The comparative effect of two types of electrode placement for acupuncture-like TENS on pain relief in patients with chronic neck pain
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Published:
Sep 25, 2018
Keywords:
Acupuncture-like TENS Low-frequency TENS Neck pain Acupoint Electrode placement
Main Article Content
Abstract
Background: Although the use of acupuncture-like transcutaneous electrical nerve stimulation (AL-TENS) has been applied for chronic neck pain alleviation, there is a lack of evidence regarding the effects of the electrode placements applied on the acupoints in individuals with chronic neck pain.
Objective: This study aimed to compare the effects of two AL-TENS electrode placements, over the painful area and the acupoints in individuals with chronic neck pain.
Method: Twenty-four participants with chronic neck pain were randomly assigned to three groups: AL-TENS group with electrode placement over painful area, the Acupoint-TENS group with electrode placement over acupoints (GB20, GB21, SI14, SI15), and the placebo group in which the electrodes were placed over acupoints like the Acupoint-TENS group but no stimulation. All groups received 7 treatment sessions of either 30 minutes of AL-TENS or 30 minutes of placebo stimulation. Pain intensity was measured using the Visual Analog Scale (VAS) at the pre- and post-treatment, and the two-week follow-up session.
Result: The AL-TENS group showed a significant reduction in VAS at the post-treatment and the two-week follow-up compared to the placebo group. The acupoint-TENS group also showed significant reduction in VAS at the two-week follow-up compared to the placebo group. However, there was no significant difference in VAS between the AL-TENS and Acupoint-TENS groups at pre- and post-treatment, and at the two-week follow-up.
Conclusion: The AL-TENS with electrode placement on the acupoints as well as the painful area could be applied as pain relief for individuals with chronic neck pain.
Article Details
How to Cite
1.
Eksakulkla S, Surapat C, Patsonwutthiload P, Kanjanakul S. The comparative effect of two types of electrode placement for acupuncture-like TENS on pain relief in patients with chronic neck pain. Thai J Phys Ther [internet]. 2018 Sep. 25 [cited 2026 Jan. 3];40(3):104-19. available from: https://he02.tci-thaijo.org/index.php/tjpt/article/view/147306
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Research Articles
References
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9. Maayah M, Al-Jarrah M. Evaluation of transcutaneous electrical nerve stimulation as a treatment of neck pain due to musculoskeletal disorders. J Clin Med Res. 2010; 2(3): 127-36.
10. Tashani O, Johnson MI. Transcutaneous electrical nerve stimulation (TENS): A possible aid for pain relief in developing countries? Libyan J Med. 2009; 4(2): 62–5.
11. Vance CGT, Dailey DL, Rakel BA, Sluka KA. Using TENS for pain control: the state of the evidence. Pain Manag. 2014; 4(3): 197–209.
12. Kalra A, Urban MO, Sluka KA. Blockade of opioid receptors in rostral ventral medulla prevents antihyperalgesia produced by transcutaneous electrical nerve stimulation (TENS). J Pharmacol Exp Ther. 2001; 298(1): 257-63.
13. Sluka KA, Deacon M, Stibal A, Strissel S, Terpstra A. Spinal blockade of opioid receptors prevents the analgesia produced by TENS in arthritic rats. J Pharmacol Exp Ther. 1999; 289(2): 840-6.
14. DeSantana JM, Da Silva LF, De Resende MA, Sluka KA. Transcutaneous electrical nerve stimulation at both high and low frequencies activates ventrolateral periaqueductal grey to decrease mechanical hyperalgesia in arthritic rats. Neuroscience. 2009; 163(4): 1233-41.
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19. Focks C. Atlas of Acupuncture. 2nd ed. Churchill Livingstone/ Elsevier, 2008.
20. Weng CS, Tsai YS, Yang CY. Using electrical conductance as the evaluation parameter of pain in patients with low back pain treated by acupuncture-like TENS. Biomed Eng Appl Basis Commun. 2004; 16: 205-12.
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28. Ghasemi A, Zahediasl S. Normality tests for statistical analysis: A guide for non-statisticians. Int J Endocrinol Metab. 2012; 10(2): 486–9.
29. Mukaka MM. Statistics corner: A guide to appropriate use of correlation coefficient in medical research. Malawi Med J. 2012; 24(3): 69-71.
30. Dworkin RH, Turk DC, Wyrwich KW, et al. Interpreting the clinical importance of treatment outcomes in chronic pain clinical trials: IMMPACT recommendations. J Pain. 2008; 9(2): 105-21.
31. Azatcam G, Atalay NS, Akkaya N, et al. Comparison of effectiveness of transcutaneous electrical nerve stimulation and kinesio taping added to exercises in patients with myofascial pain syndrome. J Back Musculoskelet Rehabil. 2017; 30(2): 291–8.
32. León-Hernández JV, Martín-Pintado-Zugasti A, Frutos LG, Alguacil-Diego IM, de la Llave-Rincón AI, Fernandez-Carnero J. Immediate and short-term effects of the combination of dry needling and percutaneous TENS on post-needling soreness in patients with chronic myofascial neck pain. Braz J Phys Ther. 2016; 20(5): 422–31.
33. Audette I, Dumas JP, Côté JN, De Serres SJ. Validity and Between-Day Reliability of the Cervical Range of Motion (CROM) Device. J Orthop Sports Phys Ther. 2010; 40(5): 318-22.
34. Jones AYM, Lee R, Holzberger D, Jones, RDM. A comparison of different electrode placements on the effectiveness of TENS in pain relief for post-cholecystectomy patients. Physiotherapy. 1990; 76(9): 567-70.
35. Ngamjarus C.n4Studies: Sample size calculation for an epidemiological study on a smart device. Siriraj Med J. 2016; 68(3): 160-70.
2. Bovim G, Schrader H, Sand T. Neck pain in the general population. Spine. 1994; 19(12): 1307-9.
3. Côté P, Cassidy JD, Carroll LJ, Kristman V. The annual incidence and course of neck pain in the general population: a population-based cohort study. Pain. 2004; 112(3): 267-73.
4. Rudolfsson T, Björklund M, Djupsjöbacka M. Range of motion in the upper and lower cervical spine in people with chronic neck pain. Man Ther. 2012; 17(1): 53-9.
5. Lee H, Nicholson LL, Adams RD. Neck muscle endurance, self-report, and range of motion data from subjects with treated and untreated neck pain. J Manipulative Physiol Ther. 2005; 28(1): 25-32.
6. Fejer R, Hartvigsen J. Neck pain and disability due to neck pain: what is the relation? Eur Spine J. 2008; 17(1): 80–8.
7. Blanpied PR, Gross AR, Elliot JM, et al. Neck pain: Revision 2017/Clinical practice guidelines linked to the international classification of functioning, disability and health from the orthopaedic section of the American Physical Therapy Association. J Orthop Sports Phys Ther. 2017; 47(7): A1-83.
8. 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.
9. Maayah M, Al-Jarrah M. Evaluation of transcutaneous electrical nerve stimulation as a treatment of neck pain due to musculoskeletal disorders. J Clin Med Res. 2010; 2(3): 127-36.
10. Tashani O, Johnson MI. Transcutaneous electrical nerve stimulation (TENS): A possible aid for pain relief in developing countries? Libyan J Med. 2009; 4(2): 62–5.
11. Vance CGT, Dailey DL, Rakel BA, Sluka KA. Using TENS for pain control: the state of the evidence. Pain Manag. 2014; 4(3): 197–209.
12. Kalra A, Urban MO, Sluka KA. Blockade of opioid receptors in rostral ventral medulla prevents antihyperalgesia produced by transcutaneous electrical nerve stimulation (TENS). J Pharmacol Exp Ther. 2001; 298(1): 257-63.
13. Sluka KA, Deacon M, Stibal A, Strissel S, Terpstra A. Spinal blockade of opioid receptors prevents the analgesia produced by TENS in arthritic rats. J Pharmacol Exp Ther. 1999; 289(2): 840-6.
14. DeSantana JM, Da Silva LF, De Resende MA, Sluka KA. Transcutaneous electrical nerve stimulation at both high and low frequencies activates ventrolateral periaqueductal grey to decrease mechanical hyperalgesia in arthritic rats. Neuroscience. 2009; 163(4): 1233-41.
15. Yang Y, Yan X, Deng H, et al. The efficacy of traditional acupuncture on patients with chronic neck pain: study protocol of a randomized controlled trial. Trials. 2017; 18(1): 312.
16. Vas J, Perea-Milla E, Méndez C, et al. Efficacy and safety of acupuncture for chronic uncomplicated neck pain: a randomised controlled study. Pain. 2006; 126(1-3): 245-55.
17. Matsubara T, Arai YC, Shiro Y, et al. Comparative effects of acupressure at local and distal acupuncture points on pain conditions and autonomic function in females with chronic neck pain. Evid Based Complement Alternat Med. 2011.
18. Yoshimizu M, Teo AR, Ando M, Kiyohara K, Kawamura T. Relief of chronic shoulder and neck pain by electro-acupuncture and transcutaneous electrical nervous stimulation: A randomized crossover trial. Med Acupunct. 2012; 24(2): 97-103.
19. Focks C. Atlas of Acupuncture. 2nd ed. Churchill Livingstone/ Elsevier, 2008.
20. Weng CS, Tsai YS, Yang CY. Using electrical conductance as the evaluation parameter of pain in patients with low back pain treated by acupuncture-like TENS. Biomed Eng Appl Basis Commun. 2004; 16: 205-12.
21. Longhurst JC. Defining meridians: a modern basis of understanding. J Acupunct Meridian Stud. 2010; 3(2): 67-74.
22. Willis WD, Westlund KN. Neuroanatomy of the pain system and of the pathways that modulate pain. J Clin Neurophysiol. 1997; 14(1): 2-31.
23. Treede RD, Rief W, Barke A, et al. A classification of chronic pain for ICD-11. Pain. 2015; 156(6): 1003–7.
24. Misailidou V, Malliou P, Beneka A, Karagiannidis A, Godolias G. Assessment of patients with neck pain: a review of definitions, selection criteria, and measurement tools. J Chiropr Med. 2010; 9(2): 49–59.
25. International Association for the Study of Pain. Classification of chronic pain: description of chronic pain syndromes and definitions of pain terms. 2nd ed. Seattle: IASP Press, 1994.
26. Uthaikhup S, Paungmali A, Pirunsan U. Validation of Thai versions of the neck disability Index and neck pain and disability scale in patients with neck pain. Spine. 2011; 36(21): E1415-21.
27. Reese NB. Joint range of motion and muscle length testing. 2nd ed. St. Louis, Missouri: Saunders/Elsevier, 2010.
28. Ghasemi A, Zahediasl S. Normality tests for statistical analysis: A guide for non-statisticians. Int J Endocrinol Metab. 2012; 10(2): 486–9.
29. Mukaka MM. Statistics corner: A guide to appropriate use of correlation coefficient in medical research. Malawi Med J. 2012; 24(3): 69-71.
30. Dworkin RH, Turk DC, Wyrwich KW, et al. Interpreting the clinical importance of treatment outcomes in chronic pain clinical trials: IMMPACT recommendations. J Pain. 2008; 9(2): 105-21.
31. Azatcam G, Atalay NS, Akkaya N, et al. Comparison of effectiveness of transcutaneous electrical nerve stimulation and kinesio taping added to exercises in patients with myofascial pain syndrome. J Back Musculoskelet Rehabil. 2017; 30(2): 291–8.
32. León-Hernández JV, Martín-Pintado-Zugasti A, Frutos LG, Alguacil-Diego IM, de la Llave-Rincón AI, Fernandez-Carnero J. Immediate and short-term effects of the combination of dry needling and percutaneous TENS on post-needling soreness in patients with chronic myofascial neck pain. Braz J Phys Ther. 2016; 20(5): 422–31.
33. Audette I, Dumas JP, Côté JN, De Serres SJ. Validity and Between-Day Reliability of the Cervical Range of Motion (CROM) Device. J Orthop Sports Phys Ther. 2010; 40(5): 318-22.
34. Jones AYM, Lee R, Holzberger D, Jones, RDM. A comparison of different electrode placements on the effectiveness of TENS in pain relief for post-cholecystectomy patients. Physiotherapy. 1990; 76(9): 567-70.
35. Ngamjarus C.n4Studies: Sample size calculation for an epidemiological study on a smart device. Siriraj Med J. 2016; 68(3): 160-70.
