title: Pain relief by transcutaneous electric nerve stimulation with bidirectional modulated sine waves in patients with chronic back pain: a randomized, double-blind, sham-controlled study.
abstract: Objectives.  Newly developed bidirectional modulated sine waves (BMW) might provide some derived benefit to patients with low back pain. Pain relief by transcutaneous electric nerve stimulation (TENS) with BMWs was tested. Materials and Methods.  Analgesic effects of BMWs and conventional bidirectional pulsed waves on chronic back pain in 28 patients were compared, and effects of repeated TENS using BMWs on chronic back pain were investigated in 21 patients by means of a randomized double-blind, sham-controlled, parallel-group method. Pain intensity was assessed using numerical rating scale (NRS). Results.  There was significant immediate reduction in NRS in patients receiving BMWs, and 60 min after treatment compared to sham TENS. Weekly repeated treatments using massage and TENS with BMWs for 5 weeks resulted in a decrease of NRS, but there were no significant differences between the TENS plus massage and sham TENS plus massage groups. Conclusions.  This study shows that TENS with BMWs significantly inhibits chronic back pain, and treatment effects are attained within a day. The results also suggest that there were no statistically significant long-term effects of TENS with BMW in the repeated treatment.
authors.affiliation: Department of Human Sciences, Ube Frontier University Graduate School, Ube, Yamaguchi, Japan;              Takahashi Clinic and              Research and Development Department, Business Development Center, Omron Healthcare Co. Ltd., Kyoto, Japan; and              Department of Anesthesiology, Saitama Medical School, Moroyama, Saitama, Japan.
authors.forename: Koki
authors.initials: K
authors.lastname: Shimoji
authors.forename: Norio
authors.initials: N
authors.lastname: Takahashi
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Nishio
authors.forename: Mika
authors.initials: M
authors.lastname: Koyanagi
authors.forename: Sumihisa
authors.initials: S
authors.lastname: Aida