An electrical stimulation technique does not offer any significant benefit to people with osteoarthritis of the knee, researchers said yesterday.
TENS – transcutaneous electrical stimulation – involves an electrical current applied to the skin at the joint to stimulate the nerves with the aim of relieving pain.
It has been used for treating the condition for twenty years, write Dr Anne Rutjes of the University of Bern in Switzerland, and colleagues in a new Cochrane Review.
Nevertheless, the evidence remains unconvincing. In the review, the team looked at 18 small trials including 813 patients. For every 100 people who received TENS treatment, 29 responded well, compared with 26 out of 100 people who received fake TENS treatment or their usual treatments.
Dr Rutjes said: "Although some people who have electrostimulation treatment for osteoarthritis of the knee show some improvement, our data suggest that this may not be greater than the improvement experienced by those who receive placebo treatment.
"After two decades of research on the use of these methods there is still no clear evidence that they work."
She added that information was only available from a few small trials, many of which were of very poor quality. Most did not provide enough information about the number of patients who dropped out, or experienced adverse side-effects.
"To clarify the effectiveness of TENS as a treatment for osteoarthritis we need larger, better quality trials," she concluded.
Another recent review of the evidence relating to TENS for pain relief suggested it is "beneficial for some patients and does no harm".
Dr Alison While and colleagues at King’s College London, UK, write in the British Journal of Community Nursing that: "More research is needed to clarify optimal treatments regimes and its cost-effectiveness compared to conventional analgesia."
Rutjes, A. W. S. et al. Transcutaneous electrostimulation for osteoarthritis of the knee. Cochrane Database of Systematic Reviews 2009, Issue 4. Art. No.: CD002823.
Ying, K. N. and While, A. Pain relief in osteoarthritis and rheumatoid arthritis: TENS. The British Journal of Community Nursing. Vol. 12, August 2007, pp. 364-71.
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