Assessment: efficacy of transcutaneous electric nerve stimulation in the treatment of pain in neurologic disorders (an evidence-based review): report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology

Neurology. 2010 Jan 12;74(2):173-6. doi: 10.1212/WNL.0b013e3181c918fc. Epub 2009 Dec 30.


Objective: To determine if transcutaneous electric nerve stimulation (TENS) is efficacious in the treatment of pain in neurologic disorders.

Methods: We performed a systematic literature search of Medline and the Cochrane Library from inception to April 2009.

Results: There are conflicting reports of TENS compared to sham TENS in the treatment of chronic low back pain, with 2 Class II studies showing benefit, but 2 Class I studies and another Class II study not showing benefit. Because the Class I studies are stronger evidence, TENS is established as ineffective for the treatment of chronic low back pain (2 Class I studies). TENS is probably effective in treating painful diabetic neuropathy (2 Class II studies).

Recommendations: Transcutaneous electric nerve stimulation (TENS) is not recommended for the treatment of chronic low back pain (Level A). TENS should be considered in the treatment of painful diabetic neuropathy (Level B). Further research into the mechanism of action of TENS is needed, as well as more rigorous studies for determination of efficacy.

Publication types

  • Meta-Analysis
  • Review

MeSH terms

  • Clinical Trials as Topic / standards
  • Clinical Trials as Topic / statistics & numerical data*
  • Contraindications
  • Diabetic Neuropathies / physiopathology
  • Diabetic Neuropathies / therapy
  • Electric Stimulation Therapy / instrumentation*
  • Electric Stimulation Therapy / methods*
  • Evidence-Based Medicine / methods
  • Humans
  • Low Back Pain / physiopathology
  • Low Back Pain / therapy
  • Outcome Assessment, Health Care / methods*
  • Pain / physiopathology
  • Pain Management*
  • Pain Measurement / methods
  • Societies, Medical
  • Treatment Outcome