Transcutaneous electrical nerve stimulation (TENS) for the treatment of rheumatoid arthritis in the hand

AL-TENS (acupuncture-like TENS) and C-TENS (conventional TENS) may be effective for pain and patient's assessment of change in disease activity in arthritis of hand.

A Cochrane review (abstract , review ) included 3 studies with a total of 78 patients. Administration of 15 minutes of AL-TENS a week, for 3 weeks, resulted in a significant decrease in rest pain (67% relative benefit, 45 points absolute benefit on 100 mm VAS scale) but not in grip pain compared to placebo. No significant difference was found between one 20-minute treatment duration of C-TENS versus AL-TENS , or C-TENS versus placebo on decrease in mean scores for rest pain or grip pain, or on the number of tender joints, but there was a clinically important benefit of C-TENS over AL-TENS on patient assessment of change in disease (risk difference 21%, NNT 5).

Comment: The quality of evidence is downgraded by study quality (inadequate or unclear allocation concealment) and by imprecise results (few patients and wide confidence intervals).

Ədəbiyyat

1. Brosseau L, Judd MG, Marchand S et al. Transcutaneous electrical nerve stimulation (TENS) for the treatment of rheumatoid arthritis in the hand. Cochrane Database Syst Rev 2003;(3):CD004377.