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Passive Care Research for Doctors
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Interferential Therapy & TENS -
Low Back Pain
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1. Zambito, A. Interferential and horizontal therapies in chronic low back pain: a randomized, double blind, clinical study. Clin Exp Rheumatol. Sep-Oct; 24 (5): 534-9 (2006)
Chronic Low Back Pain (CLBP) is one of the most frequent medical problems.
Twenty-six men and 94 women with CLBP associated with either degenerative disk disease or previous multiple vertebral osteoporotic fractures were randomly assigned to either interferential currents (IFT), horizontal therapy (HT) or sham HT administered for 10, 40 and 40 minutes, respectively, daily for 5 days per week for two weeks together with a standard flexion-extension stretching exercise program. Blind efficacy assessment were obtained at baseline and at week 2, 6 and 14 and included a functional questionnaire (Backill), the standard visual analog scale (VAS) and the mean analgesic consumption.
RESULTS:
- At week 2 a significant and similar improvement in both the VAS and Backill score was observed in all three groups.
- The pain VAS score returned to baseline values at week 6 and 14 in the control group while in the IFT and HT groups it continued to improve.
- The Backill score continued to improve only in the two active groups with changes significantly greater than those observed in control patients at week 14.
CONCLUSION:
This randomized double-blind controlled study provides the first evidence that IFT and HT therapy are significantly effective in alleviating both pain and disability in patients with CLBP.
The placebo effect is remarkable at the beginning of the treatment but it tends to vanish within a couple of weeks.
2. Melzack, R et. al. Ice massage and transcutaneous electrical stimulation: comparison of treatment for low-back pain. Pain.1980 Oct; 9(2):209-17
The purpose of this study was to examine the relative effectiveness of ice massage and TENS for the relief of low-back pain.
Patients suffering chronic low-back pain were treated with both ice massage and TENS.
The order of treatments was balanced, and changes in the intensity of pain were measured with the McGill Pain Questionnaire (MPQ).
RESULTS:
- Both methods are equally effective: based on the Pain Rating Index of the MPQ, 67-69% of patients obtained pain relief greater than 33% with each method.
- The results indicate that ice massage is an effective therapeutic tool, and appears to be more effective than TENS for some patients.
- It may also serve as an additional sensory-modulation method to alternate with TENS to overcome adaptation effects.
- Evidence that cold signals are transmitted to the spinal cord exclusively by A-delta fibers and not by C fibers suggests that ice massage provides a potential method for differentiating among the multiple feedback systems that mediate analgesia produced by different forms of intense sensory input.
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