EfficacyofTENSinCervicalPainSyndromes:AnUmbrellaReviewofSystematicReviews

Neck pain affects approximately 30-50% of the general population annually and represents 4% of patients referred to Physical Medicine and Rehabilitation outpatients in Italy. While the course is generally benign with acute episodes resolving within weeks, relapses are frequent and 10% of cases become chronic. This creates significant workplace impact, with 11-14% of workers experiencing work activity limitations. TENS (transcutaneous electrical nerve stimulation) is commonly used in rehabilitation, utilizing short-duration impulses to selectively activate A-beta fibers and block pain signals through the Gate-Control mechanism.

The researchers conducted an umbrella review of systematic reviews examining TENS effectiveness in cervical pain syndromes. They searched PubMed, PEDro, Cochrane, and Google Scholar databases for systematic reviews published in English over the past 20 years. Using the PICO model, they focused on patients with acute or chronic cervical pain syndromes, TENS intervention, comparisons with conventional therapies, and outcomes of pain, disability, and function. The methodological quality was evaluated using the AMSTAR tool, with studies scoring less than 6 excluded.

Eleven systematic reviews were included: 1 focused on acute neck pain, 6 on chronic neck pain, and 4 on both acute and chronic conditions. The reviews showed heterogeneity in their approach and findings. Some studies included TENS as part of broader rehabilitation approaches rather than specifically examining TENS for neck pain. The AMSTAR scores varied, indicating different levels of methodological quality among the included reviews.

Results suggested that TENS appears to have effects in reducing acute and chronic cervical pain intensity, particularly in the short term. However, the evidence was not sufficient to provide precise clinical recommendations.

While TENS shows promise for reducing neck pain intensity, especially in the short term, the current evidence base is insufficient for definitive clinical guidance. The heterogeneity among studies and limited methodological quality of some reviews highlight the need for higher-quality research. Clinicians should consider TENS as a potentially beneficial adjunctive treatment for cervical pain syndromes, but should recognize that the evidence remains limited. Future research should focus on well-designed studies that specifically examine TENS effectiveness in clearly defined neck pain populations with longer follow-up periods to establish more robust clinical recommendations.