritis Rheum. 34(6), 788 (1991). Excluded after full text, no chronic pain

367

E. Gentilcore-Saulnier, et al., "Pelvic Floor Muscle Assessment Outcomes in Women With and Without Provoked Vestibulodynia and the Impact of a Physical Therapy Program," 7(2), 1003 (2010). No TENS

368

R. George, et al., "Vagus nerve stimulation for treatment of partial seizures: 3. Long-term follow-up on first 67 patients exiting a controlled study. First International Vagus Nerve Stimulation Study Group," Epilepsia 35(3), 637 (1994). Invasive


125

369

M. R. Gersh and S. L. Wolf, "Applications of transcutaneous electrical nerve stimulation in the management of patients with pain: state-of-the-art update," 65(3), 314 (1985). No data on pain

370

G. R. Gerson, R. B. Jones, and D. K. Luscombe, "Studies on the concomitant use of carbamazepine and clomipramine for the relief of post-herpetic neuralgia," Postgrad. Med. J. 53 Suppl 4, 104 (1977). No adequate data

371

A. W. Ghajar and J. B. Miles, "The differential effect of the level of spinal cord stimulation on patients with advanced peripheral vascular disease in the lower limbs," Br. J. Neurosurg. 12(5), 402 (1998). No chronic pain

372

A. Gharabaghi, et al., "Volumetric image guidance for motor cortex stimulation: integration of three-dimensional cortical anatomy and functional imaging," Neurosurgery 57(1 Suppl), 114 (2005). Invasive

373

E. A. Ghoname, et al., "Percutaneous electrical nerve stimulation: an alternative to TENS in the management of sciatica," Pain 83(2), 193 (1999). Included

374

E. A. Ghoname, et al., "Percutaneous electrical nerve stimulation for low back pain: a randomized crossover study," JAMA 281(9), 818 (1999). Included

375

E. S. Ghoname, et al., "The effect of stimulus frequency on the analgesic response to percutaneous electrical nerve stimulation in patients with chronic low back pain," Anesth. Analg. 88(4), 841 (1999). Included

376

S. Ghosh and M. Galinanes, "Protection of the human heart with ischemic preconditioning during cardiac surgery: role of cardiopulmonary bypass," J. Thorac. Cardiovasc. Surg. 126(1), 133 (2003). No chronic pain

377

L. Gifford, ""Tricking pain"," PPA News (23), 3 (2007). No data on pain

378

J. M. Gilbert, et al., "Controlled trial of transcutaneous electrical nerve stimulation (TENS) for postoperative pain relief following inguinal herniorrhaphy," Br. J. Surg. 73(9), 749 (1986). No chronic pain

379

L. G. F. Giles and R. Muller, "Chronic spinal pain syndromes: a clinical pilot trial comparing acupuncture, a nonsteroidal anti-inflammatory drug, and spinal manipulation," Journal of Manipulative & Physiological Therapeutics 22(6), 376 (1999). No TENS

380

K. A. Ginn and M. L. Cohen, "Conservative treatment for shoulder pain: Prognostic indicators of outcome," 85(8), 1231 (2004). No RCT

381

A. Giombini, et al., "Hyperthermia at 434 MHz in the treatment of overuse sport tendinopathies: A randomised controlled clinical trial," 23(3), 207 (2002). No TENS


126

382

C. M. Godfrey, P. P. Morgan, and J. Schatzker, "A randomized trial of manipulation for lowback pain in a medical setting," Spine (Phila Pa 1976. ) 9(3), 301 (1984). No chronic pain

383

R. Goldman, et al., "Electrotherapy promotes healing and microcirculation of infrapopliteal ischemic wounds: a prospective pilot study," Adv. Skin Wound. Care 17(6), 284 (2004). No chronic pain

384

J. Gonzalez-Iglesias, et al., "Inclusion of thoracic spine thrust manipulation into an electrotherapy/thermal program for the management of patients with acute mechanical neck pain: a randomized clinical trial," Man. Ther. 14(3), 306 (2009). No sham control group

385

F. E. Gorbunov, et al., "(Methods of instrumental physiotherapy in the rehabilitative treatment of pareses caused by nerve compression of the extremities and spinal nerve root compression) [Russian]," (1997). no chronic pain

386

A. B. Gorelick, et al., "Differential effects of amitriptyline on perception of somatic and visceral stimulation in healthy humans," Am. J. Physiol 275(3 Pt 1), G460-G466 (1998). No chronic pain

387

L. Gormsen, et al., "The efficacy of the AMPA receptor antagonist NS1209 and lidocaine in nerve injury pain: a randomized, double-blind, placebo-controlled, three-way crossover study," Anesth. Analg. 108(4), 1311 (2009). No TENS

388

H. Gottrup, et al., "Chronic oral gabapentin reduces elements of central sensitization in human experimental hyperalgesia," Anesthesiology 101 (6), 1400 (2004). No TENS

389

S. Gottschling, et al., "Laser acupuncture in children with headache: a double-blind, randomized, bicenter, placebo-controlled trial," (2008). No TENS

390

S. B. Graff-Radford, et al., "Effects of transcutaneous electrical nerve stimulation on myofascial pain and trigger point sensitivity," Pain 37(1), 1 (1989). Excluded after full text, no data on duration of pain

391

D. J. Grant, et al., "A randomized comparative trial of acupuncture versus transcutaneous electrical nerve stimulation for chronic back pain in the elderly," Pain 82(1), 9 (1999). No sham control group

392

V. E. Grechko and E. G. Borisova, "Use of transcutaneous electrical nerve stimulation in the complex treatment of glossalgia," Neurosci. Behav. Physiol 26(6), 584 (1996). No RCT

393

A. L. Green, et al., "Deep brain stimulation can regulate arterial blood pressure in awake humans," Neuroreport 16(16), 1741 (2005). No chronic pain

394

A. L. Green, et al., "Deep brain stimulation for neuropathic cephalalgia," Cephalalgia 26(5), 561 (2006). Invasive


127

395

I. C. Green, et al., "Interventional Therapies for Controlling Pelvic Pain: What is the Evidence?," 14(1), 22 (2010). No RCT

396

K. Grimmer, "A controlled double blind study comparing the effects of strong burst mode TENS and High Rate TENS on painful osteoarthritic knees," (1992). No sham control group

397

H. Groeben, W. M. Foster, and R. H. Brown, "Intravenous lidocaine and oral mexiletine block reflex bronchoconstriction in asthmatic subjects," Am. J. Respir. Crit Care Med. 154(4 Pt 1), 885 (1996). No chronic pain

398

A. R. Gross, et al., "Physical medicine modalities for mechanical neck disorders (Withdrawn paper. 1998, art. no. CD000961)," (1) (2005). No RCT

399

A. R. Gross, et al., "Conservative management of mechanical neck disorders: A systematic review," 34(5), 1083 (2007). No RCT

400

R. Guieu, et al., "[Effects of naloxone on the analgesia induced by vibratory stimulation]," Presse Med. 18(24), 1207 (1989). No chronic pain

401

R. Guieu, et al., "[Comparison of the antalgic effects of transcutaneous vibratory and electric stimulation and placebo in chronic pain]," Presse Med. 18(40), 1978 (1989). Excluded after full text, no data extraction possible

402

C. C. Gunn, et al., "Dry needling of muscle motor points for chronic low-back pain: a randomized clinical trial with long-term follow-up," Spine (Phila Pa 1976. ) 5(3), 279 (1980). No adequate data

403

M. Haas, E. Groupp, and D. F. Kraemer, "Dose-response for chiropractic care of chronic low back pain," 4(5), 574 (2004). Excluded after full text, no primary data.

404

H. Haavik-Taylor and B. Murphy, "Cervical spine manipulation alters sensorimotor integration: A somatosensory evoked potential study," 118(2), 391 (2007). Invasive

405

C. Haigh, "Review: limited evidence suggests that acupuncture is more effective than no treatment for chronic pain... commentary on Ezzo J, Berman B, Hadhazy VA, et al. Is acupuncture effective for the treatment of chronic pain? A systematic review. PAIN 2000 Jun;86:217-25," Evidence-Based Nursing 4(1), 17 (2001). no RCT

406

R. Haigh and A. K. Clarke, "Effectiveness of rehabilitation for spinal pain," 13(1), 63 (1999). No TENS

407

J. Halbert, M. Crotty, and I. D. Cameron, "Evidence for the optimal management of acute and chronic phantom pain: A systematic review," 18(2), 84 (2002). No RCT

408

J. S. Halle, R. J. Franklin, and B. L. Karalfa, "Comparison of four treatment approaches for lateral epicondylitis of the elbow," (1986). No sham control group


128

409

R. Hammerschlag, "Methodological and ethical issues in clinical trials of acupuncture," 4(2), 159 (1998). No RCT

410

M. A. Hamza, et al., "Effect of the duration of electrical stimulation on the analgesic response in patients with low back pain," Anesthesiology 91(6), 1622 (1999). Duplicate study

411

M. A. Hamza, et al., "Effect of the frequency of transcutaneous electrical nerve stimulation on the postoperative opioid analgesic requirement and recovery profile," Anesthesiology 91(5), 1232 (1999). Excluded after full text, no chronic pain

412

M. A. Hamza, et al., "Percutaneous electrical nerve stimulation: a novel analgesic therapy for diabetic neuropathic pain," Diabetes Care 23(3), 365 (2000). Included

413

T. R. Han, H. I. Shin, and I. S. Kim, "Magnetic stimulation of the quadriceps femoris muscle: comparison of pain with electrical stimulation," Am. J. Phys. Med. Rehabil. 85(7), 593 (2006). No chronic pain

414

A. Handforth, et al., "Vagus nerve stimulation therapy for partial-onset seizures: A randomized active-control trial," Neurology 51(1), 48 (1998). Invasive

415

P. Hansson and A. Ekblom, "Transcutaneous electrical nerve stimulation (TENS) as compared to placebo TENS for the relief of acute oro-facial pain," Pain 15(2), 157 (1983). No chronic pain

416

P. Hansson and A. Ekblom, "Afferent stimulation induced pain relief in acute oro-facial pain and its failure to induce sufficient pain reduction in dental and oral surgery," Pain 20(3), 273 (1984). No chronic pain

417

P. Hansson, et al., "Influence of naloxone on relief of acute oro-facial pain by transcutaneous electrical nerve stimulation (TENS) or vibration," Pain 24(3), 323 (1986). No chronic pain

418

A. Hargreaves and J. Lander, "Use of transcutaneous electrical nerve stimulation for postoperative pain," Nurs. Res. 38(3), 159 (1989). No chronic pain

419

H. Harke, et al., "The response of neuropathic pain and pain in complex regional pain syndrome I to carbamazepine and sustained-release morphine in patients pretreated with spinal cord stimulation: a double-blinded randomized study," Anesth. Analg. 92(2), 488 (2001). Invasive

420

R. E. Harris, et al., "Traditional Chinese acupuncture and placebo (sham) acupuncture are differentiated by their effects on mu-opioid receptors (MORs)," 47(3), 1077 (2009). No TENS

421

R. F. Harrison, et al., "Pain relief in labour using transcutaneous electrical nerve stimulation (TENS). A TENS/TENS placebo controlled study in two parity groups," Br. J. Obstet. Gynaecol. 93(7), 739 (1986). No chronic pain


129

422

R. F. Harrison, et al., "A comparative study of transcutaneous electrical nerve stimulation (TENS), entonox, pethidine + promazine and lumbar epidural for pain relief in labor," Acta Obstet. Gynecol. Scand. 66(1), 9 (1987). No chronic pain

423

M. Harvey and M. Elliott, "Transcutaneous electrical nerve stimulation (TENS) for pain management during cavity preparations in pediatric patients," ASDC J. Dent. Child 62(1), 49 (1995). No chronic pain

424

S. J. Hassenbusch , et al., "Long-term results of peripheral nerve stimulation for reflex sympathetic dystrophy," J. Neurosurg. 84(3), 415 (1996). Invasive

425

R. W. Hautvast, et al., "Spinal cord stimulation in chronic intractable angina pectoris: a randomized, controlled efficacy study," Am. Heart J. 136(6), 1114 (1998). Invasive

426

E. M. Hay, K. Dziedzic, and J. Sim, "Treatment options for regional musculoskeletal pain: What is the evidence?," Bailliere's Best Pract. Res. Clin. Rheumatol. 13(2), 243 (1999). No RCT

427

J. L. Hay, et al., "Hyperalgesia in opioid-managed chronic pain and opioid-dependent patients," 10(3), 316 (2009). no RCT

428

J. A. Hayden, et al., "Exercise therapy for treatment of non-specific low back pain," (3) (2005). No RCT

429

C. C. Hemond and F. Fregni, "Transcranial magnetic stimulation in neurology: What we have learned from randomized controlled studies," 10(4), 333 (2007). No RCT

430

T. Henze, et al., "Symptomatic treatment for multiple sclerosis," 75, S2-S39 (2004). No RCT

431

E. Herman, et al., "A randomized controlled trial of transcutaneous electrical nerve stimulation (CODETRON) to determine its benefits in a rehabilitation program for acute occupational low back pain," Spine (Phila Pa 1976. ) 19(5), 561 (1994). No chronic pain

432

I. Herrera-Lasso, et al., "Comparative effectiveness of packages of treatment including ultrasound or transcutaneous electrical nerve stimulation in painful shoulder syndrome," (1993). No sham control group

433

L. Herrington and R. McCulloch, "The role of eccentric training in the management of Achilles tendinopathy: a pilot study," (2007). no TENS

434

M. Hershman, et al., "Transcutaneous electrical nerve stimulation as adjunctive analgesia in patients undergoing abdominal procedures," (1989). no chronic pain

435

H. Hertz, T. Bochdansky, and W. Scharf, "[Electrotherapy of pain relief using the Tenzcare stimulator. A clinico-experimental study]," Wien. Klin. Wochenschr. 96(15), 585


130

(1984). No chronic pain 436

D. Hettinga, A. Gardner, and D. Donachie, "Your questions answered," Talkback Magazine , 26 (2007). No data on pain

437

D. Hettinga, "Research update," Talkback Magazine , 20 (2009). No data on pain

438

L. R. Hey and A. Helewa, "Myofascial pain syndrome: a critical review of the literature," Physiotherapy Canada 46(1), 28 (1994). no RCT

439

A. Heydenreich, "[Punctate transcutaneous electrical nerve stimulation in functional vertebragenic disorders and in migraine]," Z. Gesamte Inn. Med. 43(22), 651 (1988). No chronic pain

440

A. Heydenreich, "(Single-point transcutaneous electric nerve stimulation in a simple placebo comparison in migraine (a prospective randomized study)) [German]," (1989). Not available full text

441

M. Hidderley and E. Weinel, "Effects of TENS applied to acupuncture points distal to a pain site [with consumer summary]," (1997). No chronic pain

442

R. T. Ho, et al., "Electro-acupuncture and postoperative emesis," (1989). No chronic pain

443

R. M. Hoffman, "Review: transcutaneous electrical nerve stimulation is not effective for chronic low-back pain," ACP Journal Club 135(3), 99 (2001). no RCT

444

J. E. Hollman and B. J. Morgan, "Effect of transcutaneous electrical nerve stimulation on the pressor response to static handgrip exercise," Phys. Ther. 77(1), 28 (1997). No chronic pain

445

J. Holsheimer, et al., "Clinical evaluation of paresthesia steering with a new system for spinal cord stimulation," Neurosurgery 42(3), 541 (1998). Invasive

446

V. Hopwood, et al., "Evaluating the efficacy of acupuncture in defined aspects of stroke recovery: a randomised, placebo controlled single blind study," J. Neurol. 255(6), 858 (2008). No chronic pain

447

E. D. Hord, et al., "The effect of vagus nerve stimulation on migraines," 4(9), 530 (2003). Invasive

448

S. Horsch and L. Claeys, "Epidural spinal cord stimulation in the treatment of severe peripheral arterial occlusive disease," Ann. Vasc. Surg. 8(5), 468 (1994). No chronic pain

449

Y. Hosobuchi, "Tryptophan reversal of tolerance to analgesia induced by central grey stimulation," Lancet 2(8079), 47 (1978). No RCT


131

450

C. R. Hou, et al., "Immediate effects of various physical therapeutic modalities on cervical myofascial pain and trigger-point sensitivity," Arch. Phys. Med. Rehabil. 83(10), 1406 (2002). Excluded after full text, no adequate sham control group

451

G. Hruby, et al., "Assessment of efficacy of transcutaneous electrical nerve stimulation for pain management during office-based flexible cystoscopy," Urology 67(5), 914 (2006). No chronic pain

452

C. Y. Hsieh, et al., "Functional outcomes of low back pain: comparison of four treatment groups in a randomized controlled trial," J. Manipulative Physiol Ther. 15(1), 4 (1992). No sham control group

453

R. Hsieh and A. Hyv+ñrinen, "Re: Cutaneous electrical stimulation treatment in unresolved facial nerve paralysis... Hyvarinen A, Tarkka IM, Mervaala E, et al. Cutaneous electrical stimulation treatment in unresolved facial nerve paralysis. Am J Phys Med Rehabil. 2008;87:992-7," 88(7), 593 (2009). no RCT

454

R. L. Hsieh and W. C. Lee, "One-shot percutaneous electrical nerve stimulation vs. transcutaneous electrical nerve stimulation for low back pain: comparison of therapeutic effects," Am. J. Phys. Med. Rehabil. 81(11), 838 (2002). No sham control group

455

T. C. Hsueh, et al., "The immediate effectiveness of electrical nerve stimulation and electrical muscle stimulation on myofascial trigger points," Am. J. Phys. Med. Rehabil. 76(6), 471 (1997). Excluded after full text, no data on duration of pain

456

M. Huang, et al., "Cortical stimulation for upper limb recovery following ischemic stroke: A small phase II pilot study of a fully implanted stimulator," Top. Stroke Rehabil. 15(2), 160 (2008). Invasive

457

M. H. Huang, et al., "The effects of weight reduction on the rehabilitation of patients with knee osteoarthritis and obesity," Arthritis Care Res. 13(6), 398 (2000). No TENS

458

G. S. Hughes, Jr. , et al., "Response of plasma beta-endorphins to transcutaneous electrical nerve stimulation in healthy subjects," Phys. Ther. 64(7), 1062 (1984). No chronic pain

459

P. Humaidan and E. Stener-Victorin, "Pain relief during oocyte retrieval with a new short duration electro-acupuncture technique--an alternative to conventional analgesic methods," Hum. Reprod. 19(6), 1367 (2004). No chronic pain

460

P. Humaidan, et al., "Pain relief during oocyte retrieval--exploring the role of different frequencies of electro-acupuncture," Reprod. Biomed. Online. 13(1), 120 (2006). No chronic pain

461

D. A. Hurley, et al., "Interferential therapy electrode placement technique in acute low back pain: a preliminary investigation," Arch. Phys. Med. Rehabil. 82(4), 485 (2001). No chronic pain

462

D. A. Hurley, et al., "A randomized clinical trial of manipulative therapy and interferential therapy for acute low back pain," Spine (Phila Pa 1976. ) 29(20), 2207 (2004). No chronic pain


132

463

E. L. Hurwitz, et al., "A randomized trial of chiropractic manipulation and mobilization for patients with neck pain: clinical outcomes from the UCLA neck-pain study," Am. J. Public Health 92(10), 1634 (2002). Excluded after full text, no adequate sham control group

464

E. L. Hurwitz, et al., "Frequency and clinical predictors of adverse reactions to chiropractic care in the UCLA neck pain study," Spine (Phila Pa 1976. ) 30(13), 1477 (2005). Pain not reported as outcome measure

465

J. Hush, "TENS of unknown value in the treatment of chronic low back pain," 52(1), 64 (2006). No data on pain

466

D. F. Hutchings and R. H. Reinking, "Tension headaches: what form of therapy is most effective?," (1976). No sham control group

467

U. Ihalainen and K. Perkki, "The effect of transcutaneous nerve stimulation (TNS) on chronic facial pain," Proc. Finn. Dent. Soc. 74(4), 86 (1978). No adequate data

468

M. Imamura, D. A. Cassius, and F. Fregni, "Fibromyalgia: From treatment to rehabilitation," Eur. J. Pain Suppl. 3(2), 117 (2009). No RCT

469

K. Inui, T. Tsuji, and R. Kakigi, "Temporal analysis of cortical mechanisms for pain relief by tactile stimuli in humans," Cereb. Cortex 16(3), 355 (2006). No chronic pain

470

D. Irnich, et al., "Pilotstudy of electroacupuncture in the treatment of peripheral neuropathic pain," 16(2), 114-+ (2002). No RCT

471

K. Itoh, et al., "Randomised trial of trigger point acupuncture compared with other acupuncture for treatment of chronic neck pain," Complement. Ther. Med. 15(3), 172 (2007). No TENS

472

K. Itoh, et al., "A pilot study on using acupuncture and transcutaneous electrical nerve stimulation (TENS) to treat knee osteoarthritis (OA)," (2008). No sham control group

473

K. Itoh, et al., "A pilot study on using acupuncture and transcutaneous electrical nerve stimulation to treat chronic non-specific low back pain," Complement Ther. Clin. Pract. 15(1), 22 (2009). No adequate sham control

474

R. Jacobs and Steenberghe D. van, "The effect of electronic dental analgesia during sonic scaling," J. Clin. Periodontol. 21(10), 728 (1994). No chronic pain

475

A. Jankovic and I. Binic, "Frequency rhythmic electrical modulation system in the treatment of chronic painful leg ulcers," Arch. Dermatol. Res. 300(7), 377 (2008). Excluded after full text, no adequate sham control group

476

K. Janssen, "Differential effectiveness of EMG-feedback versus combined EMG-feedback and relaxation instructions in the treatment of tension headache," (1983). no TENS


133

477

G. J. Jarit, et al., "The effects of home interferential therapy on post-operative pain, edema, and range of motion of the knee," Clin. J. Sport Med. 13(1), 16 (2003). No chronic pain

478

M. E. Jarrett, et al., "Sacral nerve stimulation for faecal incontinence in patients with previous partial spinal injury including disc prolapse," Br. J. Surg. 92(6), 734 (2005). No chronic pain

479

P. F. Jarzem, et al., "Transcutaneous electrical nerve stimulation [TENS] for chronic low back pain," J. Musculoskelet. Pain 13(2), 3 (2005). Not available full text

480

P. F. Jarzem, et al., "Transcutaneous electrical nerve stimulation [TENS] for short-term treatment of low back pain-randomized double blind crossover study of sham versus conventional TENS," J. Musculoskelet. Pain 13(2), 11 (2005). Excluded after full text, no data extraction possible

481

J. F. Jasper and S. M. Hayek, "Implanted Occipital Nerve Stimulators," Pain Phys. 11(2), 187 (2008). No RCT

482

H. Jensen, R. Zesler, and T. Christensen, "Transcutaneous electrical nerve stimulation (TNS) for painful osteoarthrosis of the knee," Int. J. Rehabil. Res. 14(4), 356 (1991). Impossible to calculate SMD

483

J. E. Jensen, et al., "The use of transcutaneous neural stimulation and isokinetic testing in arthroscopic knee surgery," Am. J. Sports Med. 13(1), 27 (1985). No chronic pain

484

M. P. Jensen, et al., "Natural history of chronic pain and pain treatment in adults with cerebral palsy," 83(6), 439 (2004). No RCT

485

Y. Jeon and B. K. Huh, "Spinal Cord Stimulation for Chronic Pain," 38(11), 998 (2009). Invasive

486

G. A. Jessurun, et al., "Coronary blood flow dynamics during transcutaneous electrical nerve stimulation for stable angina pectoris associated with severe narrowing of one major coronary artery," Am. J. Cardiol. 82(8), 921 (1998). No chronic pain

487

G. A. Jessurun, et al., "Clinical follow-up after cessation of chronic electrical neuromodulation in patients with severe coronary artery disease: a prospective randomized controlled study on putative involvement of sympathetic activity," Pacing Clin. Electrophysiol. 22(10), 1432 (1999). Excluded after full text, no chronic pain

488

G. A. Jessurun, et al., "Electrical neuromodulation improves myocardial perfusion and ameliorates refractory angina pectoris in patients with syndrome X: fad or future?," Eur. J. Pain 7(6), 507 (2003). No chronic pain

489

L. E. Jivegard, et al., "Effects of spinal cord stimulation (SCS) in patients with inoperable severe lower limb ischaemia: a prospective randomised controlled study," Eur. J. Vasc. Endovasc. Surg. 9(4), 421 (1995). Invasive


134

490

F. Johannsen, et al., "Rebox: an adjunct in physical medicine?," Arch. Phys. Med. Rehabil. 74(4), 438 (1993). Excluded after full text, no data extraction possible

491

M. Johnson and M. Martinson, "Efficacy of electrical nerve stimulation for chronic musculoskeletal pain: A meta-analysis of randomized controlled trials," Pain 130(1-2), 157 (2007). No RCT

492

M. D. Johnson and K. J. Burchiel, "Peripheral stimulation for treatment of trigeminal postherpetic neuralgia and trigeminal posttraumatic neuropathic pain: a pilot study," Neurosurgery 55(1), 135 (2004). No RCT

493

M. I. Johnson, et al., "The effects of auricular transcutaneous electrical nerve stimulation (TENS) on experimental pain threshold and autonomic function in healthy subjects," Pain 46(3), 337 (1991). No chronic pain

494

M. I. Johnson, et al., "Analgesic effects of different pulse patterns of transcutaneous electrical nerve stimulation on cold-induced pain in normal subjects," J. Psychosom. Res. 35(23), 313 (1991). No chronic pain

495

M. I. Johnson, et al., "The analgesic effects of acupuncture on experimental pain threshold and somatosensory evoked potentials in healthy volunteers," Complement. Ther. Med. 4(4), 219 (1996). no chronic pain

496

M. I. Johnson, P. Penny, and M. A. Sajawal, "An examination of the analgesic effects of microcurrent electrical stimulation (MES) on cold-induced pain in healthy subjects," Physiother. Theory Pract. 13(4), 293 (1997). No chronic pain

497

M. I. Johnson, P. Penny, and M. A. Sajawal, "Clinical technical note: an examination of the analgesic effects of microcurrent electrical stimulation (MES) on cold-induced pain in healthy subjects," Physiotherapy Theory & Practice 13(4), 293 (1997). no chronic pain

498

M. I. Johnson, "The physiology of the sensory dimensions of clinical pain... presented at an Electrotherapy Specific Interest Group study day on TENS and interferential at Solihull Hospital on May 1, 1996 [corrected] [published erratum appears in PHYSIOTHERAPY 1998 Jan; 84(1): 56]," 83(10), 526 (1997). No RCT

499

M. I. Johnson, "The clinical effectiveness of TENS in pain management," Crit. Rev. Phys. Rehabil. Med. 12(2), 131 (2000). No RCT

500

M. I. Johnson, "Transcutaneous electrical nerve stimulation (TENS) and TENS-like devices: do they provide pain relief?," 8(3/4), 121 (2001). No RCT

501

M. I. Johnson and G. Tabasam, "A single-blind placebo-controlled investigation into the analgesic effects of interferential currents on experimentally induced ischaemic pain in healthy subjects," Clin. Physiol Funct. Imaging 22(3), 187 (2002). No chronic pain


135

502

M. I. Johnson and G. Tabasam, "A single-blind investigation into the hypoalgesic effects of different swing patterns of interferential currents on cold-induced pain in healthy volunteers," Arch. Phys. Med. Rehabil. 84(3), 350 (2003). No chronic pain

503

M. I. Johnson and G. Tabasam, "An investigation into the analgesic effects of interferential currents and transcutaneous electrical nerve stimulation on experimentally induced ischemic pain in otherwise pain-free volunteers," Phys. Ther. 83(3), 208 (2003). No chronic pain

504

M. R. Johnson, et al., "Minimally invasive implantation of epidural spinal cord neurostimulator electrodes by using a tubular retractor system. Technical note," J. Neurosurg. 100(6), 1119 (2004). Invasive

505

A. Y. M. Jones and R. C. Hutchinson, "A comparison of the analgesic effect of transcutaneous electrical nerve stimulation and Entonox," (1991). no chronic pain

506

J. B. Jordan, "Acupuncture treatment for opiate addiction: A systematic review," 30(4), 309 (2006). No RCT

507

W. A. Jorgensen, B. M. Frome, and C. Wallach, "Electrochemical therapy of pelvic pain: effects of pulsed electromagnetic fields (PEMF) on tissue trauma," Eur. J. Surg. Suppl (574), 83 (1994). No RCT

508

G. I. Juhl, et al., "Central sensitization phenomena after third molar surgery: a quantitative sensory testing study," 12(1), 116 (2008). no chronic pain

509

J. Jung, et al., "Defibrillation efficacy and pain perception of two biphasic waveforms for internal cardioversion of atrial fibrillation," J. Cardiovasc. Electrophysiol. 14(8), 837 (2003). No chronic pain

510

M. Jünger, et al., "Local therapy and treatment costs of chronic, venous leg ulcers with electrical stimulation (Dermapulse<sup>Â®): A prospective, placebo controlled, double blind trial," Wound Repair Regen. 16(4), 480 (2008). Excluded after full text, no chronic pain

511

S. Kabay, et al., "Efficiency of posterior tibial nerve stimulation in category IIIB chronic prostatitis/chronic pelvic pain: a Sham-Controlled Comparative Study," Urol. Int. 83(1), 33 (2009). Invasive

512

E. Kalso, "Opioids for persistent non-cancer pain," 330(7484), 156 (2005). No TENS

513

R. W. Kang, et al., "Prospective randomized single-blinded controlled clinical trial of percutaneous neuromodulation pain therapy device versus sham for the osteoarthritic knee: a pilot study," Orthopedics 30(6), 439 (2007). Excluded after full text, no data extraction possible

514

A. S. Kapatkin, et al., "Effects of electrostimulated acupuncture on ground reaction forces and pain scores in dogs with chronic elbow joint arthritis," 228(9), 1350 (2006). Not human


136

515

B. Kaplan, et al., "Clinical evaluation of a new model of a transcutaneous electrical nerve stimulation device for the management of primary dysmenorrhea," Gynecol. Obstet. Invest 44(4), 255 (1997). No RCT

516

B. Kaplan, et al., "Transcutaneous electrical nerve stimulation (TENS) for adjuvant pain-relief during labor and delivery," Int. J. Gynaecol. Obstet. 60(3), 251 (1998). No chronic pain

517

L. Kapural and N. Mekhail, "A randomized, double-blind, controlled trial: intradiscal electrothermal therapy versus placebo for the treatment of chronic discogenic low back pain," 31(14) (2006). No RCT

518

A. Kararmaz, et al., "Effect of the frequency of transcutaneous electrical nerve stimulation on analgesia during extracorporeal shock wave lithotripsy," Urol. Res. 32(6), 411 (2004). No chronic pain

519

M. Karasek and N. Bogduk, "Twelve-month follow-up of a controlled trial of intradiscal thermal anuloplasty for back pain due to internal disc disruption," Spine (Phila Pa 1976. ) 25(20), 2601 (2000). Invasive

520

N. Karimi, et al., "The effects of consecutive supervised stability training on postural balance in patients with chronic low back pain," 25(2), 177 (2009). No TENS

521

K. Karppinen, et al., "Adjustment of dental occlusion in treatment of chronic cervicobrachial pain and headache," J. Oral Rehabil. 26(9), 715 (1999). No TENS

522

Y. Katayama, T. Tsubokawa, and T. Yamamoto, "Chronic motor cortex stimulation for central deafferentation pain: experience with bulbar pain secondary to Wallenberg syndrome," Stereotact. Funct. Neurosurg. 62(1-4), 295 (1994). Invasive

523

Z. Katsarava, et al., "A novel method of eliciting pain-related potentials by transcutaneous electrical stimulation," Headache 46(10), 1511 (2006). No chronic pain

524

J. Katz, C. France, and R. Melzack, "An association between phantom limb sensations and stump skin conductance during transcutaneous electrical nerve stimulation (TENS) applied to the contralateral leg: a case study," Pain 36(3), 367 (1989). No adequate data

525

J. Katz and R. Melzack, "Auricular transcutaneous electrical nerve stimulation (TENS) reduces phantom limb pain," J. Pain Symptom. Manage. 6(2), 73 (1991). Excluded after full text, no data on duration of pain

526

A. Keller, et al., "Effect sizes of non-surgical treatments of non-specific low-back pain," 16(11), 1776 (2007). No RCT

527

R. B. Kelly, "Acupuncture for Pain," 80(5), 481 (2009). No RCT


137

528

M. A. Kemler, et al., "Pain relief in complex regional pain syndrome due to spinal cord stimulation does not depend on vasodilation," Anesthesiology 92(6), 1653 (2000). Invasive

529

M. A. Kemler, et al., "Spinal cord stimulation in patients with chronic reflex sympathetic dystrophy," 343(9), 618 (2000). Invasive

530

M. A. Kemler, et al., "Impact of spinal cord stimulation on sensory characteristics in complex regional pain syndrome type I: a randomized trial," Anesthesiology 95(1), 72 (2001). Invasive

531

M. A. Kemler, "Complex regional pain syndrome type I," 8(1), 35 (2001). No RCT

532

M. A. Kemler, et al., "The effect of spinal cord stimulation in patients with chronic reflex sympathetic dystrophy: two years' follow-up of the randomized controlled trial," Ann. Neurol. 55(1), 13 (2004). Invasive

533

M. A. Kemler, et al., "Effect of spinal cord stimulation for chronic complex regional pain syndrome Type I: five-year final follow-up of patients in a randomized controlled trial," 108(2), 292 (2008). Invasive

534

J. N. Kenyon, C. J. Knight, and C. Wells, "Randomised double-blind trial on the immediate effects of naloxone on classical Chinese acupuncture therapy for chronic pain," Acupunct. Electrother. Res. 8(1), 17 (1983). No TENS

535

D. P. Kerr, D. M. Walsh, and D. Baxter, "Acupuncture in the management of chronic low back pain: a blinded randomized controlled trial," Clin. J. Pain 19(6), 364 (2003). Excluded after full text, acupuncture.

536

B. Kettenmann, et al., "Impact of continuous low level heatwrap therapy in acute low back pain patients: subjective and objective measurements," (2007). no chronic pain

537

A. Khadikar, et al., "Transcutaneous electrical nerve stimulation for the treatment of chronic low back pain: a systematic review," 30(23), 2657 (2005). no RCT

538

A. Khadilkar, et al., "Transcutaneous electrical nerve stimulation (TENS) for chronic low-back pain," (3) (2005). No RCT

539

A. Khadilkar, et al., "Transcutaneous electrical nerve stimulation (TENS) versus placebo for chronic low-back pain," (4) (2008). No RCT

540

A. A. Khalessi, et al., "Automated vs. manual spinal cord stimulator adjustment: A sensitivity analysis of lifetime cost data from a randomized controlled trial," 11(3), 182 (2008). No RCT

541

Z. Khalil, R. Ogrin, and P. J. Darzins, "The effect of sensory nerve stimulation on sensory nerve function in people with peripheral neuropathy associated with diabetes," Neurol. Res. 29(7), 743 (2007). Excluded after full text, no data on pain


138

542

A. A. Khan, et al., "Arthrographic distension of the shoulder joint in the management of frozen shoulder," Mymensingh. Med. J. 14(1), 67 (2005). No TENS

543

F. Khan, et al., "Multidisciplinary rehabilitation programmes following joint replacement at the hip and knee in chronic arthropathy," (2) (2008). No RCT

544

H. G. Kho, et al., "Acupuncture and transcutaneous stimulation analgesia in comparison with moderate-dose fentanyl anaesthesia in major surgery. Clinical efficacy and influence on recovery and morbidity," Anaesthesia 46(2), 129 (1991). No chronic pain

545

S. W. Kim, J. S. Paick, and J. H. Ku, "Percutaneous posterior tibial nerve stimulation in patients with chronic pelvic pain: a preliminary study," Urol. Int. 78(1), 58 (2007). No sham control group

546

T. S. Kim, "Relation of magnetic field therapy to pain and power over time in persons with chronic primary headache: a pilot study," Visions: The Journal of Rogerian Nursing Science 9(1), 27 (2001). No sham control group

547

C. E. King, et al., "Effect of helium-neon laser auriculotherapy on experimental pain threshold," Phys. Ther. 70(1), 24 (1990). No chronic pain

548

M. Kinnunen and E. Alasaarela, "Registering the response of tissues exposed to an interferential electric current stimulation," Acupunct. Electrother. Res. 29(3-4), 213 (2004). No chronic pain

549

R. Kirschner-Hermanns and G. Jakse, "[Magnetic stimulation of the pelvic floor in older patients. Results of a prospective analysis]," Urologe A 46(4), 377 (2007). No RCT

550

T. Kitade, et al., "Studies on the enhanced effect of acupuncture analgesia and acupuncture anesthesia by D-phenylalanine (2nd report)--schedule of administration and clinical effects in low back pain and tooth extraction," Acupunct. Electrother. Res. 15(2), 121 (1990). No chronic pain

551

T. Kitade and H. Ohyabu, "Analgesic effects of acupuncture on pain after mandibular wisdom tooth extraction," Acupunct. Electrother. Res. 25(2), 109 (2000). No chronic pain

552

A. Kjellgren, et al., "Effects of flotation-REST on muscle tension pain," 6(4), 181 (2001). No TENS

553

H. C. Klingler, et al., "Use of peripheral neuromodulation of the S3 region for treatment of detrusor overactivity: a urodynamic-based study," Urology 56(5), 766 (2000). Pain not reported as outcome measure

554

H. M. Klomp, et al., "Spinal-cord stimulation in critical limb ischaemia: a randomised trial. ESES Study Group," Lancet 353(9158), 1040 (1999). Invasive

555

R. Knobel, V. Radunz, and T. E. Carraro, "Utilizacao de estimulacao eletrica transcutanea para alivio da dor no trabalho de parto: um modo possivel para o cuidado a


139

parturiente (Use of transcutaneous electric nerve stimulation for pain relief in labour: a possible way to care the child-bearer) [Portuguese]," (2005). no chronic pain 556

G. D. Ko, et al., "Fibromyalgia/chronic pain syndrome: An alternative medicine perspective," Crit. Rev. Phys. Rehabil. Med. 17(1), 1 (2005). No RCT

557

N. D. Kofotolis, S. P. Vlachopoulos, and E. Kellis, "Sequentially allocated clinical trial of rhythmic stabilization exercises and TENS in women with chronic low back pain [with consumer summary]," (2008). Included

558

A. J. Koke, et al., "Pain reducing effect of three types of transcutaneous electrical nerve stimulation in patients with chronic pain: a randomized crossover trial," Pain 108(1-2), 36 (2004). Excluded after full text, no adequate sham control group

559

Dogan S. Koldas, et al., "Comparison of three different approaches in the treatment of chronic low back pain," Clin. Rheumatol. 27(7), 873 (2008). Excluded after full text, no adequate sham control group

560

M. Koltzenburg, et al., "Differential sensitivity of three experimental pain models in detecting the analgesic effects of transdermal fentanyl and buprenorphine," Pain 126(1-3), 165 (2006). No chronic pain

561

C. Kondo and A. Canter, "True and false electromyographic feedback: effect on tension headache," (1977). no TENS

562

J. Kong, et al., "A pilot study of functional magnetic resonance imaging of the brain during manual and electroacupuncture stimulation of acupuncture point (LI-4 Hegu) in normal subjects reveals differential brain activation between methods," J. Altern. Complement Med. 8(4), 411 (2002). No chronic pain

563

J. Kong, et al., "Psychophysical outcomes from a randomized pilot study of manual, electro, and sham acupuncture treatment on experimentally induced thermal pain," J. Pain 6(1), 55 (2005). No chronic pain

564

J. C. Kong, M. S. Lee, and B. C. Shin, "Randomized Clinical Trials on Acupuncture in Korean Literature: A Systematic Review," 6(1), 41 (2009). No RCT

565

J. S. Koopman, D. H. Vrinten, and A. J. van Wijck, "Efficacy of microcurrent therapy in the treatment of chronic nonspecific back pain: a pilot study," Clin. J. Pain 25(6), 495 (2009). Included

566

W. Koppert, et al., "Different profiles of buprenorphine-induced analgesia and antihyperalgesia in a human pain model," Pain 118(1-2), 15 (2005). No chronic pain

567

G. Kose, et al., "A comparison of four disability scales for Turkish patients with neck pain," J. Rehabil. Med. 39(5), 358 (2007). No RCT


140

568

R. W. Koster, et al., "A randomized trial comparing monophasic and biphasic waveform shocks for external cardioversion of atrial fibrillation," Am. Heart J. 147(5), e20 (2004). No chronic pain

569

E. Koyuncu, et al., "The effectiveness of functional electrical stimulation for the treatment of shoulder subluxation and shoulder pain in hemiplegic patients: A randomized controlled trial," Disabil. Rehabil. 32(7), 560 (2010). No chronic pain

570

B. Kraft, et al., "Lack of analgesia by oral standardized cannabis extract on acute inflammatory pain and hyperalgesia in volunteers," Anesthesiology 109(1), 101 (2008). No chronic pain

571

A. W. Krause, et al., "Effects of unilateral and bilateral auricular transcutaneous electrical nerve stimulation on cutaneous pain threshold," Phys. Ther. 67(4), 507 (1987). No chronic pain

572

P. Kroeling, A. Gross, and P. E. Houghton, "Electrotherapy for neck disorders," Cochrane Database Syst Rev (2) (2005). No RCT

573

P. Kroeling, A. R. Gross, and C. H. Goldsmith, "A Cochrane review of electrotherapy for mechanical neck disorders," 30(21) (2005). No RCT

574

L. R. Kruger, W. J. van der Linden, and P. E. Cleaton-Jones, "Transcutaneous electrical nerve stimulation in the treatment of myofascial pain dysfunction," S. Afr. J. Surg. 36(1), 35 (1998). No RCT

575

A. Kudoh, H. Katagai, and T. Takazawa, "Increased postoperative pain scores in chronic depression patients who take antidepressants," J. Clin. Anesth. 14(6), 421 (2002). No chronic pain

576

A. Kulisch, et al., "Effect of thermal water and adjunctive electrotherapy on chronic low back pain: a double-blind, randomized, follow-up study," J. Rehabil. Med. 41(1), 73 (2009). No sham control group

577

A. D. Kulkarni and R. B. Smith, "The use of microcurrent electrical therapy and cranial electrotherapy stimulation in pain control," Clinical Practice of Alternative Medicine 2(2), 99 (2001). No RCT

578

D. Kumar and H. J. Marshall, "Diabetic peripheral neuropathy: amelioration of pain with transcutaneous electrostimulation," Diabetes Care 20(11), 1702 (1997). No data on pain

579

D. Kumar, et al., "Diabetic peripheral neuropathy. Effectiveness of electrotherapy and amitriptyline for symptomatic relief," Diabetes Care 21 (8), 1322 (1998). Included

580

K. Kumar, et al., "Epidural spinal cord stimulation for treatment of chronic pain--some predictors of success. A 15-year experience," Surg. Neurol. 50(2), 110 (1998). Invasive

581

K. Kumar, S. Malik, and D. Demeria, "Treatment of chronic pain with spinal cord stimulation versus alternative therapies: cost-effectiveness analysis," Neurosurgery 51(1), 106


141

(2002). Invasive 582

K. Kumar, et al., "Spinal cord stimulation vs. conventional medical management: A prospective, randomized, controlled, multicenter study of patients with failed back surgery syndrome (PROCESS study)," 8(4), 213 (2005). Invasive

583

K. Kumar, G. Hunter, and D. Demeria, "Spinal cord stimulation in treatment of chronic benign pain: Challenges in treatment planning and present status, a 22-year experience," Neurosurgery 58(3), 481 (2006). Invasive

584

K. Kumar, et al., "Spinal cord stimulation versus conventional medical management for neuropathic pain: a multicentre randomised controlled trial in patients with failed back surgery syndrome," Pain 132(1-2), 179 (2007). Invasive

585

K. Kumar and J. R. Wilson, "Factors affecting spinal cord stimulation outcome in chronic benign pain with suggestions to improve success rate," Acta Neurochir. Suppl 97(Pt 1), 91 (2007). Invasive

586

K. Kumar, et al., "The effects of spinal cord stimulation in neuropathic pain are sustained: a 24-month follow-up of the prospective randomized controlled multicenter trial of the effectiveness of spinal cord stimulation," Neurosurgery 63(4), 762 (2008). Invasive

587

S. Kumar, "'Usual' physiotherapy is more effective than brief physiotherapy for neck pain," 51(1), 55 (2005). No RCT

588

Gursel Y. Kurtais , et al., "Adding ultrasound in the management of soft tissue disorders of the shoulder: a randomized placebo-controlled trial," Phys. Ther. 84(4), 336 (2004). No chronic pain

589

G. Kvarstein, et al., "A randomized double-blind controlled trial of intra-annular radiofrequency thermal disc therapy--a 12-month follow-up," Pain 145(3), 279 (2009). Invasive

590

C. L. Kwan, et al., "An fMRI study of the anterior cingulate cortex and surrounding medial wall activations evoked by noxious cutaneous heat and cold stimuli," Pain 85(3), 359 (2000). Pain not reported as outcome measure

591

M. Labrecque, et al., "A randomized controlled trial of nonpharmacologic approaches for relief of low back pain during labor," J. Fam. Pract. 48(4), 259 (1999). No chronic pain

592

J. Laitinen and L. Nuutinen, "Failure of transcutaneous electrical nerve stimulation and indomethacin to reduce opiate requirement following cholecystectomy," Acta Anaesthesiol. Scand. 35(8), 700 (1991). No chronic pain

593

M. I. Lambert, et al., "Electro-membrane microcurrent therapy reduces signs and symptoms of muscle damage," Med. Sci. Sports Exerc. 34(4), 602 (2002). No chronic pain


142

594

J. Lampe and B. Dunn, "Symmetrical biphasic TENS waveform for the treatment of back pain," (1987). No sham control group

595

J. Lander and S. Fowler-Kerry, "TENS for children's procedural pain," Pain 52(2), 209 (1993). No chronic pain

596

P. M. Lang, et al., "Bilateral acupuncture analgesia observed by quantitative sensory testing in healthy volunteers," Anesth. Analg. 110(5), 1448 (2010). No chronic pain

597

T. Lang, et al., "TENS relieves acute posttraumatic hip pain during emergency transport," J. Trauma 62(1), 184 (2007). No chronic pain

598

G. B. Langley, et al., "The analgesic effects of transcutaneous electrical nerve stimulation and placebo in chronic pain patients. A double-blind non-crossover comparison," Rheumatol. Int. 4(3), 119 (1984). No adequate data

599

G. Lanner and M. C. Spendel, "Spinal cord stimulation for the treatment of chronic nonmalignant pain," Acta Neurochir. Suppl 97(Pt 1), 79 (2007). Invasive

600

G. A. Lanza, et al., "Effect of spinal cord stimulation on spontaneous and stress-induced angina and 'ischemia-like' ST-segment depression in patients with cardiac syndrome X," Eur. Heart J. 26(10), 983 (2005). Invasive

601

B. Larsen, et al., "[Stellate ganglion block with transcutaneous electric nerve stimulation (TENS): a double-blind study with healthy probands]," Anasthesiol. Intensivmed. Notfallmed. Schmerzther. 30(3), 155 (1995). No chronic pain

602

B. Larsen, et al., "Blockade of the stellate ganglion by transcutaneous electric nerve stimulation (TENS): A double-blind study on healthy probands. [German]," 30(3), 155 (1995). No chronic pain

603

K. S. L. Lau and A. Y. M. Jones, "A single session of Acu-TENS increases FEV1 and reduces dyspnoea in patients with chronic obstructive pulmonary disease: a randomised, placebo-controlled trial," 54(3), 179 (2008). No chronic pain

604

Y. Laufer and M. Elboim, "Effect of burst frequency and duration of kilohertz-frequency alternating currents and of low-frequency pulsed currents on strength of contraction, muscle fatigue, and perceived discomfort," Phys. Ther. 88(10), 1167 (2008). No chronic pain

605

N. G. Lavies, "Laser acupuncture for migraine and muscle tension headache: a double-blind controlled trial," (1998). No TENS

606

P. P. Law and G. L. Cheing, "Optimal stimulation frequency of transcutaneous electrical nerve stimulation on people with knee osteoarthritis," J. Rehabil. Med. 36(5), 220 (2004). No n for groups


143

607

P. P. W. Law, G. L. Y. Cheing, and A. Y. Y. Tsui, "Does transcutaneous electrical nerve stimulation improve the physical performance of people with knee osteoarthritis?," (2004). No data on pain

608

L. Lazarou, et al., "Effects of intensity of Transcutaneous Electrical Nerve Stimulation (TENS) on pressure pain threshold and blood pressure in healthy humans: A randomized, double-blind, placebo-controlled trial," Clin. J. Pain 25(9), 773 (2009). No chronic pain

609

Y. Lazorthes, et al., "[Chronic spinal cord stimulation in the treatment of neurogenic pain. Cooperative and retrospective study on 20 years of follow-up]," Neurochirurgie 41(2), 73 (1995). Invasive

610

Y. Lazorthes, et al., "Motor cortex stimulation for neuropathic pain," Acta Neurochir. Suppl 97(Pt 2), 37 (2007). Invasive

611

M. Leandri, et al., "Comparison of TENS treatments in hemiplegic shoulder pain," Scand. J. Rehabil. Med. 22(2), 69 (1990). Excluded after full text, no data on pain

612

A. W. Lee and J. G. Pilitsis, "Spinal cord stimulation: indications and outcomes," Neurosurg Focus 21(6) (2006). No RCT

613

E. W. Lee, et al., "The role of transcutaneous electrical nerve stimulation in management of labour in obstetric patients," (1990). no chronic pain

614

S. H. Lee, et al., "A double blind study showing that two weeks of daily repetitive TMS over the left or right temporoparietal cortex reduces symptoms in patients with schizophrenia who are having treatment-refractory auditory hallucinations," Neurosci. Lett. 376(3), 177 (2005). No chronic pain

615

S. H. Lee and B. C. Lee, "Electroacupuncture relieves pain in men with chronic prostatitis/chronic pelvic pain syndrome: three-arm randomized trial," Urology 73(5), 1036 (2009). Included

616

J. P. Lefaucheur, X. Drouot, and J. P. Nguyen, "Interventional neurophysiology for pain control: duration of pain relief following repetitive transcranial magnetic stimulation of the motor cortex," Neurophysiol. Clin. 31(4), 247 (2001). Invasive

617

J. P. Lefaucheur, et al., "Pain relief induced by repetitive transcranial magnetic stimulation of precentral cortex," Neuroreport 12(13), 2963 (2001). Invasive

618

J. P. Lefaucheur, et al., "Motor cortex stimulation for the treatment of refractory peripheral neuropathic pain," Brain 132(Pt 6), 1463 (2009). Invasive

619

L. J. Lehmann, "Chronic pain in the geriatric patient: the latest treatment options," Clinical Geriatrics 6(7), 54 (1998). no RCT


144

620

T. R. Lehmann, D. W. Russell, and K. F. Spratt, "The impact of patients with nonorganic physical findings on a controlled trial of transcutaneous electrical nerve stimulation and electroacupuncture," Spine (Phila Pa 1976. ) 8(6), 625 (1983). No adequate data

621

T. R. Lehmann, et al., "Efficacy of electroacupuncture and TENS in the rehabilitation of chronic low back pain patients," Pain 26(3), 277 (1986). No adequate data

622

G. Lehmkuhl and R. Thissen, "[The effectiveness of stimulation of skin receptors in the treatment of prolonged pain (author's transl)]," Dtsch. Med. Wochenschr. 103(28), 1141 (1978). No RCT

623

D. H. Lein, Jr., et al., "Comparison of effects of transcutaneous electrical nerve stimulation of auricular, somatic, and the combination of auricular and somatic acupuncture points on experimental pain threshold," Phys. Ther. 69(8), 671 (1989). No chronic pain

624

D. Lemming, et al., "The responses to pharmacological challenges and experimental pain in patients with chronic whiplash-associated pain," Clin. J. Pain 21(5), 412 (2005). No TENS

625

D. Lemming, et al., "Managing chronic whiplash associated pain with a combination of lowdose opioid (remifentanil) and NMDA-antagonist (ketamine)," Eur. J. Pain 11(7), 719 (2007). No TENS

626

K. C. Leo, et al., "Effect of transcutaneous electrical nerve stimulation characteristics on clinical pain," Phys. Ther. 66(2), 200 (1986). No adequate data

627

S. Levy, et al., "Low-energy cardioversion of spontaneous atrial fibrillation. Immediate and long-term results," Circulation 96(1), 253 (1997). No chronic pain

628

D. Lewers, et al., "Transcutaneous electrical nerve stimulation in the relief of primary dysmenorrhea," Phys. Ther. 69(1), 3 (1989). No adequate sham control

629

B. Lewis, D. Lewis, and G. Cumming, "The comparative analgesic efficacy of transcutaneous electrical nerve stimulation and a non-steroidal anti-inflammatory drug for painful osteoarthritis," Br. J. Rheumatol. 33(5), 455 (1994). No adequate sham control

630

D. Lewis, B. Lewis, and R. D. Sturrock, "Transcutaneous electrical nerve stimulation in osteoarthrosis: a therapeutic alternative?," Ann. Rheum. Dis. 43(1), 47 (1984). No adequate data

631

S. M. Lewis, et al., "Effects of auricular acupuncture-like transcutaneous electric nerve stimulation on pain levels following wound care in patients with burns: a pilot study," J. Burn Care Rehabil. 11(4), 322 (1990). No chronic pain

632

G. Li, et al., "Synergistic effects of compound physical factor treatment on neurological outcome after peripheral nerve entrapment surgery: a randomized controlled study," (2008). no TENS


145

633

K. Li, et al., "Changes in FMRI in the human brain related to different durations of manual acupuncture needling," J. Altern. Complement Med. 12(7), 615 (2006). Pain not reported as outcome measure

634

R. Likar, et al., "[Postoperative transcutaneous electrical nerve stimulation (TENS) in shoulder surgery (randomized, double blind, placebo controlled pilot trial)]," Schmerz. 15(3), 158 (2001). No chronic pain

635

A. T. Lim, et al., "Postoperative pain control: contribution of psychological factors and transcutaneous electrical stimulation," Pain 17(2), 179 (1983). No chronic pain

636

M. F. Limoges and B. Rickabaugh, "Evaluation of TENS during screening flexible sigmoidoscopy," Gastroenterol. Nurs. 27(2), 61 (2004). No chronic pain

637

J. G. Lin, et al., "The effect of high and low frequency electroacupuncture in pain after lower abdominal surgery," Pain 99(3), 509 (2002). No chronic pain

638

J. G. Lin and W. L. Chen, "Review: Acupuncture Analgesia in Clinical Trials," 37(1), 1 (2009). No RCT

639

G. Lind, et al., "Intrathecal baclofen as adjuvant therapy to enhance the effect of spinal cord stimulation in neuropathic pain: a pilot study," Eur. J. Pain 8(4), 377 (2004). Invasive

640

C. Linde, G. Isacsson, and B. G. Jonsson, "Outcome of 6-week treatment with transcutaneous electric nerve stimulation compared with splint on symptomatic temporomandibular joint disk displacement without reduction," Acta Odontol. Scand. 53(2), 92 (1995). No sham control group

641

K. Linde, et al., "Acupuncture for tension-type headache," (1) (2009). No RCT

642

K. Linde, et al., "Acupuncture for migraine prophylaxis," (1) (2009). No RCT

643

S. L. Linn, M. H. Granat, and K. R. Lees, "Prevention of shoulder subluxation after stroke with electrical stimulation," Stroke 30(5), 963 (1999). No chronic pain

644

S. Liss and B. Liss, "Physiological and therapeutic effects of high frequency electrical pulses," Integr. Physiol Behav. Sci. 31(2), 88 (1996). No chronic pain

645

T. List, et al., "Acupuncture and occlusal splint therapy in the treatment of craniomandibular disorders. Part I. A comparative study," Swed. Dent. J. 16(4), 125 (1992). Excluded after full text, no data extraction possible

646

T. List and M. Helkimo, "Adverse events of acupuncture and occlusal splint therapy in the treatment of craniomandibular disorders," (1992). no TENS

647

K. M. Little and A. H. Friedman, "Postherpetic neuralgia," Semin. Neurosurg. 15(1), 93 (2004). No RCT


146

648

S. S. Liu, et al., "The effects of electrical stimulation at different frequencies on perception and pain in human volunteers: epidural versus intravenous administration of fentanyl," Anesth. Analg. 82(1), 98 (1996). No chronic pain

649

Y. C. Liu, W. S. Liao, and I. N. Lien, "Effect of transcutaneous electrical nerve stimulation for post-thoracotomic pain," (1985). no chronic pain

650

Y. Y. Liu, et al., "Evaluation of transcutaneous electroacupoint stimulation with the train-of-four mode for preventing nausea and vomiting after laparoscopic cholecystectomy," Chin J. Integr. Med. 14(2), 94 (2008). No chronic pain

651

S. Lockwood, "The variable parameters of transcutaneous electrical nerve stimulation (TENS) and their clinical use," New Zealand Journal of Physiotherapy 24(1), 7 (1996). No RCT

652

M. Lofgren and C. Norrbrink, "Pain relief in women with fibromyalgia: a cross-over study of superficial warmth stimulation and transcutaneous electrical nerve stimulation," J. Rehabil. Med. 41(7), 557 (2009). No sham control group

653

L. Loh, et al., "Acupuncture versus medical treatment for migraine and muscle tension headaches," (1984). no TENS

654

J. Longbottom, "Not so simple pain: the complexity of chronic pain management," Journal of Chinese Medicine (79), 53 (2005). no RCT

655

A. G. Longobardi, et al., "Effects of auricular transcutaneous electrical nerve stimulation on distal extremity pain: a pilot study," Phys. Ther. 69(1), 10 (1989). No adequate sham control

656

F. D. Lorenzana, "A randomized controlled trial of the efficacy of transcutaneous electrical nerve stimulation (TENS) versus lidocaine in the relief of episiotomy pain," Philipp. J. Obstet. Gynecol. 23(4), 135 (1999). No chronic pain

657

D. W. Losordo, et al., "Intramyocardial transplantation of autologous CD34+ stem cells for intractable angina: a phase I/IIa double-blind, randomized controlled trial," Circulation 115(25), 3165 (2007). No chronic pain

658

C. A. Luchesa, et al., "The role of electroanalgesia in patients undergoing coronary artery bypass surgery," Rev. Bras. Cir. Cardiovasc. 24(3), 391 (2009). No chronic pain

659

T. Lundeberg, "The pain suppressive effect of vibratory stimulation and transcutaneous electrical nerve stimulation (TENS) as compared to aspirin," Brain Res. 294(2), 201 (1984). No adequate sham control

660

T. Lundeberg, "A comparative study of the pain alleviating effect of vibratory stimulation, transcutaneous electrical nerve stimulation, electroacupuncture and placebo," (1984). No data extraction possible


147

661

T. Lundeberg, L. Bondesson, and V. Lundstrom, "Relief of primary dysmenorrhea by transcutaneous electrical nerve stimulation," Acta Obstet. Gynecol. Scand. 64(6), 491 (1985). No adequate data

662

T. Lundeberg, et al., "Long-term results of acupuncture in chronic head and neck pain," 2(1), 15 (1988). Acupuncture

663

T. Lundeberg, et al., "Acupuncture and sensory thresholds," Am. J. Chin Med. 17(3-4), 99 (1989). No chronic pain

664

T. Lundeberg, et al., "Effect of acupuncture and naloxone in patients with osteoarthritis pain. A sham acupuncture controlled study," 4(3), 155 (1991). Acupuncture

665

T. Lundeberg and I. Lund, "Are reviews based on sham acupuncture procedures in fibromyalgia syndrome (FMS) valid?," Acupunct. Med. 25(3), 100 (2007). No RCT

666

T. C. Lundeberg, "Vibratory stimulation for the alleviation of chronic pain," Acta Physiol Scand. Suppl 523, 1 (1983). No RCT

667

G. M. Lyons, et al., "An investigation of the effect of electrode size and electrode location on comfort during stimulation of the gastrocnemius muscle," Med. Eng Phys. 26(10), 873 (2004). No chronic pain

668

C. Ma, et al., "Comparison of Miniscalpel-needle Release, Acupuncture Needling, and Stretching Exercise to Trigger Point in Myofascial Pain Syndrome," 26(3), 251 (2010). No TENS

669

J. Maarrawi, P. Mertens, and M. Sindou, "Neurosurgical management of refractory neuropathic pain," 9(2), 99 (2002). no RCT

670

A. J. Macdonald, et al., "Superficial acupuncture in the relief of chronic low back pain," Ann. R. Coll. Surg. Engl. 65(1), 44 (1983). No adequate sham control

671

A. J. R. Macdonald and T. W. Coates, "The discovery of transcutaneous spinal electroanalgesia and its relief of chronic pain," 81(11), 653 (1995). Excluded after full text, no adequate data

672

L. A. C. Machado, et al., "Analgesic effects of treatments for non-specific low back pain: a meta-analysis of placebo-controlled randomized trials," 48(5), 520 (2009). No RCT

673

D. Machin, G. T. Lewith, and S. Wylson, "Pain Measurement in Randomized ClinicalTrials - A Comparison of 2 Pain Scales," 4(3), 161 (1988). Included

674

C. Mackintosh and S. Elson, "Chronic pain: clinical features, assessment and treatment," Nursing Standard 23(5), 48 (2008). No RCT


148

675

E. A. Macklin, "Pain management -- an overview," Ohio Nurses Review 74(2), 4 (1999). No RCT

676

D. Magis, et al., "Occipital nerve stimulation for drug-resistant chronic cluster headache: a prospective pilot study," Lancet Neurol. 6(4), 314 (2007). Invasive

677

A. Mailis-Gagnon, et al., "Spinal cord stimulation for chronic pain," (3) (2004). Invasive

678

A. Mailis, et al., "Chest wall pain after aortocoronary bypass surgery using internal mammary artery graft: a new pain syndrome?," Heart & Lung 18(6), 553 (1989). no TENS

679

A. Mainstone, "Transcutaneous electrical nerve stimulus (TENS)," British Journal of Midwifery 12(9), 578 (2004). No RCT

680

G. Malanga and E. Wolff, "Evidence-informed management of chronic low back pain with trigger point injections," 8(1), 243 (2008). No TENS

681

A. Manca, et al., "Quality of life, resource consumption and costs of spinal cord stimulation versus conventional medical management in neuropathic pain patients with failed back surgery syndrome (PROCESS trial)," Eur. J. Pain 12(8), 1047 (2008). Invasive

682

L. Manchikanti, et al., "Reassessment of Evidence Synthesis of Occupational Medicine Practice Guidelines for Interventional Pain Management," Pain Phys. 11(4), 393 (2008). No RCT

683

L. Manchikanti, et al., "Comprehensive review of therapeutic interventions in managing chronic spinal pain," Pain Phys. 12(4) (2009). No RCT

684

L. Manchikanti, et al., "Evaluation of Lumbar Facet Joint Nerve Blocks in Managing Chronic Low Back Pain: A Randomized, Double-Blind, Controlled Trial with a 2-Year FollowUp," 7(3), 124 (2010). No TENS

685

S. Mangold, et al., "Motor training of upper extremity with functional electrical stimulation in early stroke rehabilitation," Neurorehabil. Neural Repair 23(2), 184 (2009). No chronic pain

686

E. Manheimer, et al., "Meta-analysis: Acupuncture for low back pain," 142(8), 651 (2005). No RCT

687

C. Mannheimer, S. Lund, and C. A. Carlsson, "The effect of transcutaneous electrical nerve stimulation (TNS) on joint pain in patients with rheumatoid arthritis," Scand. J. Rheumatol. 7(1), 13 (1978). No RCT

688

C. Mannheimer and C. A. Carlsson, "The analgesic effect of transcutaneous electrical nerve stimulation (TNS) in patients with rheumatoid arthritis. A comparative study of different pulse patterns," (1979). No RCT


149

689

C. Mannheimer, et al., "The effects of transcutaneous electrical nerve stimulation in patients with severe angina pectoris," (1985). No RCT

690

C. Mannheimer, et al., "Transcutaneous electrical nerve stimulation in severe angina pectoris: a controlled long-term study," (1985). No RCT

691

C. Mannheimer, et al., "Transcutaneous electrical nerve stimulation (TENS) in angina pectoris," Pain 26(3), 291 (1986). No chronic pain

692

C. Mannheimer, et al., "Influence of naloxone on the effects of high frequency transcutaneous electrical nerve stimulation in angina pectoris induced by atrial pacing," Br. Heart J. 62(1), 36 (1989). No chronic pain

693

C. Mannheimer, H. Emanuelsson, and F. Waagstein, "The effect of transcutaneous electrical nerve stimulation (TENS) on catecholamine metabolism during pacing-induced angina pectoris and the influence of naloxone," Pain 41(1), 27 (1990). No chronic pain

694

C. Mannheimer, et al., "Electrical stimulation versus coronary artery bypass surgery in severe angina pectoris: the ESBY study," Circulation 97(12), 1157 (1998). No chronic pain

695

J. S. Mannheimer and E. C. Whalen, "The efficacy of transcutaneous electrical nerve stimulation in dysmenorrhea," (1985). No sham control group

696

J. J. Mao and R. Kapur, "Acupuncture in Primary Care," 37(1), 105-+ (2010). No TENS

697

S. Marchand, et al., "The effects of dorsal column stimulation on measures of clinical and experimental pain in man," Pain 45(3), 249 (1991). No chronic pain

698

S. Marchand, M. C. Bushnell, and G. H. Duncan, "Modulation of heat pain perception by high frequency transcutaneous electrical nerve stimulation (TENS)," Clin. J. Pain 7(2), 122 (1991). No chronic pain

699

S. Marchand, et al., "Is TENS purely a placebo effect? A controlled study on chronic low back pain," Pain 54(1), 99 (1993). Excluded after full text, no data extraction possible

700

S. Marchand, J. Li, and J. Charest, "Effects of caffeine on analgesia from transcutaneous electrical nerve stimulation," N. Engl. J. Med. 333(5), 325 (1995). No sham control group

701

E. Marco, et al., "Is botulinum toxin type A effective in the treatment of spastic shoulder pain in patients after stroke? A double-blind randomized clinical trial," J. Rehabil. Med. 39(6), 440 (2007). No sham control group

702

G. Marineo, "Untreatable pain resulting from abdominal cancer: new hope from biophysics?," JOP. 4(1), 1 (2003). Excluded after full text, no data extraction possible


150

703

J. D. Markman and A. Philip, "Interventional approaches to pain management," 91(2), 271-+ (2007). No RCT

704

M. Martelete and A. M. Fiori, "Comparative study of the analgesic effect of transcutaneous nerve stimulation (TNS); electroacupuncture (EA) and meperidine in the treatment of postoperative pain," Acupunct. Electrother. Res. 10(3), 183 (1985). No chronic pain

705

P. Martelletti and H. van Suijlekom, "Cervicogenic headache - Practical approaches to therapy," 18(12), 793 (2004). No RCT

706

D. Maugeri, et al., "Electroionotherapy in acute arthrorheumatic pain," Eur. Rev. Med. Pharmacol. Sci. 3(2), 89 (1999). No RCT

707

A. Mauskop, "Vagus nerve stimulation relieves chronic refractory migraine and cluster headaches," Cephalalgia 25(2), 82 (2005). Invasive

708

L. Mazzola, J. Isnard, and F. Mauguiere, "Somatosensory and pain responses to stimulation of the second somatosensory area (SII) in humans. A comparison with SI and insular responses," Cereb. Cortex 16(7), 960 (2006). No chronic pain

709

M. I. McCallum, et al., "Transcutaneous electrical nerve stimulation in the management of acute postoperative pain," Br. J. Anaesth. 61(3), 308 (1988). No chronic pain

710

K. McCamey and P. Evans, "Low back pain," 34(1), 71-+ (2007). No RCT

711

B. C. McDowell, et al., "The lack of hypoalgesic efficacy of H-wave therapy on experimental ischaemic pain," Pain 61(1), 27 (1995). No chronic pain

712

B. C. McDowell, et al., "Comparative analgesic effects of H-wave therapy and transcutaneous electrical nerve stimulation on pain threshold in humans," Arch. Phys. Med. Rehabil. 80(9), 1001 (1999). No chronic pain

713

K. McGann, "Clinical update. Pain management in primary care," Primary Health Care 12(1), 25 (2002). no RCT

714

D. McNab, et al., "An open label, single-centre, randomized trial of spinal cord stimulation vs. percutaneous myocardial laser revascularization in patients with refractory angina pectoris: the SPiRiT trial," Eur. Heart J. 27(9), 1048 (2006). Invasive

715

C. S. Meade, et al., "A randomized trial of transcutaneous electric acupoint stimulation as adjunctive treatment for opioid detoxification," J. Subst. Abuse Treat. 38(1), 12 (2010). No chronic pain

716

J. G. Meechan and R. A. Winter, "A comparison of topical anaesthesia and electronic nerve stimulation for reducing the pain of intra-oral injections," Br. Dent. J. 181(9), 333


151

(1996). No chronic pain 717

J. G. Meechan, A. J. Gowans, and R. R. Welbury, "The use of patient-controlled transcutaneous electronic nerve stimulation (TENS) to decrease the discomfort of regional anaesthesia in dentistry: a randomised controlled clinical trial," J. Dent. 26(56), 417 (1998). No chronic pain

718

J. H. Mehrkens and U. Steude, "Chronic electrostimulation of the trigeminal ganglion in trigeminal neuropathy: current state and future prospects," Acta Neurochir. Suppl 97(Pt 2), 91 (2007). Invasive

719

G. Melo de Paula, et al., "Estimulacao eletrica vervosa transcutanea (TENS) no posoperatorio de cesariana (Transcutaneous electrical nerve stimulation (TENS) following cesarean surgery) [Portuguese]," (2006). no chronic pain

720

E. A. Melvin, Jr. , et al., "Using peripheral stimulation to reduce the pain of C2-mediated occipital headaches: a preliminary report," Pain Phys. 10(3), 453 (2007). Invasive

721

R. Melzack, "Prolonged relief of pain by brief, intense transcutaneous somatic stimulation," Pain 1(4), 357 (1975). No RCT

722

R. Melzack, et al., "Ice massage and transcutaneous electrical stimulation: comparison of treatment for low-back pain," Pain 9(2), 209 (1980). No RCT

723

R. Melzack, P. Vetere, and L. Finch, "Transcutaneous electrical nerve stimulation for low back pain. A comparison of TENS and massage for pain and range of motion," Phys. Ther. 63(4), 489 (1983). No adequate sham control

724

R. Melzack and J. Katz, "Auriculotherapy fails to relieve chronic pain. A controlled crossover study," JAMA 251(8), 1041 (1984). Excluded after full text, no data extraction possible

725

C. F. Meng, et al., "Acupuncture for chronic low back pain in older patients: a randomized, controlled trial," 42(12), 1508 (2003). Excluded after full text, acupuncture.

726

J. Meng, "The effects of acupuncture in treatment of coronary heart diseases," J. Tradit. Chin Med. 24(1), 16 (2004). No chronic pain

727

Z. Q. Meng, et al., "Electro-acupuncture to prevent prolonged postoperative ileus: a randomized clinical trial," World J. Gastroenterol. 16(1), 104 (2010). No chronic pain

728

P. Mertens, et al., "Precentral cortex stimulation for the treatment of central neuropathic pain: results of a prospective study in a 20-patient series," Stereotact. Funct. Neurosurg. 73(1-4), 122 (1999). Invasive


152

729

A. Michalek-Sauberer, et al., "Perioperative auricular electroacupuncture has no effect on pain and analgesic consumption after third molar tooth extraction," Anesth. Analg. 104(3), 542 (2007). No chronic pain

730

F. Michot, K. Ajdacic, and L. Glaus, "A double-blind clinical trial to determine if an interaction exists between diclofenac sodium and the oral anticoagulant acenocoumarol (nicoumalone)," J. Int. Med. Res. 3(3), 153 (1975). No TENS

731

L. Miller, et al., "The effects of transcutaneous electrical nerve stimulation (TENS) on spasticity in multiple sclerosis," Mult. Scler. 13(4), 527 (2007). Excluded after full text, no adequate sham control group

732

D. S. Millson and S. J. Tepper, "Chronic daily headache," Headache: The Journal of Head & Face Pain 44(3), 300 (2004). No RCT

733

S. Milne, et al., "Transcutaneous electrical nerve stimulation (TENS) for chronic low back pain," Cochrane Database Syst Rev (2) (2001). No RCT

734

I. Milsom, N. Hedner, and C. Mannheimer, "A comparative study of the effect of high-intensity transcutaneous nerve stimulation and oral naproxen on intrauterine pressure and menstrual pain in patients with primary dysmenorrhea," Am. J. Obstet. Gynecol. 170(1 Pt 1), 123 (1994). No adaquete sham control

735

P. M. Minder, et al., "Interferential therapy: lack of effect upon experimentally induced delayed onset muscle soreness," Clin. Physiol Funct. Imaging 22(5), 339 (2002). No chronic pain

736

O. Minton and I. J. Higginson, "Electroacupuncture as an adjunctive treatment to control neuropathic pain in patients with cancer," J. Pain Symptom. Manage. 33(2), 115 (2007). No chronic pain

737

A. Mitchell and S. Kafai, "Patient education in TENS pain management," Professional Nurse 12(11), 804 (1997). No RCT

738

A. R. Molloy, et al., "Does a combination of intensive cognitive-behavioral pain management and a spinal implantable device confer any advantage? A preliminary examination," Pain Pract. 6(2), 96 (2006). Invasive

739

R. Monhemius and B. A. Simpson, "Efficacy of spinal cord stimulation for neuropathic pain: assessment by abstinence," Eur. J. Pain 7(6), 513 (2003). Invasive

740

D. E. Moore and H. M. Blacker, "How effective is TENS for chronic pain?," American Journal of Nursing 83(8), 1175 (1983). No primary data

741

K. N. Moore, D. Griffiths, and A. Hughton, "Urinary incontinence after radical prostatectomy: a randomized controlled trial comparing pelvic muscle exercises with or without electrical stimulation," BJU. Int. 83(1), 57 (1999). No chronic pain


153

742

S. R. Moore and J. Shurman, "Combined neuromuscular electrical stimulation and transcutaneous electrical nerve stimulation for treatment of chronic back pain: a double-blind, repeated measures comparison," Arch. Phys. Med. Rehabil. 78(1), 55 (1997). Included

743

B. Mora, et al., "Transcutaneous electrical nerve stimulation: an effective treatment for pain caused by renal colic in emergency care," J. Urol. 175(5), 1737 (2006). No chronic pain

744

D. Moreau, et al., "Effects of electromyostimulation and strength training on muscle soreness, muscle damage and sympathetic activation," J. Sports Sci. 13(2), 95 (1995). No chronic pain

745

B. Morgan, et al., "Transcutaneous electric nerve stimulation (TENS) during distension shoulder arthrography: a controlled trial," (1996). no chronic pain

746

F. Mori, et al., "Effects of Anodal Transcranial Direct Current Stimulation on Chronic Neuropathic Pain in Patients With Multiple Sclerosis," 11(5), 436 (2010). Excluded after full text, no data extraction possible

747

L. Morris and R. A. Newton, "Use of high voltage pulsed galvanic stimulation for patients with levator ani syndrome," Phys. Ther. 67(10), 1522 (1987). No chronic pain

748

G. L. Moseley, M. K. Nicholas, and P. W. Hodges, "A randomized controlled trial of intensive neurophysiology education in chronic low back pain," 20(5), 324 (2004). No TENS

749

D. E. Moulin, et al., "Methadone in the management of intractable neuropathic noncancer pain," 32(3), 340 (2005). No TENS

750

A. Moystad, B. S. Krogstad, and T. A. Larheim, "Transcutaneous nerve stimulation in a group of patients with rheumatic disease involving the temporomandibular joint," J. Prosthet. Dent. 64(5), 596 (1990). No adequate data

751

F. Murina, et al., "Transcutaneous electrical nerve stimulation to treat vestibulodynia: a randomised controlled trial," BJOG. 115(9), 1165 (2008). Excluded after full text, invasive.

752

S. Murray, P. D. Collins, and M. A. James, "An investigation into the 'carry over' effect of neurostimulation in the treatment of angina pectoris," Int. J. Clin. Pract. 58(7), 669 (2004). No chronic pain

753

T. Nabeta and K. Kawakita, "Relief of chronic neck and shoulder pain by manual acupuncture to tender points - A sham-controlled randomized trial," Complement. Ther. Med. 10(4), 217 (2002). No TENS

754

S. F. Nadler, "Nonpharmacologic management of pain," JAOA: Journal of the American Osteopathic Association 104(11), S6 (2004). No RCT


154

755

M. Naef, et al., "The analgesic effect of oral delta-9-tetrahydrocannabinol (THC), morphine, and a THC-morphine combination in healthy subjects under experimental pain conditions," Pain 105(1-2), 79 (2003). No chronic pain

756

M. A. Naeser, et al., "Carpal tunnel syndrome pain treated with low-level laser and microamperes transcutaneous electric nerve stimulation: A controlled study," Arch. Phys. Med. Rehabil. 83(7), 978 (2002). Included

757

S. Nagamachi, et al., "Alteration of regional cerebral blood flow in patients with chronic pain-evaluation before and after epidural spinal cord stimulation," Ann. Nucl. Med. 20(4), 303 (2006). Pain not reported as outcome measure

758

N. Naglic and M. Klopcic-Spevak, "The effect of TENS during kinesiotherapy on chronic shoulder pain... Proceedings of the 10th Congress of the European Federation for Research in Rehabilitation, Riga, Latvia, 09-12 September 2009," International Journal of Rehabilitation Research 32, S10-S11 (2009). no chronic pain

759

Z. M. Naja, et al., "Occipital nerve blockade for cervicogenic headache: A double-blind randomized controlled clinical trial," 6(2), 89 (2006). No TENS

760

D. Nandi, et al., "Peri-ventricular grey stimulation versus motor cortex stimulation for post stroke neuropathic pain," J. Clin. Neurosci. 9(5), 557 (2002). Invasive

761

T. P. Nash, J. D. Williams, and D. Machin, "TENS: Does the type of stimulus really matter?," 3(3), 161 (1990). Not available full text

762

R. G. Navarathnam , et al., "Evaluation of the transcutaneous electrical nerve stimulator for postoperative analgesia following cardiac surgery," Anaesth. Intensive Care 12(4), 345 (1984). No chronic pain

763

S. Naveau, et al., "Efficacite de lâ€™electrostimulation transcutaneo-cranienne dans lâ€™analgesie de patients traites par le laser Nd: YAG pour cancer du rectum . Essai randomise en double insu (Analgesic effect of transcutaneous cranial electrostimulation in patients treated by Nd: YAG laser for cancer of the rectum. A double-blind randomised trial) [French]," (1992). no chronic pain

764

L. E. Neighbors, et al., "Transcutaneous electrical nerve stimulation for pain relief in primary dysmenorrhea," (1987). No chronic pain

765

R. Neri, et al., "Effect of electrode configuration and capacitor size on internal atrial defibrillation threshold using leads currently used for ventricular defibrillation," J. Interv. Card Electrophysiol. 3(2), 149 (1999). No chronic pain

766

B. I. Nesheim, "The use of transcutaneous nerve stimulation for pain relief during labor. A controlled clinical study," Acta Obstet. Gynecol. Scand. 60(1), 13 (1981). No chronic pain


155

767

T. J. Ness, et al., "Low intensity vagal nerve stimulation lowers human thermal pain thresholds," Pain 86(1-2), 81 (2000). Invasive

768

D. K. Newman, "Pelvic disorders in women: chronic pelvic pain and vulvodynia," Ostomy Wound Management 46(12), 48 (2000). no RCT

769

M. M. Ng, M. C. Leung, and D. M. Poon, "The effects of electro-acupuncture and transcutaneous electrical nerve stimulation on patients with painful osteoarthritic knees: a randomized controlled trial with follow-up evaluation," J. Altern. Complement Med. 9(5), 641 (2003). No sham control group

770

J.-P. Nguyen, et al., "Treatment of chronic neuropathic pain by motor cortex stimulation: Results of a bicentric controlled crossover trial," 1(2), 89 (2008). Invasive

771

J. P. Nguyen, et al., "Chronic motor cortex stimulation in the treatment of central and neuropathic pain. Correlations between clinical, electrophysiological and anatomical data," Pain 82(3), 245 (1999). Invasive

772

J. P. Nguyen, et al., "[Treatment of central and neuropathic facial pain by chronic stimulation of the motor cortex: value of neuronavigation guidance systems for the localization of the motor cortex]," Neurochirurgie 46(5), 483 (2000). Invasive

773

J. P. Nguyen, et al., "Motor cortex stimulation in the treatment of central and neuropathic pain," Arch. Med. Res. 31(3), 263 (2000). Invasive

774

C. L. Nicholson, S. Korfias, and A. Jenkins, "Spinal cord stimulation for failed back surgery syndrome and other disorders," Acta Neurochir. Suppl 97(Pt 1), 71 (2007). Invasive

775

D. M. Niddam, et al., "Central modulation of pain evoked from myofascial trigger point," Clin. J. Pain 23(5), 440 (2007). Invasive

776

H. J. Nilsson, A. Levinsson, and J. Schouenborg, "Cutaneous field stimulation (CFS): a new powerful method to combat itch," Pain 71(1), 49 (1997). No chronic pain

777

H. J. Nilsson and J. Schouenborg, "Differential inhibitory effect on human nociceptive skin senses induced by local stimulation of thin cutaneous fibers," Pain 80(1-2), 103 (1999). No chronic pain

778

K. E. Nnoaham and J. Kumbang, "Transcutaneous electrical nerve stimulation (TENS) for chronic pain," (3) (2008). No RCT

779

L. B. Noling, et al., "Effect of transcutaneous electrical nerve stimulation at auricular points on experimental cutaneous pain threshold," Phys. Ther. 68(3), 328 (1988). No chronic pain


156

780

R. Nordemar and C. Thorner, "Treatment of acute cervical pain--a comparative group study," Pain 10(1), 93 (1981). No chronic pain

781

C. Norrbrink, "Transcutaneous electrical nerve stimulation for treatment of spinal cord injury neuropathic pain," J. Rehabil. Res. Dev. 46(1), 85 (2009). No sham control group

782

H. Norrsell, et al., "Effects of spinal cord stimulation and coronary artery bypass grafting on myocardial ischemia and heart rate variability: further results from the ESBY study," Cardiology 94(1), 12 (2000). Invasive

783

R. B. North, et al., "A prospective, randomized study of spinal cord stimulation versus reoperation for failed back surgery syndrome: initial results," Stereotact. Funct. Neurosurg. 62(1-4), 267 (1994). Invasive

784

R. B. North, D. H. Kidd, and S. Piantadosi, "Spinal cord stimulation versus reoperation for failed back surgery syndrome: a prospective, randomized study design," Acta Neurochir. Suppl 64, 106 (1995). Invasive

785

R. B. North, et al., "Spinal cord stimulation electrode design: prospective, randomized, controlled trial comparing percutaneous and laminectomy electrodes-part I: technical outcomes," Neurosurgery 51(2), 381 (2002). Invasive

786

R. B. North, et al., "Spinal cord stimulation for chronic pain of spinal origin: A valuable longterm solution," 27(22), 2584 (2002). No RCT

787

R. B. North, et al., "Automated, patient-interactive, spinal cord stimulator adjustment: a randomized controlled trial," Neurosurgery 52(3), 572 (2003). Invasive

788

R. B. North, et al., "Spinal cord stimulation for axial low back pain: a prospective, controlled trial comparing dual with single percutaneous electrodes," Spine (Phila Pa 1976. ) 30(12), 1412 (2005). Invasive

789

R. B. North, et al., "Spinal cord stimulation versus repeated lumbosacral spine surgery for chronic pain: a randomized, controlled trial," Neurosurgery 56(1), 98 (2005). Invasive

790

R. B. North, et al., "Spinal cord stimulation electrode design: A prospective, randomized, controlled trial comparing percutaneous with laminectomy electrodes: Part II - Clinical outcomes," Neurosurgery 57(5), 990 (2005). Invasive

791

R. B. North, et al., "Spinal cord stimulation versus reoperation for failed back surgery syndrome: a cost effectiveness and cost utility analysis based on a randomized, controlled trial," Neurosurgery 61(2), 361 (2007). Invasive

792

M. R. Nourbakhsh and F. J. Fearon, "An alternative approach to treating lateral epicondylitis. A randomized, placebo-controlled, double-blinded study," 22(7),


157

601 (2008). Included 793

A. Nouwen, "EMG biofeedback used to reduce standing levels of paraspinal muscle tension in chronic low back pain," (1983). no TENS

794

J. C. Oakley and J. P. Prager, "Spinal cord stimulation: mechanisms of action," 27(22), 2574 (2002). no RCT

795

M. Obermann, et al., "Impaired trigeminal nociceptive processing in patients with trigeminal neuralgia," Neurology 69(9), 835 (2007). No RCT

796

M. Ocelnik, "Considering noninvasive neuromodulation as an adjunct to rehabilitation for the injured worker," Professional Case Management 14(6), 333 (2009). No data on pain

797

M. Offenbacher and G. Stucki, "Physical therapy in the treatment of fibromyalgia," 29, 78 (2000). No RCT

798

D. D. Ohnmeiss, R. F. Rashbaum, and G. M. Bogdanffy, "Prospective outcome evaluation of spinal cord stimulation in patients with intractable leg pain," Spine (Phila Pa 1976. ) 21(11), 1344 (1996). Invasive

799

B. Olausson, et al., "Effects of naloxone on dental pain threshold following muscle exercise and low frequency transcutaneous nerve stimulation: a comparative study in man," Acta Physiol Scand. 126(2), 299 (1986). No chronic pain

800

A. C. Oliveri, et al., "Effects of auricular transcutaneous electrical nerve stimulation on experimental pain threshold," Phys. Ther. 66(1), 12 (1986). No chronic pain

801

M. F. Olsen, et al., "A comparison of high- versus low-intensity, high-frequency transcutaneous electric nerve stimulation for painful postpartum uterine contractions," Acta Obstet. Gynecol. Scand. 86(3), 310 (2007). No chronic pain

802

Y. Omura, et al., "Common factors contributing to intractable pain and medical problems with insufficient drug uptake in areas to be treated, and their pathogenesis and treatment: Part I. Combined use of medication with acupuncture, (+) Qi gong energy-stored material, soft laser or electrical stimulation," Acupunct. Electrother. Res. 17(2), 107 (1992). No RCT

803

M. Oncel, et al., "Transcutaneous electrical nerve stimulation for pain management in patients with uncomplicated minor rib fractures," Eur. J. Cardiothorac. Surg. 22(1), 13 (2002). No chronic pain

804

J. Oosterhof, et al., "Outcome of transcutaneous electrical nerve stimulation in chronic pain: short-term results of a double-blind, randomised, placebo-controlled trial," J. Headache Pain 7(4), 196 (2006). Included


158

805

J. Oosterhof, et al., "Predicting outcome of TENS in chronic pain: a prospective, randomized, placebo controlled trial," Pain 136(1-2), 11 (2008). Excluded after full text, no data on pain

806

R. F. A. Oosterwijk, et al., "Pain control with TENS and team nerve stimulators: a review... Tannenbaum electroanalgesic method (TEAM)," Critical Reviews in Physical & Rehabilitation Medicine 6(3), 219 (1994). no RCT

807

W. L. Oppenheim, "Complementary and alternative methods in cerebral palsy," 51, 122 (2009). No TENS

808

G. J. Ordog, "Transcutaneous electrical nerve stimulation versus oral analgesic: a randomized double-blind controlled study in acute traumatic pain," Am. J. Emerg. Med. 5(1), 6 (1987). No chronic pain

809

M. Osiri, et al., "Transcutaneous electrical nerve stimulation for knee osteoarthritis," Cochrane Database Syst Rev (4) (2000). No RCT

810

S. L. Owen, et al., "Deep brain stimulation for the alleviation of post-stroke neuropathic pain," Pain 120(1-2), 202 (2006). Invasive

811

S. L. Owen, et al., "Deep brain stimulation for neuropathic pain," Acta Neurochir. Suppl 97(Pt 2), 111 (2007). Invasive

812

N. Oztas, A. Olmez, and B. Yel, "Clinical evaluation of transcutaneous electronic nerve stimulation for pain control during tooth preparation," Quintessence. Int. 28(9), 603 (1997). No chronic pain

813

T. Paiva, et al., "Effects of frontalis EMG biofeedback and diazepam in the treatment of tension headache," (1982). no TENS

814

N. Paker, et al., "Comparison of the therapeutic efficacy of TENS versus intra-articular hyaluronic acid injection in patients with knee osteoarthritis: a prospective randomized study," Adv. Ther. 23(2), 342 (2006). No sham control group

815

S. Palmer, et al., "Transcutaneous electrical nerve stimulation and transcutaneous spinal electroanalgesia: a preliminary efficacy and mechanisms-based investigation," Physiotherapy. 95(3), 185 (2009). No chronic pain

816

S. T. Palmer, et al., "Alteration of interferential current and transcutaneous electrical nerve stimulation frequency: effects on nerve excitation," Arch. Phys. Med. Rehabil. 80(9), 1065 (1999). No chronic pain

817

C. X. Pan, et al., "Complementary and alternative medicine in the management of pain, dyspnea, and nausea and vomiting near the end of life: A systematic review," J. Pain Symptom Manage. 20(5), 374 (2000). No RCT


159

818

P. J. Pan, et al., "Extracorporeal shock wave therapy for chronic calcific tendinitis of the shoulders: A functional and sonographic study," 84(7), 988 (2003). Excluded after full text, no sham control group

819

S. Patel, et al., "The effects of GABA(B) agonists and gabapentin on mechanical hyperalgesia in models of neuropathic and inflammatory pain in the rat," Pain 90(3), 217 (2001). Not human

820

S. Patel, et al., "Psychophysical elements of place and modality specificity in the thalamic somatic sensory nucleus (ventral caudal, vc) of awake humans," J. Neurophysiol. 95(2), 646 (2006). No chronic pain

821

K. J. Pauza, et al., "A randomized, placebo-controlled trial of intradiscal electrothermal therapy for the treatment of discogenic low back pain," Spine J. 4(1), 27 (2004). Invasive

822

S. PÃ©rez-Palomares, et al., "Percutaneous electrical nerve stimulation versus dry needling: Effectiveness in the treatment of chronic low back pain," J. Musculoskelet. Pain 18(1), 23 (2010). Not available full text

823

J. L. Pedersen, G. W. Rung, and H. Kehlet, "Effect of sympathetic nerve block on acute inflammatory pain and hyperalgesia," Anesthesiology 86(2), 293 (1997). No chronic pain

824

R. Peeker and M. Fall, "Treatment guidelines for classic and non-ulcer interstitial cystitis," Int. Urogynecol. J. Pelvic Floor Dysfunct. 11(1), 23 (2000). No RCT

825

H. M. Pengel, C. G. Maher, and K. M. Refshauge, "Systematic review of conservative interventions for subacute low back pain (Reprinted from Clinical Rehabilitation, vol 16, pg 811-820, 2002)," 9(3-4), 153 (2002). No RCT

826

E. G. Peniston and P. C. Kao, "The role of biofeedback-assisted relaxation training in muscle tension and analgesia," (1985). no TENS

827

R. D. Penn, "Treatment of pain in persons with spinal cord injury: spinal cord stimulation and intrathecal drugs," Topics in Spinal Cord Injury Rehabilitation 7(2), 51 (2001). No data on pain

828

E. A. Pereira, et al., "Regional cerebral perfusion differences between periventricular grey, thalamic and dual target deep brain stimulation for chronic neuropathic pain," Stereotact. Funct. Neurosurg. 85(4), 175 (2007). Invasive

829

E. A. C. Pereira, et al., "Deep brain stimulation: Indications and evidence," Expert Rev. Med. Devices 4(5), 591 (2007). No RCT

830

A. L. Persson, et al., "Validity of electrical stimulus magnitude matching in chronic pain," Journal of Rehabilitation Medicine (Stiftelsen Rehabiliteringsinformation) 41(11), 898 (2009). No RCT


160

831

L. Persson, M. Karlberg, and M. Magnusson, "Effects of different treatments on postural performance in patients with cervical root compression. A randomized prospective study assessing the importance of the neck in postural control," (1996). No TENS

832

M. Pescatori and G. Gagliardi, "Postoperative complications after procedure for prolapsed hemorrhoids (PPH) and stapled transanal rectal resection (STARR) procedures," 12(1), 7 (2008). No RCT

833

E. J. G. Peters, "Transcutaneous electrical stimulation: a double-blind trial of its efficacy for pain," Foot & Ankle Quarterly--The Seminar Journal 14(4), 135 (2001). Not available full text

834

K. L. Petersen, et al., "A Randomized study of the effect of oral lamotrigine and hydromorphone on pain and hyperglesia following heat/capsaicin sensitization," 4(7), 400 (2003). No chronic pain

835

I. E. Petrakis and V. Sciacca, "Epidural spinal cord electrical stimulation in diabetic critical lower limb ischemia," J. Diabetes Complications 13(5-6), 293 (1999). Invasive

836

I. E. Petrakis and V. Sciacca, "Does autonomic neuropathy influence spinal cord stimulation therapy success in diabetic patients with critical lower limb ischemia?," Surg. Neurol. 53(2), 182 (2000). Invasive

837

J. P. Petrie and G. B. Langley, "Acupuncture in the treatment of chronic cervical pain. A pilot study," Clin. Exp. Rheumatol. 1(4), 333 (1983). No adequate sham control

838

J. P. Petrie and B. L. Hazleman, "A controlled study of acupuncture in neck pain," Br. J. Rheumatol. 25(3), 271 (1986). No adequate sham control

839

B. G. Pietrosimone, et al., "Immediate effects of transcutaneous electrical nerve stimulation and focal knee joint cooling on quadriceps activation," (2009). no data on pain

840

P. M. Pike, "Transcutaneous electrical stimulation. Its use in the management of postoperative pain," Anaesthesia 33(2), 165 (1978). No chronic pain

841

P. Piletta, H. C. Porchet, and P. Dayer, "[Central analgesic effect of paracetamol]," Schweiz. Med. Wochenschr. 120(50), 1950 (1990). No TENS

842

M. D. Pinkowish, "Complementary approaches to chronic pain," Patient Care 35(14), 21 (2001). No data on pain

843

B. Pirotte, et al., "The Zeiss-MKM system for frameless image-guided approach in epidural motor cortex stimulation for central neuropathic pain," Neurosurg. Focus. 11(3), E3 (2001). Invasive


161

844

B. Platon, et al., "High-frequency, high-intensity transcutaneous electrical nerve stimulation as treatment of pain after surgical abortion," Pain 148(1), 114 (2010). No chronic pain

845

B. Pleger, et al., "Repetitive transcranial magnetic stimulation of the motor cortex attenuates pain perception in complex regional pain syndrome type I," Neurosci. Lett. 356(2), 87 (2004). Excluded after full text, no data extraction possible

846

S. Poitras and L. Brosseau, "Evidence-informed management of chronic low back pain with transcutaneous electrical nerve stimulation, interferential current, electrical muscle stimulation, ultrasound, and thermotherapy," 8(1), 226 (2008). No RCT

847

C. J. Poletto and C. L. Van Doren, "Elevating pain thresholds in humans using depolarizing prepulses," IEEE Trans. Biomed. Eng 49(10), 1221 (2002). No chronic pain

848

W. Pollmann, et al., "Therapy of pain syndromes in multiple sclerosis - An overview with evidence-based recommendations," 73(5), 268 (2005). No RCT

849

W. Pollmann and W. Feneberg, "Current management of pain associated with multiple sclerosis," 22(4), 291 (2008). No RCT

850

M. H. Pope, et al., "A prospective randomized three-week trial of spinal manipulation, transcutaneous muscle stimulation, massage and corset in the treatment of subacute low back pain," Spine (Phila Pa 1976. ) 19(22), 2571 (1994). No chronic pain

851

D. B. Popovic, et al., "Lumbar stimulation belt for therapy of low-back pain," Artif. Organs 33(1), 54 (2009). No RCT

852

D. Prezioso, et al., "Chronic pain in urological diseases: a clinical review," 3(4), 381 (2008). No RCT

853

M. Proctor, et al., "Transcutaneous electrical nerve stimulation for primary dysmenorrhoea," (1) (2002). no RCT

854

S. Puranik, et al., "A randomised, single blind study to evaluate the effects of action potential simulator therapy compared with placebo in patients with chronic back pain," 14(1), 69 (2002). Not available full text

855

E. Qerama, et al., "A double-blind, controlled study of botulinum toxin A in chronic myofascial pain," Neurology 67(2), 241 (2006). No TENS

856

F. Quarnstrom and E. N. Libed, "Electronic anesthesia versus topical anesthesia for the control of injection pain," Quintessence. Int. 25(10), 713 (1994). No chronic pain

857

D. N. Quinton, J. P. Sloan, and J. Theakstone, "Transcutaneous electrical nerve stimulation in acute hand infections," J. Hand Surg. Br. 12(2), 267 (1987). No chronic pain


162

858

M. Quittan, "Management of back pain," 24(8), 423 (2002). No RCT

859

A. G. Rabin, "Efficacy of TENS compared with TENS dead battery (placebo) in chronically disabled low back pain patients," Pain 29(3), 399 (1987). Excluded after full text, no data on effect of TENS on chronic pain

860

N. G. Rainov and V. Heidecke, "Hardware failures in spinal cord stimulation (SCS) for chronic benign pain of spinal origin," Acta Neurochir. Suppl 97(Pt 1), 101 (2007). Invasive

861

B. Rakel and R. Frantz, "Effectiveness of transcutaneous electrical nerve stimulation on postoperative pain with movement," J. Pain 4(8), 455 (2003). No chronic pain

862

B. Rakel and J. O. Barr, "Physical modalities in chronic pain management," Nursing Clinics of North America 38(3), 477 (2003). No RCT

863

B. Rakel, et al., "A new transient sham TENS device allows for investigator blinding while delivering a true placebo treatment," J. Pain 11(3), 230 (2010). No chronic pain

864

R. E. Ramsay, et al., "Vagus nerve stimulation for treatment of partial seizures: 2. Safety, side effects, and tolerability. First International Vagus Nerve Stimulation Study Group," Epilepsia 35(3), 627 (1994). Invasive

865

D. Rasche, et al., "Deep brain stimulation for the treatment of various chronic pain syndromes," Neurosurg. Focus. 21(6), E8 (2006). Invasive

866

D. Rasche, et al., "Motor cortex stimulation for long-term relief of chronic neuropathic pain: a 10 year experience," Pain 121(1-2), 43 (2006). Invasive

867

D. Rasche, D. Klase, and V. M. Tronnier, "Neuromodulation in cluster headache. Clinical follow-up after deep brain stimulation in the posterior hypothalamus for chronic cluster headache, case report - Part II," 22, 37 (2008). No RCT

868

M. Razavi and G. B. Jansen, "Effects of acupuncture and placebo TENS in addition to exercise in treatment of rotator cuff tendinitis," Clin. Rehabil. 18(8), 872 (2004). Excluded after full text, no data on pain

869

M. W. Reed, et al., "Pain relief after inguinal herniorrhaphy. Ineffectiveness of pulsed electromagnetic energy," Br. J. Clin. Pract. 41(6), 782 (1987). No chronic pain

870

J. L. Reeves, II, S. B. Graff-Radford, and D. Shipman, "The effects of transcutaneous electrical nerve stimulation on experimental pain and sympathetic nervous system response," 5(2), 150 (2004). No chronic pain

871

N. P. Reeves, et al., "The effects of stochastic resonance stimulation on spine proprioception and postural control in chronic low back pain patients," 34(4), 316 (2009). No TENS


163

872

B. A. Reich, "Non-invasive treatment of vascular and muscle contraction headache: a comparative longitudinal clinical study," Headache 29(1), 34 (1989). Excluded after full text, no data extraction possible

873

O. Reichelt, et al., "Effective analgesia for extracorporeal shock wave lithotripsy: transcutaneous electrical nerve stimulation," Urology 54(3), 433 (1999). No chronic pain

874

L. Reichstein, et al., "Effective treatment of symptomatic diabetic polyneuropathy by highfrequency external muscle stimulation," Diabetologia 48(5), 824 (2005). No sham control group

875

K. I. Reid, et al., "Evaluation of iontophoretically applied dexamethasone for painful pathologic temporomandibular joints," Oral Surg. Oral Med. Oral Pathol. 77(6), 605 (1994). No TENS

876

G. J. Renzenbrink and M. J. IJzerman, "Percutaneous neuromuscular electrical stimulation (PNMES) for treating shoulder pain in chronic hemiplegia. Effects on shoulder pain and quality of life," Clin. Rehabil. 18(4), 359 (2004). No TENS

877

S. Resim, et al., "Effectiveness of electro-acupuncture compared to sedo-analgesics in relieving pain during shockwave lithotripsy," Urol. Res. 33(4), 285 (2005). No chronic pain

878

R. Reuss and S. C. Meyer, "The use of TENS in the management of cancer pain," Clinical Management in Physical Therapy 5(5), 26 (1985). No data on pain

879

R. Reuss, P. Cronen, and L. Abplanalp, "Transcutaneous electrical nerve stimulation for pain control after cholecystectomy: lack of expected benefits," South. Med. J. 81(11), 1361 (1988). No chronic pain

880

A. C. Reynolds, S. E. Abram, and R. A. Anderson, "Chronic pain therapy with transcutaneous electrical nerve stimulation: predictive value of questionnaires," Archives of Physical Medicine & Rehabilitation 64(7), 311 (1983). No RCT

881

T. Riant, et al., "Medical treatment of pudendal neuralgia," 3 (3), 250 (2008). No RCT

882

C. D. Richardson, et al., "Patient reports of the effects and side-effects of TENS for chronic non-malignant pain following a four week trial," 13(3), 265 (2002). No RCT

883

S. Rickman, B. H. Wuebbels, and G. A. Holloway, Jr., "Spinal cord stimulation for relief of ischemic pain in end-stage arterial occlusive disease," J. Vasc. Nurs. 12(1), 14 (1994). Invasive

884

L. Rieb and B. Pomeranz, "Alterations in electrical pain thresholds by use of acupuncture-like transcutaneous electrical nerve stimulation in pain-free subjects," Phys. Ther. 72(9), 658 (1992). No chronic pain

885

M. Rigato, et al., "Comparison between the analgesic and therapeutic effects of a musically modulated electromagnetic field (TAMMEF) and those of a 100 Hz electromagnetic field: blind experiment on patients suffering from cervical spondylosis or shoulder


164

periarthritis," J. Med. Eng Technol. 26(6), 253 (2002). No chronic pain 886

G. Ringel and K. Taubert, "(The efficacy of transcutaneous nerve stimulation in migraine) [German]," (1991). No sham control group

887

D. Ristic, P. Spangenberg, and J. Ellrich, "Analgesic and antinociceptive effects of peripheral nerve neurostimulation in an advanced human experimental model," Eur. J. Pain 12(4), 480 (2008). No chronic pain

888

K. Robb, chronic pain management in breast cancer patients (The Chartered Society of Physiotherapy, 2003). Ref ID: 1107

889

K. Robb, et al., "A Cochrane Systematic Review of Transcutaneous Electrical Nerve Stimulation for Cancer Pain," J. Pain Symptom Manage. 37(4), 746 (2009). No RCT

890

K. A. Robb, "Managing chronic pain in breast cancer survivors," PPA News (17), 26 (2004). No data on pain

891

K. A. Robb, D. J. Newham, and J. E. Williams, "Transcutaneous electrical nerve stimulation vs. transcutaneous spinal electroanalgesia for chronic pain associated with breast cancer treatments," J. Pain Symptom. Manage. 33(4), 410 (2007). Excluded after full text, no adequate data

892

K. A. Robb, et al., "Transcutaneous electric nerve stimulation (TENS) for cancer pain in adults," (3) (2008). no RCT

893

A. J. Robinson, "Transcutaneous electrical nerve stimulation for the control of pain in musculoskeletal disorders," Journal of Orthopaedic & Sports Physical Therapy 24(4), 208 (1996). No RCT

894

R. Robinson, et al., "Is transcutaneous electrical nerve stimulation an effective analgesia during colonoscopy?," Postgrad. Med. J. 77(909), 445 (2001). No chronic pain

895

P. A. Roche, et al., "Modification of haemophiliac haemorrhage pain by transcutaneous electrical nerve stimulation," (1985). No chronic pain

896

J. Rodriguez, et al., "A comparison of stimulation patterns in axillary block: part 2," Reg Anesth. Pain Med. 31(3), 202 (2006). No chronic pain

897

J. D. Rollnik, et al., "Repetitive transcranial magnetic stimulation for the treatment of chronic pain - A pilot study," 48(1), 6 (2002). Excluded after full text, no extraction of data possible.

898

M. F. Rolzen, P. Newfield, and E. I. Eger II, "Reduced anesthetic requirement after electrical stimulation of periaqueductal gray matter," Anesthesiology 62(2), 120 (1985). No chronic pain


165

899

L. L. Ronk, "Spinal cord stimulation for chronic, nonmalignant pain," Orthopaedic Nursing 15(5), 53 (1996). No RCT

900

S. M. Rooney, S. Jain, and P. L. Goldiner, "Effect of transcutaneous nerve stimulation on postoperative pain after thoracotomy," Anesth. Analg. 62(11), 1010 (1983). No chronic pain

901

M. G. Rosemffet, et al., "Effects of functional electrostimulation on pain, muscular strength, and functional capacity in patients with osteoarthritis of the knee," 10(5), 246 (2004). Excluded after full text, no sham control group

902

M. Rosenberg, L. Curtis, and D. L. Bourke, "Transcutaneous electrical nerve stimulation for the relief of postoperative pain," Pain 5(2), 129 (1978). No chronic pain

903

S. Rossi, et al., "Effects of repetitive transcranial magnetic stimulation on chronic tinnitus: A randomised, crossover, double blind, placebo controlled study," 78(8), 857 (2007). No chronic pain

904

M. Rossini, et al., "Capacitively coupled electric field for pain relief in patients with vertebral fractures and chronic pain," Clin. Orthop. Relat Res. 468(3), 735 (2010). No sham control group

905

P. M. Roth and W. J. Thrash, "Effect of transcutaneous electrical nerve stimulation for controlling pain associated with orthodontic tooth movement," Am. J. Orthod. Dentofacial Orthop. 90(2), 132 (1986). No chronic pain

906

M. C. Rowbotham, "Pharmacologic management of complex regional pain syndrome," 22(5), 425 (2006). No RCT

907

E. Rowe, et al., "A prospective, randomized, placebo controlled, double-blind study of pelvic electromagnetic therapy for the treatment of chronic pelvic pain syndrome with 1 year of followup," 173(6), 2044 (2005). No TENS

908

J. Royle, P. Barlas, and N. E. L. Foster, "Transcutaneous spinal electroanalgesia and chronic pain... Hillerstadt DF, Barlas P, Foster NEL (2000). 'The effect of transcutaneous spinal electroanalgesia upon chronic pain: a single case study' (abstract), 86,3, 150151," 86(5), 279 (2000). no RCT

909

J. Royle, "A new form of electroanalgesia in the management of chronic pain," International Journal of Therapy & Rehabilitation 11(4), 146 (2004). No data on pain

910

D. N. Rushton, "Electrical stimulation in the treatment of pain," Disability & Rehabilitation 24(8), 407 (2002). No data on pain

911

A. W. S. Rutjes, et al., "Transcutaneous electrostimulation for osteoarthritis of the knee," (4) (2009). No RCT

912

J. A. Saal and J. S. Saal, "Intradiscal electrothermal treatment for chronic discogenic low back pain: A prospective outcome study with minimum 1-year follow-up," 25(20), 2622


166

(2000). Invasive 913

A. F. Sabato, G. Marineo, and A. Gatti, "Scrambler therapy," Minerva Anestesiol. 71(7-8), 479 (2005). No RCT

914

S. M. Sagar, "Acupuncture as an evidence-based option for symptom control in cancer patients," Curr. Treat. Options Oncol. 9(2-3), 117 (2008). No RCT

915

N. Sahin, et al., "Efficacy of Acupunture in Patients with Chronic Neck Pain - A Randomised, Sham Controlled Trial," 35(1-2), 17 (2010). No TENS

916

M. A. Sahmeddini, A. Farbood, and S. Ghafaripuor, "Electro-acupuncture for pain relief after nasal septoplasty: a randomized controlled study," J. Altern. Complement Med. 16(1), 53 (2010). No chronic pain

917

G. Sakalauskiene, "Nonpharmacological correction of low back pain by single or integrated means of medical rehabilitation and the evaluation of their effectiveness," 45(9), 739 (2009). No RCT

918

M. Salim, "Transcutaneous electrical nerve stimulation (TENS) in chronic pain," Alternative Therapies in Clinical Practice 3(4), 33 (1996). Not available full text

919

D. Salvador, P. D. Neto, and F. P. Ferrari, "Aplicacao de tecnica de energia muscular em coletores de lixo com lombalgia mecanica aguda (Application of muscle energy technique in garbage collectors with acute mechanical lumbar pain) [Portuguese]," (2005). no chronic pain

920

S. M. Sampson, J. D. Rome, and T. A. Rummans, "Slow-frequency rTMS reduces fibromyalgia pain," Pain Med. 7(2), 115 (2006). No RCT

921

H. J. A. Samwel, et al., "Multidisciplinary allocation of pain treatment: long-term outcome and correlates of cognitive-behavioral processes," J. Musculoskelet. Pain 17(1), 26 (2009). No TENS

922

G. Sandrini, et al., "Effects of nimesulide on nitric oxide-induced hyperalgesia in humans--a neurophysiological study," Eur. J. Pharmacol. 450(3), 259 (2002). No TENS

923

C. Sangdee, et al., "Electroacupuncture versus diclofenac in symptomatic treatment of osteoarthritis of the knee: a randomized controlled trial," BMC. Complement Altern. Med. 2, 3 (2002). Included

924

T. M. Sarhan and M. A. Doghem, "Effect of microcurrent skin patch on the epidural fentanyl requirements for post operative pain relief of total hip arthroplasty," Middle East J. Anesthesiol. 20(3), 411 (2009). No chronic pain


167

925

S. M. Sator-Katzenschlager, et al., "Does pain relief improve pain behavior and mood in chronic pain patients?," Anesth. Analg. 97(3), 791 (2003). No RCT

926

S. M. Sator-Katzenschlager, et al., "Electrical stimulation of auricular acupuncture points is more effective than conventional manual auricular acupuncture in chronic cervical pain: a pilot study," Anesth. Analg. 97(5), 1469 (2003). Excluded after full text, no data extraction possible

927

S. M. Sator-Katzenschlager, et al., "The short- and long-term benefit in chronic low back pain through adjuvant electrical versus manual auricular acupuncture," Anesth. Analg. 98(5), 1359, table (2004). Excluded after full text, no data extraction possible

928

S. M. Sator-Katzenschlager and A. Michalek-Sauberer, "P-Stim (TM) auricular electroacupuncture stimulation device for pain relief," Expert Rev. Med. Devices 4(1), 23 (2007). No RCT

929

A. R. Sauter, et al., "Electrical nerve stimulation or ultrasound guidance for lateral sagittal infraclavicular blocks: a randomized, controlled, observer-blinded, comparative study," Anesth. Analg. 106(6), 1910 (2008). No sham control group

930

E. Schafer, H. Finkensiep, and M. Kaup, "Effect of transcutaneous electrical nerve stimulation on pain perception threshold of human teeth: a double-blind, placebo-controlled study," Clin. Oral Investig. 4(2), 81 (2000). No chronic pain

931

M. Schiller, "Breath therapy--a possible support for patients with chronic pain. [German]," 152(1-2), 40 (2010). No TENS

932

J. R. Schlaier, et al., "Effects of spinal cord stimulation on cortical excitability in patients with chronic neuropathic pain: a pilot study," Eur. J. Pain 11(8), 863 (2007). Invasive

933

A. Schneider, K. Streitberger, and S. Joos, "Acupuncture treatment in gastrointestinal diseases: A systematic review," World J. Gastroenterol. 13(25), 3417 (2007). No RCT

934

D. M. Schultz, et al., "Acute cardiovascular effects of epidural spinal cord stimulation," Pain Phys. 10(5), 677 (2007). No chronic pain

935

G. D. Schuster and M. C. Infante, "Pain relief after low back surgery: the efficacy of transcutaneous electrical nerve stimulation," (1980). no chronic pain

936

B. Schwab, Th Lenarz, and R. Heermann, "Use of the Round Window Î¼Cath for Inner Ear Therapy - Results of a Placebo-Controlled, Prospective Study on Chronic Tinnitus," Laryngo- Rhino- Otol. 83(3), 164 (2004). No chronic pain

937

R. J. Schwartzman, "New treatments for reflex sympathetic dystrophy," 343(9), 654 (2000). No RCT


168

938

T. J. Schwedt, et al., "Response to occipital nerve block is not useful in predicting efficacy of occipital nerve stimulation," Cephalalgia 27 (3), 271 (2007). Invasive

939

R. J. Scudds, et al., "Transcutaneous Electrical Nerve Stimulation for the Treatment of Pain in Physiotherapy Practices in Hong Kong and the United Kingdom-A Survey of Usage and Perceived Effectiveness Compared With Other Pain Relieving Modalities," 27(pp 11-20), -20 (2009). No RCT

940

R. Segal, et al., "Spinal cord stimulation revisited," Neurol. Res. 20(5), 391 (1998). Invasive

941

K. Seidl, et al., "Importance of preimplantation procedures in candidates for an implantable atrial defibrillator," J. Cardiovasc. Electrophysiol. 9(8 Suppl), S127-S131 (1998). Invasive

942

T. K. Selfe, C. Bourguignon, and A. G. Taylor, "Effects of noninvasive interactive neurostimulation on symptoms of osteoarthritis of the knee: a randomized, shamcontrolled pilot study," J. Altern. Complement Med. 14(9), 1075 (2008). Excluded after full text, unclear data.

943

S. Seltzer, et al., "The effects of dietary tryptophan on chronic maxillofacial pain and experimental pain tolerance," J. Psychiatr. Res. 17(2), 181 (1982). No TENS

944

S. Sencan, et al., "A study to compare the therapeutic efficacy of aerobic exercise and paroxetine in fibromyalgia syndrome," (2004). No TENS

945

A. Sestito, et al., "Spinal cord stimulation normalizes abnormal cortical pain processing in patients with cardiac syndrome X," Pain 139(1), 82 (2008). No chronic pain

946

A. Shafik, "Re: A Prospective, Randomized, Placebo Controlled, Double-Blind Study of Pelvic Electromagnetic Therapy for the Treatment of Chronic Pelvic Pain Syndrome With 1 Year of Followup. E. Rowe, C. Smith, L. Laverick, J. Elkabir, R. O. Witherow and A. Patel," 175(5), 1964 (2006). No RCT

947

C. N. Shealy and P. Thomlinson, "Safe effective nondrug treatment of chronic depression: a review of research on low-voltage cranial electrical stimulation and other adjunctive therapies," Complementary Health Practice Review 13(2), 92 (2008). No RCT

948

G. Sheean, "Botulinum toxin treatment of adult spasticity - A benefit-risk assessment," 29(1), 31 (2006). No RCT

949

L. R. Sheffler and J. Chae, "Neuromuscular electrical stimulation in neurorehabilitation," 35(5), 562 (2007). No RCT

950

D. Shehab and N. Adham, "Comparative effectiveness of ultrasound and transcutaneous electrical stimulation in treatment of periarticular shoulder pain," (2000). No sham control group


169

951

F. H. Shen, D. Samartzis, and G. B. J. Andersson, "Nonsurgical management of acute and chronic low back pain," 14(8), 477 (2006). No RCT

952

J. Shen, "Research on the neurophysiological mechanisms of acupuncture: review of selected studies and methodological issues... papers from the Symposium on Scientific Integration of Western Medicine and Complementary, Alternative-Mind, Body Medicine, Seoul, Korea," Journal of Alternative & Complementary Medicine 7, S121S127 (2001). No RCT

953

K. J. Sherman, "Electro-acupuncture reduces pain and dysfunction in chronic lumbar pain patients," Focus on Alternative & Complementary Therapies 9(1), 39 (2004). Not available full text

954

R. A. Sherman, N. M. Acosta, and L. Robson, "Treatment of migraine with pulsing electromagnetic fields: a double-blind, placebo-controlled study," (1999). Excluded after full text, no data extraction possible

955

E. Sherry, P. Kitchener, and R. Smart, "A prospective randomized controlled study of VAX-D and TENS for the treatment of chronic low back pain," Neurol. Res. 23(7), 780 (2001). No sham control group

956

K. Shimoji, et al., "Pain relief by transcutaneous electric nerve stimulation with bidirectional modulated sine waves in patients with chronic back pain: A randomized, double-blind, sham-controlled study," 10(1), 42 (2007). Excluded after full text, no data extraction possible

957

L. Sikiru, H. Shmaila, and S. A. Muhammed, "Transcutaneous electrical nerve stimulation (TENS) in the symptomatic management of chronic prostatitis/chronic pelvic pain syndrome: a placebo-control randomized trial," Int. Braz. J. Urol. 34(6), 708 (2008). Excluded after full text, no adequate sham control group

958

C. K. Sim, et al., "Effects of electroacupuncture on intraoperative and postoperative analgesic requirement," Acupunct. Med. 20(2-3), 56 (2002). No chronic pain

959

D. T. Sim, "Effectiveness of transcutaneous electrical nerve stimulation following cholecystectomy," (1991). no chronic pain

960

E. L. Simpson, et al., "Spinal cord stimulation for chronic pain of neuropathic or ischaemic origin: systematic review and economic evaluation," Health Technol Assess 13(17) (2009). No RCT

961

K. H. Simpson and J. Ward, "A randomized, double-blind, crossover study of the use of transcutaneous spinal electroanalgesia in patients with pain from chronic critical limb ischemia," J. Pain Symptom. Manage. 28(5), 511 (2004). Excluded after full text, no chronic pain

962

A. N. Singh, "Multidisciplinary management of chronic pain," International Medical Journal 12(2), 111 (2005). No RCT

963

M. Singh, et al., "Non-pharmacological relief of acute pain following total abdominal hysterectomy," Can. J. Anaesth. 49(5), 530 (2002). No chronic pain


170

964

B. Sjolund and M. Eriksson, "Electro-acupunture and endogenous morphines," Lancet 2(7994), 1085 (1976). No RCT

965

K. V. Slavin, et al., "Efficacy of transverse tripolar stimulation for relief of chronic low back pain: results of a single center," Stereotact. Funct. Neurosurg. 73(1-4), 126 (1999). Invasive

966

D. Slawson, "Is percutaneous electrical nerve stimulation (PENS) effective in the treatment of long-term chronic low back pain (LBP)?," Evidence-Based Practice 2(6), 3, insert (1999). Not available full text

967

J. P. Sloan, et al., "Multiple rib fractures: transcutaneous nerve stimulation versus conventional analgesia," J. Trauma 26(12), 1120 (1986). No chronic pain

968

K. A. Sluka and H. Rees, "The neuronal response to pain," Physiotherapy Theory & Practice 13(1), 3 (1997). No RCT

969

N. Smania, et al., "Repetitive magnetic stimulation: a novel therapeutic approach for myofascial pain syndrome," J. Neurol. 252(3), 307 (2005). No sham control group

970

F. Smedley, M. Taube, and C. Wastell, "Transcutaneous electrical nerve stimulation for pain relief following inguinal hernia repair: a controlled trial," Eur. Surg. Res. 20(4), 233 (1988). No chronic pain

971

C. M. Smith, et al., "The effects of transcutaneous electrical nerve stimulation on postcesarean pain," Pain 27(2), 181 (1986). No chronic pain

972

C. R. Smith, G. T. Lewith, and D. Machin, "TNS and osteo-arthritic pain. Preliminary study to establish a controlled method of assessing transcutaneous nerve stimulation as a treatment for the pain caused by osteo-arthritis of the knee," (1983). No data extraction possible

973

H. Smith, et al., "Motor cortex stimulation for neuropathic pain," Neurosurg. Focus. 11(3), E2 (2001). Invasive

974

L. A. Smith, et al., "Teasing apart quality and validity in systematic reviews: an example from acupuncture trials in chronic neck and back pain," Pain 86(1-2), 119 (2000). No RCT

975

R. Smith, "Curbing the pain," Rehab Management: The Interdisciplinary Journal of Rehabilitation 20(9), 10 (2007). No RCT

976

J. O. Sodipo, S. A. Adedeji, and O. Olumide, "Postoperative pain relief by transcutaneous electrical nerve stimulation (TENS)," Am. J. Chin Med. 8(1-2), 190 (1980). No chronic pain

977

O. Solak, et al., "Transcutaneous electric nerve stimulation for the treatment of postthoracotomy pain: a randomized prospective study," Thorac. Cardiovasc. Surg.


171

55(3), 182 (2007). No chronic pain 978

O. Solak and V. Kavuncu, "Current Approaches in Therapeutic Management of Chronic Neuropathic Pain," 23(4), 135 (2008). No RCT

979

S. Solomon and K. M. Guglielmo, "Treatment of headache by transcutaneous electrical stimulation," (1985). Excluded after full text, no data extraction possible

980

S. Solomon, et al., "Safety and effectiveness of cranial electrotherapy in the treatment of tension headache," Headache 29(7), 445 (1989). No chronic pain

981

A. Sommer, et al., "[Coronary angina and stimulation of carotid sinus nerves. Long-term results]," Arch. Mal Coeur Vaiss. 66(10), 1325 (1973). No chronic pain

982

V. K. H. Sonntag and P. R. Cooper, "Spinal cord stimulation versus repeated lumbosacral spine surgery for chronic pain: A randomized, controlled trial - Comments," Neurosurgery 56(1), 106 (2005). No RCT

983

G. H. Spincemaille, et al., "Technical data and complications of spinal cord stimulation: data from a randomized trial on critical limb ischemia," Stereotact. Funct. Neurosurg. 74(2), 63 (2000). Invasive

984

G. H. Spincemaille, et al., "Pain and quality of life in patients with critical limb ischaemia: results of a randomized controlled multicentre study on the effect of spinal cord stimulation. ESES study group," Eur. J. Pain 4(2), 173 (2000). Invasive

985

G. H. Spincemaille, et al., "Spinal cord stimulation in patients with critical limb ischemia: A preliminary evaluation of a multicentre trial," 32(2), 49 (2000). No RCT

986

M. Spruit and W. C. Jacobs, "Pain and function after intradiscal electrothermal treatment (IDET) for symptomatic lumbar disc degeneration," Eur. Spine J. 11(6), 589 (2002). Invasive

987

L. J. Standish, L. Kozak, and S. Congdon, "Acupuncture is underutilized in hospice and palliative medicine," 25(4), 298 (2008). No RCT

988

R. Staud, et al., "Enhanced central pain processing of fibromyalgia patients is maintained by muscle afferent input: a randomized, double-blind, placebo-controlled study," Pain 145(1-2), 96 (2009). No TENS

989

E. Stener-Victorin, et al., "A prospective randomized study of electro-acupuncture versus alfentanil as anaesthesia during oocyte aspiration in in-vitro fertilization," Hum. Reprod. 14(10), 2480 (1999). No chronic pain

990

E. Stener-Victorin, J. Kowalski, and T. Lundeberg, "A new highly reliable instrument for the assessment of pre- and postoperative gynecological pain," Anesth. Analg. 95(1), 151,


172

table (2002). No chronic pain 991

E. Stener-Victorin, C. Kruse-Smidje, and K. Jung, "Comparison between electro-acupuncture and hydrotherapy, both in combination with patient education and patient education alone, on the symptomatic treatment of osteoarthritis of the hip," Clin. J. Pain 20(3), 179 (2004). No sham control group

992

P. G. Stenn, K. J. Mothersill, and R. I. Brooke, "Biofeedback and a cognitive behavioral approach to treatment of myofascial pain dysfunction syndrome," (1979). no TENS

993

C. Stevensen, "Non-pharmacological aspects of acute pain management," Complementary Therapies in Nursing & Midwifery 1(3), 77 (1995). No RCT

994

V. L. Stevenson, "Rehabilitation in practice Spasticity management," 24(4), 293 (2010). No RCT

995

S. W. Stralka, J. A. Jackson, and A. R. Lewis, "Treatment of hand and wrist pain. A randomized clinical trial of high voltage pulsed, direct current built into a wrist splint," AAOHN. J. 46(5), 233 (1998). No chronic pain

996

S. A. Stratton and M. M. Smith, "Postoperative thoracotomy. Effect of transcutaneous electrical nerve stimulation on forced vital capacity," Phys. Ther. 60(1), 45 (1980). No chronic pain

997

G. Strauss-Blasche, et al., "Contribution of individual spa therapies in the treatment of chronic pain," Clin. J. Pain 18(5), 302 (2002). No RCT

998

D. W. Strege, et al., "Chronic peripheral nerve pain treated with direct electrical nerve stimulation," J. Hand Surg. Am. 19(6), 931 (1994). No RCT

999

K. Streitberger and J. Kleinhenz, "Introducing a placebo needle into acupuncture research," Lancet 352(9125), 364 (1998). No RCT

1000

J. F. Stubbing and J. A. Jellicoe, "Transcutaneous electrical nerve stimulation after thoracotomy. Pain relief and peak expiratory flow rate--a trial of transcutaneous electrical nerve stimulation," Anaesthesia 43(4), 296 (1988). No chronic pain

1001

W. Sunshine, et al., "Fibromyalgia benefits frommassage therapy and transcutaneous electrical stimulation," (1996). Excluded after full text, no data extraction possible.

1002

S. T. Sutbeyaz, N. Sezer, and B. F. Koseoglu, "The effect of pulsed electromagnetic fields in the treatment of cervical osteoarthritis: a randomized, double-blind, sham-controlled trial," Rheumatol. Int. 26(4), 320 (2006). Excluded after full text, electromagnetic.

1003

N. Takakura, H. Yajima, and I. Homma, "Inhibitory effect of pain-eliciting transcutaneous electrical stimulation on vibration-induced finger flexion reflex in the human upper


173

limb," Jpn. J. Physiol 54(3), 243 (2004). No chronic pain 1004

L. A. Talbot, et al., "A home-based protocol of electrical muscle stimulation for quadriceps muscle strength in older adults with osteoarthritis of the knee," J. Rheumatol. 30(7), 1571 (2003). No data on pain

1005

L. S. Tam, et al., "Acupuncture in the treatment of rheumatoid arthritis: a double-blind controlled pilot study," BMC. Complement Altern. Med. 7, 35 (2007). Included

1006

Y. Tamura, et al., "Effects of 1-Hz repetitive transcranial magnetic stimulation on acute pain induced by capsaicin," Pain 107(1-2), 107 (2004). Excluded after full text, no chronic pain

1007

G. Tan, T. Monga, and J. Thornby, "Electromedicine. Efficacy of microcurrent electrical stimulation on pain severity, psychological distress, and disability," American Journal of Pain Management 10(1), 35 (2000). Not available full text

1008

G. Tan, et al., "Using cranial electrotherapy stimulation to treat pain associated with spinal cord injury," J. Rehabil. Res. Dev. 43(4), 461 (2006). No chronic pain

1009

D. L. Tanelian, "Reflex sympathetic dystrophy: A reevaluation of the literature," 5(4), 247 (1996). No RCT

1010

A. G. Taylor, et al., "How effective is TENS for acute pain?," (1983). no chronic pain

1011

D. Taylor, C. Miaskowski, and J. Kohn, "A randomized clinical trial of the effectiveness of an acupressure device (relief brief) for managing symptoms of dysmenorrhea," J. Altern. Complement Med. 8(3), 357 (2002). No TENS

1012

D. N. Taylor, J. J. Katims, and L. K. Ng, "Sine-wave auricular TENS produces frequencydependent hypesthesia in the trigeminal nerve," Clin. J. Pain 9(3), 216 (1993). No chronic pain

1013

P. Taylor, M. Hallett, and L. Flaherty, "Treatment of osteoarthritis of the knee with transcutaneous electrical nerve stimulation," Pain 11(2), 233 (1981). No adequate data

1014

R. Taylor, "Clinical research in interventional pain management techniques: An epidemiologist/trialist's view," 8(6), 439 (2008). No RCT

1015

E. teDuits, et al., "The effectiveness of electronic dental anesthesia in children," Pediatr. Dent. 15(3), 191 (1993). No chronic pain

1016

N. A. Tejano, R. Puno, and J. M. Ignacio, "The use of implantable direct current stimulation in multilevel spinal fusion without instrumentation. A prospective clinical and radiographic evaluation with long-term follow-up," Spine (Phila Pa 1976. ) 21(16), 1904 (1996). Invasive


174

1017

I. A. TenVaarwerk, et al., "Clinical outcome of patients treated with spinal cord stimulation for therapeutically refractory angina pectoris. The Working Group on Neurocardiology," Heart 82(1), 82 (1999). Invasive

1018

S. Tesfaye, et al., "Electrical spinal-cord stimulation for painful diabetic peripheral neuropathy," Lancet 348(9043), 1698 (1996). Invasive

1019

R. Thakur and P. Rekha, "Comparative study of transcutaneous electrical nerve stimulation (TENS) and tramadol hydrochloride for pain relief in labor," (2004). no chronic pain

1020

T. C. Theoharides and G. R. Sant, "New agents for the medical treatment of interstitial cystitis," 10(3), 521 (2001). No RCT

1021

A. W. Thomas, et al., "A randomized, double-blind, placebo-controlled clinical trial using a lowfrequency magnetic field in the treatment of musculoskeletal chronic pain," 12(4), 249 (2007). Excluded after full text, no data extraction possible

1022

I. L. Thomas, et al., "An evaluation of transcutaneous electrical nerve stimulation for pain relief in labour," Aust. N. Z. J. Obstet. Gynaecol. 28(3), 182 (1988). No chronic pain

1023

M. Thomas, et al., "Pain and discomfort in primary dysmenorrhea is reduced by preemptive acupuncture or low frequency TENS," (1995). No chronic pain

1024

J. W. Thompson, S. Bower, and S. P. Tyrer, "A double blind randomised controlled clinical trial on the effect of transcutaneous spinal electroanalgesia (TSE) on low back pain," Eur. J. Pain 12(3), 371 (2008). Included

1025

S. Thomson and L. Jacques, "Demographic characteristics of patients with severe neuropathic pain secondary to failed back surgery syndrome," Pain Pract. 9(3), 206 (2009). No primary data

1026

G. Thorsteinsson , et al., "Transcutaneous electrical stimulation: a double-blind trial of its efficacy for pain," Arch. Phys. Med. Rehabil. 58(1), 8 (1977). Excluded after full text, no data extraction possible

1027

G. Thorsteinsson, "Chronic pain: use of TENS in the elderly," (1987). No chronic pain

1028

C. Timm, et al., "Sympathomimetic effects of low-dose S(+)-ketamine. Effect of propofol dosage. [German]," 57(4), 338 (2008). No TENS

1029

K. E. Timm, "A randomized-control study of active and passive treatments for chronic low back pain following L5 laminectomy," J. Orthop. Sports Phys. Ther. 20(6), 276 (1994). No sham control group

1030

C. Timmermans, et al., "Effect of butorphanol tartrate on shock-related discomfort during internal atrial defibrillation," Circulation 99(14), 1837 (1999). No chronic pain


175

1031

M. Tinazzi, et al., "TENS for the treatment of writer's cramp dystonia: a randomized, placebocontrolled study," (2005). Excluded after full text, no data on pain

1032

W. Tirakotai, et al., "Localization of precentral gyrus in image-guided surgery for motor cortex stimulation," Acta Neurochir. Suppl 97(Pt 2), 75 (2007). Invasive

1033

G. Tomassoni, et al., "Testing different biphasic waveforms and capacitances: effect on atrial defibrillation threshold and pain perception," J. Am. Coll. Cardiol. 28(3), 695 (1996). No chronic pain

1034

R. M. Tonella, S. Araujo, and A. M. O. da Silva, "Estimulacao eletrica nervosa transcutanea no alivio da dor pos-operatoria relacionada com procedimentos fisioterapeuticos em pacientes submetidos a intervencoes cirurgicas abdominais (Transcutaneous electrical nerve stimulation in the relief of pain related to physical therapy after abdominal surgery) [Spanish]," (2006). no chronic pain

1035

K. C. Tong, S. K. Lo, and G. L. Cheing, "Alternating frequencies of transcutaneous electric nerve stimulation: does it produce greater analgesic effects on mechanical and thermal pain thresholds?," Arch. Phys. Med. Rehabil. 88(10), 1344 (2007). No chronic pain

1036

O. Topuz, et al., "Efficacy of transcutaneous electrical nerve stimulation and percutaneous neuromodulation therapy in chronic low back pain," (2004). Included

1037

P. Torelli, R. Jensen, and J. Olesen, "Physiotherapy for tension-type headache: a controlled study," (2004). no TENS

1038

M. Touche, et al., "[Ventricular fibrillation at the acute phase of myocardial infarction: prognosis after resuscitation]," Arch. Mal Coeur Vaiss. 66(11), 1435 (1973). No chronic pain

1039

T. W. Tourville, D. A. Connolly, and B. V. Reed, "Effects of sensory-level high-volt pulsed electrical current ondelayed-onset muscle soreness," J. Sports Sci. 24(9), 941 (2006). No chronic pain

1040

S. Toyota, T. Satake, and Y. Amaki, "Transcutaneous electrical nerve stimulation as an alternative therapy for microlaryngeal endoscopic surgery," (1999). No sham control group

1041

G. M. K. Tsang, et al., "Chronic muscle stimulation improves ischaemic muscle performance in patients with peripheral vascular disease," (1994). No data on pain

1042

L. C. Tsen, et al., "Transcutaneous electrical nerve stimulation does not augment combined spinal epidural labour analgesia," Can. J. Anaesth. 47(1), 38 (2000). No chronic pain

1043

L. C. Tsen, et al., "Transcutaneous electrical nerve stimulation does not augment epidural labor analgesia," J. Clin. Anesth. 13(8), 571 (2001). No chronic pain

1044

M. L. Tsui and G. L. Cheing, "The effectiveness of electroacupuncture versus electrical heat acupuncture in the management of chronic low-back pain," J. Altern. Complement


176

Med. 10(5), 803 (2004). Excluded after full text, no adequate sham control group 1045

P. Tsui and M. C. Leung, "Comparison of the effectiveness between manual acupuncture and electro-acupuncture on patients with tennis elbow," Acupunct. Electrother. Res. 27(2), 107 (2002). No sham control group

1046

H. Tsukayama, et al., "Randomised controlled trial comparing the effectiveness of electroacupuncture and TENS for low back pain: a preliminary study for a pragmatic trial," Acupunct. Med. 20(4), 175 (2002). No sham control group

1047

N. Tugay, et al., "Effectiveness of transcutaneous electrical nerve stimulation and interferential current in primary dysmenorrhea," Pain Med. 8(4), 295 (2007). No sham control group

1048

E. Tukmachi, et al., "The effect of acupuncture on the symptoms of knee osteoarthritis--an open randomised controlled study," Acupunct. Med. 22(1), 14 (2004). No sham control group

1049

M. Tulgar, et al., "Comparative effectiveness of different stimulation modes in relieving pain. Part II. A double-blind controlled long-term clinical trial," Pain 47(2), 157 (1991). No adequate sham control

1050

M. Tulgar, et al., "Comparative effectiveness of different stimulation modes in relieving pain. Part I. A pilot study," Pain 47(2), 151 (1991). No RCT

1051

E. H. Tuzun, et al., "Effectiveness of two different physical therapy programmes in the treatment of knee osteoarthritis," (2004). No TENS

1052

E. Tyler, C. Caldwell, and J. N. Ghia, "Transcutaneous electrical nerve stimulation: an alternative approach to the management of postoperative pain," Anesth. Analg. 61(5), 449 (1982). No chronic pain

1053

D. T. Ubbink, et al., "Microcirculatory investigations to determine the effect of spinal cord stimulation for critical leg ischemia: the Dutch multicenter randomized controlled trial," J. Vasc. Surg. 30(2), 236 (1999). Invasive

1054

D. T. Ubbink, et al., "Systematic review and meta-analysis of controlled trials assessing spinal cord stimulation for inoperable critical leg ischaemia," 91(8), 948 (2004). No RCT

1055

D. T. Ubbink and H. Vermeulen, "Spinal cord stimulation for non-reconstructable chronic critical leg ischaemia," (3) (2005). Invasive

1056

M. Umino, T. Ohwatari, and M. Nagao, "A new method of recording somatosensory evoked potentials by randomized electrical tooth stimulation with 6 levels of intensity," Pain 64(2), 269 (1996). No chronic pain


177

1057

Unknown, "Percutaneous electrical nerve stimulation (PENS) creates a gigantic stir: but can it relieve chronic back pain?," Back Letter 14(5), 49 (1999). No data on pain

1058

Unknown, "Images in study show acupuncture eases pain: electro-acupuncture relieved pain in all patients," Case Management Advisor 11(2), 24 (2000). No data on pain

1059

Unknown, "Practice Nurse Award 2000," Practice Nurse 20(7), 423 (2000). no RCT

1060

A. F. Unterrainer, et al., "Postoperative and preincisional electrical nerve stimulation TENS reduce postoperative opioid requirement after major spinal surgery," J. Neurosurg. Anesthesiol. 22(1), 1 (2010). No chronic pain

1061

T. I. Usichenko, O. I. Ivashkivsky, and V. V. Gizhko, "Treatment of rheumatoid arthritis with electromagnetic millimeter waves applied to acupuncture points--a randomized double blind clinical study," Acupunct. Electrother. Res. 28(1-2), 11 (2003). No electrotherapy

1062

C. Vallbona, C. F. Hazlewood, and G. Jurida, "Response of pain to static magnetic fields in postpolio patients: A double-blind pilot study," 78(11), 1200 (1997). Excluded after full text, no data on duration of pain

1063

M. R. van Balken , et al., "Percutaneous tibial nerve stimulation as neuromodulative treatment of chronic pelvic pain," Eur. Urol. 43(2), 158 (2003). Excluded after full text, no RCT

1064

M. R. van Balken, H. Vergunst, and B. L. Bemelmans, "Prognostic factors for successful percutaneous tibial nerve stimulation," Eur. Urol. 49(2), 360 (2006). No chronic pain

1065

J. P. Van Buyten, "Radiofrequency or neuromodulation treatment of chronic pain, when is it useful?," , 57 (2008). No RCT

1066

G. J. van der Heijden, et al., "No effect of bipolar interferential electrotherapy and pulsed ultrasound for soft tissue shoulder disorders: a randomised controlled trial," Ann. Rheum. Dis. 58(9), 530 (1999). Excluded after full text, mixed patient pain duration.

1067

J. M. van der Ploeg, et al., "Transcutaneous nerve stimulation (TENS) during the first stage of labour: a randomized clinical trial," Pain 68(1), 75 (1996). No chronic pain

1068

J. T. van der Spank, et al., "Pain relief in labour by transcutaneous electrical nerve stimulation (TENS)," Arch. Gynecol. Obstet. 264(3), 131 (2000). No chronic pain

1069

M. W. van Tulder , et al., "The effectiveness of acupuncture in the management of acute and chronic low back pain: a systematic review within the framework of the Cochrane Collaboration Back Review Group," 24(11), 1113 (1999). No RCT

1070

M. W. van Tulder, B. Koes, and A. Malmivaara, "Outcome of non-invasive treatment modalities on back pain: an evidence-based review," 15, S64-S81 (2006). No RCT


178

1071

Eijs F. van, et al., "Brush-evoked allodynia predicts outcome of spinal cord stimulation in complex regional pain syndrome type 1," Eur. J. Pain 14(2), 164 (2010). Invasive

1072

Kleef M. van, et al., "Randomized trial of radiofrequency lumbar facet denervation for chronic low back pain," Spine (Phila Pa 1976. ) 24(18), 1937 (1999). Invasive

1073

Zundert J. Van, et al., "Pulsed radiofrequency adjacent to the cervical dorsal root ganglion in chronic cervical radicular pain: a double blind sham controlled randomized clinical trial," Pain 127(1-2), 173 (2007). Invasive

1074

M. W. vanTulder, B. W. Koes, and L. M. Bouter, "Conservative treatment of acute and chronic nonspecific low back pain - A systematic review of randomized controlled trials of the most common interventions," 22(18), 2128 (1997). No RCT

1075

A. varez-Arenal, et al., "Effect of occlusal splint and transcutaneous electric nerve stimulation on the signs and symptoms of temporomandibular disorders in patients with bruxism," J. Oral Rehabil. 29(9), 858 (2002). No RCT

1076

J. Vas, et al., "Efficacy and safety of acupuncture for chronic uncomplicated neck pain: a randomised controlled study," Pain 126(1-3), 245 (2006). Excluded after full text, acupuncture.

1077

J. Vas, et al., "Single-point acupuncture and physiotherapy for the treatment of painful shoulder: a multicentre randomized controlled trial," Rheumatology. (Oxford) 47(6), 887 (2008). No sham control group

1078

Ch Vecht, "Treatment of posttraumatic dystrophy," Ned. Tijdschr. Geneeskd. 144(34), 1620 (2000). No RCT

1079

F. Velasco, et al., "Efficacy of motor cortex stimulation in the treatment of neuropathic pain: a randomized double-blind trial," J. Neurosurg. 108(4), 698 (2008). Invasive

1080

K. Verhoeven and J. G. van Dijk, "Decreasing pain in electrical nerve stimulation," Clin. Neurophysiol. 117(5), 972 (2006). No chronic pain

1081

A. Vickers, P. Wilson, and J. Kleijnen, "Acupuncture," 11(1), 92 (2002). No RCT

1082

A. J. Vickers, "Statistical reanalysis of four recent randomized trials of acupuncture for pain using analysis of covariance," Clin. J. Pain 20(5), 319 (2004). No RCT

1083

C. J. Vierck, "Mechanisms underlying development of spatially distributed chronic pain (fibromyalgia)," Pain 124(3), 242 (2006). No RCT

1084

Filho O. Vilela and R. R. Tasker, "Pathways involved in thalamic ventrobasal stimulation for pain relief: evidence against the hypothesis VB stimulation-->rostroventral medulla


179

excitation-->dorsal horn inhibition," Arq Neuropsiquiatr. 52(3), 386 (1994). No RCT 1085

Filho O. Vilela, "Risk factors for unpleasant paresthesiae induced by paresthesiae-producing deep brain stimulation," Arq Neuropsiquiatr. 54(1), 57 (1996). Invasive

1086

A. Vinik, "CLINICAL REVIEW: Use of antiepileptic drugs in the treatment of chronic painful diabetic neuropathy," 90(8), 4936 (2005). No RCT

1087

A. L. Vitiello, R. Bonello, and H. Pollard, "The effectiveness of ENARÂ® for the treatment of chronic neck pain in Australian adults: A preliminary single-blind, randomised controlled trial," Chiropr. Osteopathy 15 (2007). Included

1088

J. W. Vlaeyen, et al., "Catastrophic thinking about pain increases discomfort during internal atrial cardioversion," J. Psychosom. Res. 56(1), 139 (2004). No chronic pain

1089

E. Volinn, "Do workplace interventions prevent low-back disorders? If so, why?: a methodologic commentary," 42(1), 258 (1999). No RCT

1090

A. Wadhwa, et al., "Women have the same desflurane minimum alveolar concentration as men," Anesthesiology 99(5), 1062 (2003). No TENS

1091

R. H. Walker, et al., "Postoperative use of continuous passive motion, transcutaneous electrical nerve stimulation, and continuous cooling pad following total knee arthroplasty," J. Arthroplasty 6(2), 151 (1991). No chronic pain

1092

D. M. Walsh, et al., "Transcutaneous electrical nerve stimulation. Relevance of stimulation parameters to neurophysiological and hypoalgesic effects," Am. J. Phys. Med. Rehabil. 74(3), 199 (1995). No sham control group

1093

D. M. Walsh, et al., "A double-blind investigation of the hypoalgesic effects of transcutaneous electrical nerve stimulation upon experimentally induced ischaemic pain," Pain 61(1), 39 (1995). No chronic pain

1094

D. M. Walsh, et al., "Transcutaneous electrical nerve stimulation: effect on peripheral nerve conduction, mechanical pain threshold, and tactile threshold in humans," Arch. Phys. Med. Rehabil. 79(9), 1051 (1998). No chronic pain

1095

D. M. Walsh, et al., "Study of the effects of various transcutaneous electrical nerve stimulation (TENS) parameters upon the RIII nociceptive and H-reflexes in humans," Clin. Physiol 20(3), 191 (2000). No chronic pain

1096

B. Wang, et al., "Effect of the intensity of transcutaneous acupoint electrical stimulation on the postoperative analgesic requirement," Anesth. Analg. 85(2), 406 (1997). No chronic pain


180

1097

B. Wang, X. Xiong, and W. Li, "Study on transcutaneous electrical nerve stimulation (TENS) applied to acupoints for relieving labour pain," (2007). no chronic pain

1098

K. L. Wang, P. Svensson, and L. rendt-Nielsen, "Effect of acupuncture-like electrical stimulation on chronic tension-type headache: A randomized, double-blinded, placebo-controlled trial," 23(4), 316 (2007). Excluded after full text, no data extraction possible

1099

N. Wang, Ph.D. Hong Kong Polytechnic (People's Republic of China), 2001. Ref ID: 1099

1100

N. Wang and C. Hui-Chan, "Effects of acupoints TENS on heat pain threshold in normal subjects," Chin Med. J. (Engl. ) 116(12), 1864 (2003). No chronic pain

1101

S. M. Wang, Z. N. Kain, and P. F. White, "Acupuncture analgesia: II. Clinical considerations," 106(2), 611 (2008). No RCT

1102

W. C. Wang, S. L. George, and J. A. Wilimas, "Transcutaneous electrical nerve stimulation treatment of sickle cell pain crises," Acta Haematol. 80(2), 99 (1988). No chronic pain

1103

Y. Wang, et al., "Effect of electroacupuncture on neuropathic pain and its mechanism," 31(12), 158 (2006). Not available full text

1104

A. R. Ward and V. J. Robertson, "Variation in torque production with frequency using medium frequency alternating current," Arch. Phys. Med. Rehabil. 79(11), 1399 (1998). No chronic pain

1105

A. R. Ward and V. J. Robertson, "Sensory, motor, and pain thresholds for stimulation with medium frequency alternating current," Arch. Phys. Med. Rehabil. 79(3), 273 (1998). No chronic pain

1106

A. R. Ward, W. G. Oliver, and D. Buccella, "Wrist extensor torque production and discomfort associated with low-frequency and burst-modulated kilohertz-frequency currents," Phys. Ther. 86(10), 1360 (2006). No chronic pain

1107

A. R. Ward and S. Lucas-Toumbourou, "Lowering of sensory, motor, and pain-tolerance thresholds with burst duration using kilohertz-frequency alternating current electric stimulation," Arch. Phys. Med. Rehabil. 88(8), 1036 (2007). No chronic pain

1108

L. Ward, E. Wright, and S. B. McMahon, "A comparison of the effects of noxious and innocuous counterstimuli on experimentally induced itch and pain," Pain 64(1), 129 (1996). No chronic pain

1109

C. A. Warfield, J. M. Stein, and H. A. Frank, "The effect of transcutaneous electrical nerve stimulation on pain after thoracotomy," Ann. Thorac. Surg. 39(5), 462 (1985). No chronic pain

1110

K. Warke, et al., "Use of self-applied TENS for low back pain in people with multiple sclerosis [with consumer summary]," (2004). Not available full text


181

1111

K. Warke, et al., "Efficacy of transcutaneous electrical nerve stimulation (tens) for chronic lowback pain in a multiple sclerosis population: a randomized, placebo-controlled clinical trial," Clin. J. Pain 22(9), 812 (2006). Excluded after full text, no adequate data

1112

M. D. Weber, F. J. Servedio, and W. R. Woodall, "The effects of three modalities on delayed onset muscle soreness," J. Orthop. Sports Phys. Ther. 20(5), 236 (1994). No sham control group

1113

B. S. Webster, S. Verma, and G. S. Pransky, "Outcomes of Workers' Compensation Claimants with Low Back Pain Undergoing Intradiscal Electrothermal Therapy," 29(4), 435 (2004). Invasive

1114

D. P. Webster, L. Pellegrini, and K. Duffy, "Use of transcutaneous electrical nerve stimulation for fingertip analgesia: a pilot study," Ann. Emerg. Med. 21(12), 1472 (1992). No chronic pain

1115

D. K. Weiner, et al., "Efficacy of percutaneous electrical nerve stimulation for the treatment of chronic low back pain in older adults," J. Am. Geriatr. Soc. 51(5), 599 (2003). Included

1116

D. K. Weiner, et al., "Efficacy of periosteal stimulation therapy for the treatment of osteoarthritis-associated chronic knee pain: an initial controlled clinical trial," J. Am. Geriatr. Soc. 55(10), 1541 (2007). Included

1117

D. K. Weiner, et al., "Efficacy of percutaneous electrical nerve stimulation and therapeutic exercise for older adults with chronic low back pain: a randomized controlled trial," Pain 140(2), 344 (2008). Included

1118

M. I. Weintraub and S. P. Cole, "Neuromagnetic treatment of pain in refractory carpal tunnel syndrome: an electrophysiological and placebo analysis," (2000). No TENS

1119

M. I. Weintraub and S. P. Cole, "Pulsed magnetic field therapy in refractory neuropathic pain secondary to peripheral neuropathy: electrodiagnostic parameters--pilot study," Neurorehabil. Neural Repair 18(1), 42 (2004). No RCT

1120

M. Weiss, D. Vanderlin, and J. Hietpas, "Controlling chronic pain in the workplace: nerve stimulation and intrathecal drug delivery systems," AAOHN Journal 55(11), 463 (2007). No RCT

1121

C. S. Weng, et al., "The evaluation of two modulated frequency modes of acupuncturelike TENS on the treatment of tennis elbow pain," (2005). Included

1122

C. S. Weng, et al., "The treatment of upper back pain by two modulated frequency modes of acupuncture-like TENS," (2005). Included

1123

R. Werners, P. B. Pynsent, and C. J. Bulstrode, "Randomized trial comparing interferential therapy with motorized lumbar traction and massage in the management of low back


182

pain in a primary care setting," Spine (Phila Pa 1976. ) 24(15), 1579 (1999). No sham control group 1124

F. T. Wetzel, et al., "Treatment of chronic pain in failed back surgery patients with spinal cord stimulation: A review of current literature and proposal for future investigation," 3(2), 59 (2000). No RCT

1125

F. T. Wetzel and T. A. McNally, "New directions and interventions: Intradiscal electrothermal annuloplasty to treat chronic discogenic low back pain," 13(3), 172 (2002). No RCT

1126

A. White, "Acupuncture for chrome neck pain (n=135)," Acupunct. Med. 23(2), 87 (2005). Excluded after full text, no RCT

1127

A. White, et al., "Acupuncture treatment for chronic knee pain: A systematic review," 46(3), 384 (2007). No RCT

1128

A. R. White, "Effectiveness for treating back pain: acupuncture compared with transcutaneous electrical nerve stimulation," Focus on Alternative & Complementary Therapies 4(4), 187 (1999). No TENS

1129

P. White, et al., "Acupuncture versus placebo for the treatment of chronic mechanical neck pain: a randomized, controlled trial," Ann. Intern. Med. 141(12), 911 (2004). Excluded after full text, no electrical stimulation.

1130

P. F. White, et al., "Percutaneous neuromodulation therapy: does the location of electrical stimulation effect the acute analgesic response?," Anesth. Analg. 91(4), 949 (2000). No chronic pain

1131

K. E. Whitmore, et al., "Sacral neuromodulation in patients with interstitial cystitis: a multicenter clinical trial," Int. Urogynecol. J. Pelvic. Floor. Dysfunct. 14(5), 305 (2003). No RCT

1132

E. Widerstrom-Noga, et al., "Pain threshold responses to two different modes of sensory stimulation in patients with orofacial muscular pain: psychologic considerations," J. Orofac. Pain 12(1), 27 (1998). No sham control group

1133

K. Wieselmann-Penkner, et al., "A comparison of the muscular relaxation effect of TENS and EMG-biofeedback in patients with bruxism," (2001). No data on pain

1134

P. J. Wiffen, "Evidence-based pain management and palliative care. Pain and palliative care in The Cochrane Library; Issue Number 4, 2001," Journal of Pain & Palliative Care Pharmacotherapy 16(3), 73 (2002). No RCT

1135

P. J. Wiffen, "Pain and palliative care in the Issue Number 3, 2001 of The Cochrane Library," Journal of Pain & Palliative Care Pharmacotherapy 16(2), 81 (2002). No RCT

1136

P. J. Wiffen, "Evidence-based pain management and palliative care in issue three for 2004 of The Cochrane Library," Journal of Pain & Palliative Care Pharmacotherapy 19(1), 63 (2005). no RCT


183

1137

P. J. Wiffen, "Evidence-based pain management and palliative care in Issue Two for 2009 of The Cochrane Library," Journal of Pain & Palliative Care Pharmacotherapy 23(3), 290 (2009). No RCT

1138

P. Wilder-Smith and M. Zimmermann, "[Analgesia by transcutaneous electrical nerve stimulation (TENS)]," Schweiz. Monatsschr. Zahnmed. 99(6), 653 (1989). No chronic pain

1139

D. H. Wilson, "Treatment of soft-tissue injuries by pulsed electrical energy," Br. Med. J. 2(5808), 269 (1972). No chronic pain

1140

M. H. Winemiller , et al., "Effect of magnetic vs sham-magnetic insoles on nonspecific foot pain in the workplace: A randomized, double-blind, placebo-controlled trial," 80(9), 1138 (2005). No chronic pain

1141

C. J. Winfree, "Spinal cord stimulation for the relief of chronic pain," Curr Surg 62 (5), 476 (2005). Invasive

1142

W. Winkelm++ller, "Neuromodulation techniques in the treatment of chronic painful diseases," 6(3), 203 (1999). No RCT

1143

M. F. Winnem and T. Amundsen, "Treatment of phantom limb pain with TENS," Pain 12(3), 299 (1982). No RCT

1144

T. Witjas, et al., "Effects of chronic subthalamic stimulation on nonmotor fluctuations in Parkinson's disease," Mov Disord. 22(12), 1729 (2007). Invasive

1145

A. P. Wolff, et al., "Do diagnostic segmental nerve root blocks in chronic low back pain patients with radiation to the leg lack distinct sensory effects? A preliminary study," Br. J. Anaesth. 96(2), 253 (2006). No TENS

1146

R. H. Wong, et al., "Analgesic effect of electroacupuncture in postthoracotomy pain: a prospective randomized trial," Ann. Thorac. Surg. 81(6), 2031 (2006). No chronic pain

1147

H. Xiao, S. Z. She, and L. X. Xu, "(Effects of transcutaneous electric nerve stimulation on the postoperative analgesia with PCEA and recovery after surgery) [Chinese - simplified characters]," (2002). no chronic pain

1148

W. H. Xiao, L. Naso, and G. J. Bennett, "Experimental studies of potential analgesics for the treatment of chemotherapy-evoked painful peripheral neuropathies," 9(5), 505 (2008). No RCT

1149

W. D. Xu, et al., "The pain-relieving effects induced by electroacupuncture with different intensities at homotopic and heterotopic acupoints in humans," Am. J. Chin Med. 31(5), 791 (2003). No chronic pain


184

1150

C. C. L. Xue, et al., "Electroacupuncture for tension-type headache on distal acupoints only: a randomized, controlled, crossover trial," (2004). Excluded after full text, no data extraction possible

1151

K. Yamashiro, et al., "Neurons with spontaneous high-frequency discharges in the central nervous system and chronic pain," Acta Neurochir. Suppl 87, 153 (2003). Pain not reported as outcome measure

1152

A. U. Yap and H. C. Ho, "Electronic and local anesthesia: a clinical comparison for operative procedures," Quintessence. Int. 27(8), 549 (1996). No chronic pain

1153

T. Yasuda, et al., "Effects of amitriptyline and gabapentin on bilateral hyperalgesia observed in an animal model of unilateral axotomy," Pain 115(1-2), 161 (2005). Not human

1154

J. Ye, et al., "Pain management using Han's acupoint nerve stimulator combined with patientcontrolled analgesia following neurosurgery: a randomized case control study," (2008). No chronic pain

1155

C. K. Yeung, M. C. Leung, and D. H. Chow, "The use of electro-acupuncture in conjunction with exercise for the treatment of chronic low-back pain," J. Altern. Complement Med. 9(4), 479 (2003). No sham control group

1156

Y. B. Yip and S. H. M. Tse, "The effectiveness of relaxation acupoint stimulation and acupressure with aromatic lavender essential oil for non-specific low back pain in Hong Kong: a randomised controlled trial," Complement. Ther. Med. 12(1), 28 (2004). Excluded after full text, no data extraction possible

1157

Y. B. Yip, H. M. Tse, and K. K. Wu, "An experimental study comparing the effects of combined transcutaneous acupoint electrical stimulation and electromagnetic millimeter waves for spinal pain in Hong Kong," Complement Ther. Clin. Pract. 13(1), 4 (2007). No chronic pain

1158

M. Yokoyama, et al., "Comparison of percutaneous electrical nerve stimulation with transcutaneous electrical nerve stimulation for long-term pain relief in patients with chronic low back pain," Anesth. Analg. 98(6), 1552, table (2004). No sham control group

1159

R. F. Young and V. I. Chambi, "Pain relief by electrical stimulation of the periaqueductal and periventricular gray matter. Evidence for a non-opioid mechanism," J. Neurosurg. 66(3), 364 (1987). No RCT

1160

D. T. Yu, et al., "Comparing stimulation-induced pain during percutaneous (intramuscular) and transcutaneous neuromuscular electric stimulation for treating shoulder subluxation in hemiplegia," Arch. Phys. Med. Rehabil. 82(6), 756 (2001). No chronic pain

1161

D. T. Yu, et al., "Intramuscular neuromuscular electric stimulation for poststroke shoulder pain: a multicenter randomized clinical trial," Arch. Phys. Med. Rehabil. 85(5), 695 (2004). Invasive

1162

C. S. Yuan, et al., "Transcutaneous electrical acupoint stimulation potentiates analgesic effect of morphine," J. Clin. Pharmacol. 42(8), 899 (2002). No chronic pain


185

1163

J. Yuan, et al., "Effectiveness of Acupuncture for Low Back Pain A Systematic Review," 33(23), E887-E900 (2008). No RCT

1164

J. Yuan, et al., "Treatment regimens of acupuncture for low back pain-A systematic review," Complement. Ther. Med. 16(5), 295 (2008). No RCT

1165

A. Yucel, et al., "The effect of venlafaxine on ongoing and experimentally induced pain in neuropathic pain patients: a double blind, placebo controlled study," Eur. J. Pain 9(4), 407 (2005). No chronic pain

1166

M. Yurtkuran and T. Kocagil, "TENS, electroacupuncture and ice massage: comparison of treatment for osteoarthritis of the knee," (1999). Excluded after full text, no data extraction possible

1167

N. Zabihi, et al., "Short-term results of bilateral S2-S4 sacral neuromodulation for the treatment of refractory interstitial cystitis, painful bladder syndrome, and chronic pelvic pain," Int. Urogynecol. J. Pelvic. Floor. Dysfunct. 19(4), 553 (2008). Invasive

1168

A. Zambito, et al., "Interferential and horizontal therapies in chronic low back pain: a randomized, double blind, clinical study," Clin. Exp. Rheumatol. 24(5), 534 (2006). No data extraction possible

1169

A. Zambito, et al., "Interferential and horizontal therapies in chronic low back pain due to multiple vertebral fractures: a randomized, double blind, clinical study," Osteoporos. Int. 18(11), 1541 (2007). Excluded after full text, no clear data.

1170

S. D. Zanette, et al., "A pilot study of acupuncture as adjunctive treatment of rheumatoid arthritis," 27(5), 627 (2008). No TENS

1171

S. F. Zarbock, "Stimulating the pain: technology to manage pain in the home," Rehab Management: The Interdisciplinary Journal of Rehabilitation 12(3), 36 (1999). No RCT

1172

C. J. Zaslawski, et al., "The impact of site specificity and needle manipulation on changes to pain pressure threshold following manual acupuncture: a controlled study," Complement Ther. Med. 11(1), 11 (2003). No chronic pain

1173

A. Zati, et al., "Trattamento della lombalgia causata da ernia del disco: confronto tra laser ad alta potenza, TENS e fans (Treatment of low back pain caused by intervertebral disk displacement: comparison between high power laser, TENS and NSAIDs) [Italian]," (2004). Wrong language

1174

L. Zhang and L. Li, "202 cases of headache treated with electro-acupuncture," J. Tradit. Chin Med. 15(2), 124 (1995). No RCT

1175

W. Zhang, et al., "OARSI recommendations for the management of hip and knee osteoarthritis, Part II: OARSI evidence-based, expert consensus guidelines," 16(2), 137 (2008). No RCT


186

1176

W. T. Zhang, et al., "Relations between brain network activation and analgesic effect induced by low vs. high frequency electrical acupoint stimulation in different subjects: a functional magnetic resonance imaging study," Brain Res. 982(2), 168 (2003). Pain not reported as outcome measure

1177

Z. Zheng, et al., "The effect of electroacupuncture on opioid-like medication consumption by chronic pain patients: a pilot randomized controlled clinical trial," Eur. J. Pain 12(5), 671 (2008). Excluded after full text, no clear data.

1178

L. X. Zhi, "(Randomized controlled study on the analgesic effect of superficial needling plus electro-stimulation of Sanyinjiao (SP6) for primary dysmenorrhea) [Chinese simplified characters]," (2007). Wrong language

1179

X. M. Zhu and B. Polus, "A controlled trial on acupuncture for chronic neck pain," Am. J. Chin Med. 30(1), 13 (2002). No TENS

1180

F. G. Zitman, et al., "Hypnosis and autogenic training in the treatment of tension headaches: a two-phase constructive design study with follow-up," (1992). no TENS

1181

R. Zou, H. X. Zhang, and T. F. Zhang, "Comparative study on treatment of acute gouty arthritis by electroacupuncture with different frequency," Chin J. Integr. Med. 12(3), 212 (2006). No sham control group


187

Effectiviteit van uitwendige elektrostimulatie ter behandeling van chronische pijn

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