Health Problem: Chronic low back pain (CLBP) can be defined as low back pain (usually, in the L1-L5 vertebrae in the lumbar region) that persists ≥ 12 weeks, even after treatment of the initial injury or underlying cause of acute low back pain. Low back pain impairs people’s physical and psychological health and their ability to work and take care of their family and social responsibilities. In the United States, an estimated 13% of adults 20 to 60 years of age have CLBP.

Technology Description: Transcutaneous electrical nerve stimulation (TENS) devices comprise a small, programmable, electronic stimulus generator and ≥ 1 pairs of electrodes that are placed directly on the skin, usually via adhesive electrodes, to deliver pulsed electrical stimulation of modifiable frequency, intensity, and duration.

Controversy: The demand for effective nonpharmacologic therapies is fueled by guidelines that recommend them to be used for first-line treatment for CLBP. Since the introduction of TENS in the early 1970s, use of TENS has spread widely despite inconsistencies and gaps in the evidence supporting its use.

Key Questions:

  • Is TENS effective in treating CLBP in adults?
  • How does TENS compare with other nonpharmacologic treatment modalities in treating CLBP in adults?
  • Is TENS safe in adults with CLBP?
  • Have definitive patient selection criteria been identified for TENS to treat CLBP in adults?

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