Loh, J., & Gulati, A. (2015). The use of transcutaneous electrical nerve stimulation (TENS) in a major cancer center for the treatment of severe cancer-related pain and associated disability. Pain Medicine, 16, 1204–1210. 

DOI Link

Study Purpose

To examine the usefulness of transcutaneous electrical nerve stimulation (TENS) for cancer-related pain and functionality

Intervention Characteristics/Basic Study Process

Records of patients who received TENS were reviewed for data collection. High-frequency TENS was trialed. Patients who reported subjective pain relief were provided with a TENS unit and instructed to use it four to six times daily for 30–60 minutes. Prior to the trial, pain was assessed. Pain was reassessed between one and two months.

Sample Characteristics

  • N = 55
  • AGE RANGE = 10–89 years
  • MALES: 22%, FEMALES: 78%
  • KEY DISEASE CHARACTERISTICS: Varied tumor types

Setting

  • SITE: Single site  
  • SETTING TYPE: Outpatient  
  • LOCATION: New York, NY

Phase of Care and Clinical Applications

  • APPLICATIONS: Palliative care

Study Design

Retrospective, descriptive study

Measurement Instruments/Methods

  • Visual Analogue Scale (VAS)
  • Numeric Rating Scale (NRS)
  • McGill Pain Questionnaire Short Form (MPQ-SF)

Results

Overall, 69.7% of patients who trialed TENS reported benefits. Among those who responded to TENS (40 patients), there was an average VAS score decrease of 9.8 mm (p < 0.001).

Conclusions

TENS may be helpful for pain management in patients with cancer. The results from this study were inconclusive.

Limitations

  • Small sample (< 100)
  • Risk of bias (no control group)
  • Risk of bias (no blinding)
  • Risk of bias (no random assignment) 
  • Unintended interventions or applicable interventions not described that would influence results
  • Measurement/methods not well described
  • Other limitations/explanation: No information about whether analgesics were used or changed over time was provided. The results reporting was confusing, and the sample sizes reported in various places differed.

 

Nursing Implications

This study's findings regarding the efficacy of TENS for cancer-related pain treatment were not conclusive. Well-designed research evaluating its efficacy is needed so that options for improved pain management can be identified. Modalities such as TENS may be helpful adjuncts for patients who experience limited effectiveness with standard analgesics. However, good supporting evidence is needed.