Short-term Effect of Transcutaneous Electrical Nerve Stimulation (TENS) on Pain in Patients with Bone Metastasis: An Uncontrolled Pretest-Posttest Study

Thipawan Bowornkitiwong; Wanida  Seevokom; Pawinee  Tawatchot; Teeraporn  Paisan; Suganyapatch  Sirichotpapa; Sirinya  Nanthanangkul; Teerapol  Sommaichaiya

doi:10.33192/Smj.2020.63

Authors

Thipawan Bowornkitiwong Department of Palliative Care Unit, Udonthani Cancer Hospital http://orcid.org/0000-0002-7760-6081
Wanida Seevokom Research and Medical Technology Assessment Department, Udonthani Cancer Hospital http://orcid.org/0000-0001-6477-8696
Pawinee Tawatchot Research and Medical Technology Assessment Department, Udonthani Cancer Hospital http://orcid.org/0000-0002-8204-5274
Teeraporn Paisan Research and Medical Technology Assessment Department, Udonthani Cancer Hospital http://orcid.org/0000-0002-3250-4188
Suganyapatch Sirichotpapa Physical Therapy Department, Palliative Care Unit, Udonthani Cancer Hospital http://orcid.org/0000-0003-2771-4129
Sirinya Nanthanangkul Research and Medical Technology Assessment Department, Udonthani Cancer Hospital http://orcid.org/0000-0001-9860-9268
Teerapol Sommaichaiya Anesthesiology Department, Lerdsin Hospital, Bangkok http://orcid.org/0000-0001-9576-3745

DOI:

https://doi.org/10.33192/Smj.2020.63

Keywords:

TENS, cancer with bone metastasis

Abstract

Objective: To evaluate the short-term effect of TENS on pain for patients with bone metastasis.
Methods: An experimental descriptive study of 25 eligible advanced cancer patients with bone metastasis. Patients were enrolled in the study from June 1, 2018 to December 31, 2019. Pain intensity measurements were recorded at baseline prior to TENS application, then after 30 minutes and 60 minutes of TENS while the device was switched on. TENS was applied prior to radiotherapy at the same time every day for 5 days. Pain score was evaluated with the Visual Analogue Scale (VAS). Symptom assessment was measured by a Thai version of the Edmonton symptom assessment system (ESAS-Thai) on the first day prior to and five days after TENS application began. The paired t-test and Generalized Estimating Equations (GEE) were used analysis.
Results: Mean VAS scores decreased by 1.08 (-1.08; 95% CI; -1.66 to 0.50, p < 0.001) and 1.82 (-1.82; 95 CI; -2.40 to 1.24, p < 0.001) after 30 and 60 minutes, respectively, compared to the baseline. Lower VAS scores were also correlated to the number of TENS visits. Mean ESAS scores showed a statistically significant difference before and after TENS application (before: 4.32 (95% CI: 3.60–5.03); after: 3.08 (95% CI: 2.61–3.54), p = 0.004). During TENS application there was a reduction in VAS pain scores over time.
Conclusion: TENS is non-invasive, inexpensive and safe. It may be a useful adjunct to the multimodality treatment of pain and may reduce the need for morphine.

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