Acute Back Injury Clinical Trial
Official title:
The Use of Transcutaneous Electrical Nerve Stimulation on the Efficacy of Acute Back Pain Within an Emergency Department Triage: A Randomized Trial
Transcutaneous Electrical Nerve Stimulation (TENS) devices produce a gentle electrical stimulation that when applied through pads applied directly to the skin, has a noticeable effect in reducing pain associated with various types of injuries and ailments. Several recent studies have shown efficacy when used for acute pain specific to primary dysmenorrhea, renal colic, lower-extremity pain, and pain associated with spinal cord injury, and was achieved without adverse effects. This study is intended to compare the effects of TENS units on acute back pain on ambulatory patients who are awaiting emergency medical treatment, to uncover if a statistically-significant analgesic effect is noted compared to a placebo device.
With the emerging amount of new data on the treatment specific to acute pain, it is theorized
that early TENS application can be an adjunct for acute pain reduction, specifically for
patients awaiting treatment in an emergency department triage waiting room. TENS stimulators
are advantageous to patients in that they are non-pharmacologic and non-invasive therapy.
TENS devices have an excellent safety profile, are associated with very few
contraindications, and have negligible side-effects or adverse events: the most common being
minor skin irritation. (Sluka and Walsh 2003) Of financial benefit to a hospital considering
their implementation, these devices are also inexpensive. In the realm of emergency medicine,
which is being scrutinized to reduce opioid prescriptions, measures must be taken to maximize
the efficacy of alternative pain-relief adjuncts.
There are significant gaps in the literature which have depicted no significant benefits
compared to physical therapy and other modalities. These studies had used variable treatments
times and frequencies, which were not solidified in scientific research at the time of their
results. The use of these stimulators has been extensively studied, and the evidence to
support their use on various conditions has been inconclusive. Early meta-analyses and
systematic reviews have noted the data are inconsistent to suggest a mean reduction of pain
when assessed on chronic pain. (Brosseau et al. 2002) However, when applied extensively and
at regular settings, TENS has shown the presence of tolerance to TENS when used chronically
in as few as four days. (Chandran and Sluka, 2003) This study is intended to harness the
newest research comparing the most-effective settings and durations of TENS units, and
compare the effects of TENS units on acute back pain on ambulatory patients who are awaiting
emergency medical treatment.
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