Acupuncture, transcutaneous electrical nerve stimulation, and laser therapy in chronic pain.
OBJECTIVE
The purpose of this review was to determine how effective acupuncture, transcutaneous electrical nerve stimulation, acupuncture-like transcutaneous nerve stimulation, laser therapy, electrical nerve stimulation, and neuroreflexotherapy are in the management of chronic pain.


METHODS
The literature search identified six systematic reviews of the literature and four randomized controlled trials to provide evidence for this review.


RESULTS
The systematic reviews included different methodologies and heterogeneity of study groups, but studies were generally of poor methodology. Although sham acupuncture may have analgesic effects, it was used as a control in many studies.


CONCLUSIONS
In general, the evidence was contradictory or inadequate, reflecting poor study methodologies. No positive conclusion could be reached for acupuncture, transcutaneous electrical nerve stimulation, acupuncture-like transcutaneous nerve stimulation, laser therapy, or neuroreflexotherapy. A single randomized controlled trial provided limited evidence (level 3) that electrical nerve stimulation is effective for pain relief in myofascial pain syndrome for up to 4 weeks, but further study in humans is needed. Future randomized controlled trials and systematic reviews should include subgroup analyses of sham acupuncture and inert placebos as controls.
Fargas-Babjak
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Department of Anesthesia, McMaster University, Hamilton, Ontario, Canada. babjaka@mcmaster.ca
D026881:Acupuncture; D002908:Chronic Disease; D006801:Humans; D053685:Laser Therapy; D059408:Pain Management; D010166:Palliative Care / Q000379:methods*; D004561:Transcutaneous Electric Nerve Stimulation