TENS for Chronic Low Back Pain Management

Introduction to TENS Use

• The American Society of Anesthesiologists recommends TENS as part of multimodal pain management for chronic back pain, with consideration for neck and phantom limb pain 1
• TENS should be used as part of a multimodal approach for chronic low back pain, but evidence does not support its routine use as a standalone therapy for acute or subacute low back pain 1

Evidence and Recommendations

• Insufficient evidence exists to determine TENS effectiveness for acute or subacute low back pain according to the 2017 American College of Physicians guidelines 2
• TENS must be combined with other interventions (exercise, physical therapy, medications) rather than used as monotherapy 1, 3

Practical Considerations

• Approximately one-third of patients experience mild skin irritation at electrode sites 4
• The American College of Physicians explicitly states that evidence is inadequate to determine TENS effectiveness in acute or subacute low back pain populations 2