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J Back Musculoskelet Rehabil. 2016 Nov 21;29(4):661-671.

The effectiveness of transcutaneous electrical nerve stimulation in the management of patients with complex regional pain syndrome: A randomized, double-blinded, placebo-controlled prospective study.

Author information

1
Physical Medicine and Rehabilitation Clinics, Iğdır State Hospital, Iğdır, Turkey.
2
Physical Medicine and Rehabilitation Clinics, Antalya Training & Research Hospital, Antalya, Turkey.
3
Department of Algologia, Physical Medicine and Rehabilitation Clinics, School of Medicine, Marmara University, Istanbul, Turkey.

Abstract

OBJECTIVE:

To investigate the effect of transcutaneous electrical nerve stimulation (TENS) on clinical recovery in the management of patients with complex regional pain syndrome Type I (CRPS Type I).

MATERIAL AND METHOD:

The study included 30 patients with stage 1 and 2 CRPS Type I in the upper extremities. The patients were randomly assigned into 2 groups, group 1 (n= 15) received conventional TENS therapy for 20 minutes, and group 2 (n= 15) received sham TENS therapy. The standard physical therapy program, which included contrast bath for 20 minutes; whirlpool bath for 15 minutes; assisted active and passive range of motion, and static stretching exercises up to the pain threshold, was also conducted in both groups. Therapy was scheduled for 15 sessions. A visual analogue scale (VAS) was used to assess spontaneous pain. The Leeds Assessment of Neuropathic Signs and Symptoms (LANSS) scale and the Douleur Neuropathique en 4 Questions (DN-4) were used to assess neuropathic pain. In addition, range of motion (ROM) was measured using a goniometer and volumetric measurements were taken to assess edema. Functional capacity was assessed using a hand dynamometer and the Duruöz Hand Index (DHI). All measurements were performed at baseline and after therapy.

RESULTS:

Significant improvements were achieved in spontaneous and neuropathic pain scores, edema, ROM, and functional capacity in both groups (p< 0.05). However, improvement was found to be significantly greater in group 1 regarding pain intensity, neuropathic pain assessed using LANNS, edema, and in the 2nd-3rd finger ROM measurements (p< 0.05). No significant difference was detected between groups regarding improvements in 4th-5th finger and wrist ROM measurements, grip strength, and DN4 and DHI scores (p> 0.05).

CONCLUSION:

The addition of TENS to the physical therapy program was seen to make a significant contribution to clinical recovery in CRPS Type 1.

KEYWORDS:

Complex regional pain syndrome; functional capacity; pain; transcutaneous electrical nerve stimulation

PMID:
26922847
DOI:
10.3233/BMR-160667
[Indexed for MEDLINE]

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