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Transcutaneous neurostimulation parameters for neuropathic radicular pain: Results from a two period crossover randomized trial - 05/03/25

Doi : 10.1016/j.jbspin.2024.105797 
Vincent Ducoulombier a, , Hassane Challi b, Pavlos Petit c, Bernard Leroy d, Adeline Versavel c, Hélène Luraschi a, Romain Chiquet c, Kheira Zenati b, Jean-François Budzik e, Jean-François Desrousseaux f, Hichem Khenioui g, Anne Bera-Louville h, Eric Houvenagel a, Laurène Norberciak i, Tristan Pascart a
a Department of Rheumatology, Saint-Philibert Hospital, Catholic University of Lille, Lomme, France 
b Department of Algology, Béthune Hospital Center, Béthune, France 
c Department of Algology, Saint-Vincent Hospital, Catholic University of Lille, Lille, France 
d Department of Algology, Roubaix Hospital Center, Roubaix, France 
e Department of Radiology, Saint-Philibert Hospital, Catholic University of Lille, Lomme, France 
f Department of Orthopedic Surgery, Saint-Philibert Hospital, Catholic University of Lille, Lomme, France 
g Department of Reeducation, Saint-Philibert Hospital, Catholic University of Lille, Lomme, France 
h Department of Rheumatology, Roger-Salengro Hospital, Lille, France 
i Research Department – Biostatistics and Methodology, Catholic University of Lille, Lomme, France 

Corresponding author. Service de Rhumatologie, Hôpital Saint-Philibert, rue du Grand-But, 59160 Lomme, France.Service de Rhumatologie, Hôpital Saint-Philibertrue du Grand-ButLomme59160France

Highlights

Transcutaneous neurostimulation is commonly used to treat chronic neuropathic radicular pain.
Two types of current are usually used: the c-TENS and the m-TENS.
There is no consensus on the mode of stimulation to be used and in fact practices are quiet variable.
Our study did not identify any argument to favor one or the other.

Il testo completo di questo articolo è disponibile in PDF.

Abstract

Objectives

Transcutaneous neurostimulation (TENS) is commonly used in the treatment of chronic radicular pain, but without any consensus on the type of current to be delivered. The aim of this study was to compare the conventional high-frequency, low-intensity current called c-TENS with a mixed current called m-TENS, combining c-TENS with a low-frequency, high-intensity current.

Methods

This was a single-blind, two-period crossover randomized trial. Included patients had chronic (≥3months), neuropathic (dn44) radicular pain of at least moderate intensity (Visual Analogic Scale [VAS]40mm [0–100mm]). Patients were randomized to receive either c-TENS or m-TENS first, then the other, and both during one month. The primary outcome was the level of radicular pain, measured by VAS at the end of each of the two period.

Results

Seventy-four patients were included (mean age: 51.9±13.5years, female proportion: 65.6%). The mean duration of radicular pain was 45.2±51months and the mean radicular intensity was 67±12.5/100mm. After one month of treatment, VAS decreased to 53.9±20.1mm under c-TENS and to 53.9±21.3 under m-TENS (NS). Thirteen patients (20.3%) had a VAS<40/100 with either c-TENS or m-TENS (NS). Tolerance was the same for the two modes. Twenty-nine patients (46%) designated c-TENS as the most effective mode, and 34 patients (54%) designated m-TENS.

Conclusion

This study shows no difference in terms of efficacy or tolerance between c-TENS and m-TENS. There is no justification for preferring one of these two modes over the other for the treatment of chronic neuropathic radicular pain.

Il testo completo di questo articolo è disponibile in PDF.

Keywords : Neurostimulation, TENS, Chronic pain, Neuropathic pain, Radicular pain


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Vol 92 - N° 2

Articolo 105797- Marzo 2025 Ritorno al numero
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