Neck Pain Clinical Trial
Official title:
Is Transcutaneous Electrical Nerve Stimulation (TENS) an Effective Method to Modulate Pain Transmission and Pain Perception in Patients Suffering From Chronic Non-Specific Pain Syndromes?
- Transcutaneous electrical nerve stimulation (TENS) is a frequently applied therapy in
chronic pain. Although evidence regarding the effectiveness of TENS in chronic pain is
inconclusive many patients continue using TENS on long term in daily practice. An
important question is therefore why some patients respond well and others don't at all.
In chronic pain evidence for abnormal pain processing (sensitization) has been found in
several patients groups. The process of sensitization might influence effectiveness of
TENS as the theoretical working mechanism of TENS is based on the modulation of the
transmission of nociceptive impulses form peripheral receptors throughout spinal nerve
system into the brain. In this study we want to study the effect of TENS on pain
transmission, as measured by contact heat evoked potentials (CHEPS), between
'responders' and non-responders' after a two weeks TENS treatment. 'Responders' will be
defined as patients with a pain reduction of ≥ 30% on a VAS after a two week treatment
period with TENS. Non-responders are patients with a pain reduction < 15%.
- Objective: a) Is pain reducing effect TENS in responders based on modulation of pain
transmission and perception, as measured by CHEPS? b) Is the ability of TENS to
modulate pain transmission and perception influenced by abnormal pain processing?
- Prospective cohort study
- Patients with chronic non specific pain (duration > 6 months), above 18 year, will be
included. Patients are referred from the Pain Clinic of the University Hospital
Maastricht (MUMC). Exclusion criteria are: a) pain due to cancer, b) the use of a
cardiac pacemaker, c) pregnancy, d) neurological sensory deficits, e) language and/or
cognitive inability to complete the health assessment questionnaires f) previous TENS
for pain relief.
- Patients receive a two week treatment period with TENS-treatment, as regular, at home
after instruction. The frequency is set at 100 Hz and pulse duration at 250 μ sec.
Patients have to use the TENS daily (minimal 4 times a day for 30 minutes).
Main study parameters/endpoints are decrease in amplitude of CHEPS in responders versus
non-responders.
n/a
Observational Model: Cohort, Time Perspective: Prospective
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