TENS for Secondary Back Pain in Lymphoma Patients

Primary Treatment Considerations

TENS can be considered as part of a multimodal pain management approach for lymphoma patients with secondary back pain, but should never be used as standalone therapy and must be combined with appropriate oncologic treatment, physical therapy, and other analgesic interventions, as recommended by the American College of Physicians and the National Comprehensive Cancer Network 1, 2

The NCCN recommends TENS among non-pharmacologic rehabilitation interventions and modalities for pain management, alongside movement-based therapies, with a strength of evidence rated as moderate 2
The American Society of Anesthesiologists supports TENS as part of multimodal approaches for chronic back pain, with a strength of evidence rated as low 3, 5
TENS should be part of multimodal pain management for chronic back pain, not used as monotherapy, as recommended by the American College of Physicians and the National Comprehensive Cancer Network 3, 4

Insufficient evidence exists to determine TENS effectiveness for acute or subacute low back pain, according to the American College of Physicians, with a strength of evidence rated as low 3
For cancer-related pain specifically, evidence is inadequate with contradictory results from only three small randomized controlled trials involving 88 cancer patients total, with a strength of evidence rated as very low 5
TENS must be combined with exercise, physical therapy, and medications rather than used alone, as recommended by the American College of Physicians and the National Comprehensive Cancer Network 3, 4

If TENS is used in lymphoma patients with secondary back pain, it should be initiated after ruling out spinal cord compression and initiating definitive oncologic treatment, and as part of a multimodal regimen that includes appropriate analgesic medications, physical therapy, and therapeutic exercise, as recommended by the National Comprehensive Cancer Network 1, 2
Approximately one-third of patients experience mild skin irritation at electrode sites with TENS use, with a strength of evidence rated as moderate 3, 4, 5