Effect of the duration of electrical stimulation on the analgesic response in patients with low back pain.
BACKGROUND
Electrical stimulation of peripheral nerves produces acute analgesic effects. This randomized, sham-controlled, crossover study was designed to evaluate the effect of differing durations of electrical stimulation on the analgesic response to percutaneous electrical nerve stimulation in 75 consenting patients with low back pain.


METHODS
All patients received electrical stimulation for four different time intervals (0, 15, 30, and 45 min) in a random sequence over the course of an 11-week study period. All active percutaneous electrical nerve stimulation treatments were administered using alternating frequencies of 15 and 30 Hz three times per week for 2 consecutive weeks. The prestudy assessments included the health status survey short form questionnaire and 10-cm visual analog scale scores for pain, physical activity, and quality of sleep, with 0 being the best and 10 being the worst. The pain scoring was repeated 5-10 min after each 60-min study session and 24 h after the last treatment session with each of the four methods. The daily oral analgesic requirements were assessed during each of the four treatment blocks. At the end of each 2-week treatment block, the questionnaire was repeated.


RESULTS
Electrical stimulation using percutaneously placed needles produced short-term improvements in the visual analog scale pain, physical activity, and quality of sleep scores, and a reduction in the oral analgesic requirements. The 30-min and 45-min durations of electrical stimulation produced similar hypoalgesic effects (48+/-21% and 46+/-19%, respectively) and were significantly more effective than either 15 min (21+/-17%) or 0 min (10+/-11%). The 30- and 45-min treatments were also more effective in improving physical activity and sleep scores over the course of the 2-week treatment period. In contrast to the sham treatment (0 min), the health status survey short form revealed that electrical stimulation for 15 to 45 min three times per week for 2 weeks improved patient function.


CONCLUSIONS
The recommended duration of electrical stimulation with percutaneous electrical nerve stimulation therapy is 30 min.
Hamza
M A
MA
Eugene McDermott Center for Pain Management, Department of Anesthesiology and Pain Management, University of Texas Southwestern Medical Center, Dallas 75235-9068, USA.
Ghoname
E A
EA
White
P F
PF
Craig
W F
WF
Ahmed
H E
HE
Gajraj
N M
NM
Vakharia
A S
AS
Noe
C E
CE
D000328:Adult; D000368:Aged; D000700:Analgesics / Q000008:administration & dosage / Q000627:therapeutic use; D018592:Cross-Over Studies; D004599:Electric Stimulation Therapy; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000188:drug therapy / Q000523:psychology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology; D010147:Pain Measurement; D016037:Single-Blind Method; D012890:Sleep / Q000502:physiology; D013997:Time Factors
D000700:Analgesics