Nerve stimulation ineffective for low back pain

People often ask me if TENS would be useful with certain ailments.  The truth-as I see it- is that it's relative on a case-by-case basis.   Studies have suggested that it can be both useful and worthless. 

A new study suggests that for some chronic low back pain (LBP) it is useless, however it is helpful in treating diabetic neuropathy (DN).

A new German study suggests that people with chronic low back pain who seek relief with transcutaneous electric nerve stimulation or TENS are wasting their time and money.

However, TENS appears to be effective in relieving diabetic nerve pain, also called diabetic neuropathy. Roughly 60 percent of people with diabetes will develop diabetic neuropathy.

According to the new TENS practice guideline -- issued by the American Academy of Neurology (AAM) and published in the academy's journal Neurology -- TENS is "ineffective" for the treatment of chronic low back pain but is "probably effective" in reducing pain from diabetic neuropathy.

Does anyone other than me have a problem with "probably"?  Can we be definitive about anything in science and medicine?

'Probably' not.  But I digress...

The AAM's new guideline results from a comprehensive review of the scientific literature which they show TENS for chronic low back pain has yielded conflicting results.  Thus, doing what most people in research do, researchers will disparage the treatment if there's not overwhelming conclusive evidence for treatment support.  (Except, of course, when it comes to new drugs on the market).

Of 263 research studies on TENS research found, two resarchers (one from Univ. of Kansas, and one from Canada) found five studies that met their criteria for meaningful scientific conclusions.

Of the two studies that had the strongest designs one showed "no benefit" from TENS in relieving chronic lower back pain, while the other weaker studies had conflicting results, with "modest" TENS benefits found in two of them and no benefit in the third.

For people suffering from numbness, tingling, or jabbing pain associated with diabetic neuropathy, the results were more promising. Two studies found modest reductions in pain, leading to the conclusion that "TENS should be considered for the treatment of painful diabetic neuropathy."

A TENS unit is a portable, pocket-sized, battery-operated device. Electrodes are applied to the skin at the area of pain. When turned on, an electric current is sent through the electrodes causing a tingling sensation in the underlying skin and muscle. The current is adjustable and may be applied in short bursts.

It is thought that electric nerve stimulation blocks the pain signal to the brain, providing short-term relief.

Pfft.

Rebutting arguments from other scientists posit that in spite of the relatively weak scientific and clinical evidence, TENS still represents a valuable therapeutic alternative.