The effectiveness of transcutaneous electrical nerve stimulation in the management of patients with complex regional pain syndrome: A randomized, double-blinded, placebo-controlled prospective study
Affiliations: [a] Physical Medicine and Rehabilitation Clinics, Iğdır State Hospital, Iğdır, Turkey | [b] Physical Medicine and Rehabilitation Clinics, Antalya Training & Research Hospital, Antalya, Turkey | [c] Department of Algologia, Physical Medicine and Rehabilitation Clinics, School of Medicine, Marmara University, Istanbul, Turkey
Correspondence:
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Corresponding author: Tuncay Çakır, Antalya Training & Research Hospital, Department of Physical Medicine and Rehabilitation, Varlık Mahallesi Kazım, Karabekir Caddesi Soğuksu, 07100 Antalya, Turkey. Tel.: +90 242 249 44 00 4287, +90 505 3466629; Fax: +90 242 249 44 62; E-mail:ftr1979@gmail.com
Abstract: OBJECTIVE: To investigate the effect of transcutaneous electrical
nerve stimulation (TENS) on clinical recovery in the management of patients
with complex regional pain syndrome Type I (CRPS Type I). MATERIAL AND METHOD: The study included 30 patients with stage 1
and 2 CRPS Type I in the upper extremities. The patients were randomly assigned
into 2 groups, group 1 (n= 15) received conventional TENS therapy for 20
minutes, and group 2 (n= 15) received sham TENS therapy. The standard
physical therapy program, which included contrast bath for 20 minutes;
whirlpool bath for 15 minutes; assisted active and passive range of motion,
and static stretching exercises up to the pain threshold, was also conducted
in both groups. Therapy was scheduled for 15 sessions. A visual analogue
scale (VAS) was used to assess spontaneous pain. The Leeds Assessment of
Neuropathic Signs and Symptoms (LANSS) scale and the Douleur Neuropathique
en 4 Questions (DN-4) were used to assess neuropathic pain. In addition,
range of motion (ROM) was measured using a goniometer and volumetric
measurements were taken to assess edema. Functional capacity was assessed
using a hand dynamometer and the Duruöz Hand Index (DHI). All
measurements were performed at baseline and after therapy. RESULTS: Significant improvements were achieved in spontaneous and
neuropathic pain scores, edema, ROM, and functional capacity in both groups
(p< 0.05). However, improvement was found to be significantly greater in
group 1 regarding pain intensity, neuropathic pain assessed using LANNS,
edema, and in the 2nd-3rd finger ROM measurements (p< 0.05). No
significant difference was detected between groups regarding improvements in
4th-5th finger and wrist ROM measurements, grip strength, and DN4
and DHI scores (p> 0.05). CONCLUSION: The addition of TENS to the physical therapy program
was seen to make a significant contribution to clinical recovery in CRPS
Type 1.
