title: The effectiveness of transcutaneous electrical nerve stimulation in the management of patients with complex regional pain syndrome: A randomized, double-blinded, placebo-controlled prospective study.
abstract: OBJECTIVE
  To investigate the effect of transcutaneous electrical nerve stimulation (TENS) on clinical recovery in the management of patients with complex regional pain syndrome Type I (CRPS Type I).
  
  
  METHODS
  The study included 30 patients with stage 1 and 2 CRPS Type I in the upper extremities. The patients were randomly assigned into 2 groups, group 1 (n= 15) received conventional TENS therapy for 20 minutes, and group 2 (n= 15) received sham TENS therapy. The standard physical therapy program, which included contrast bath for 20 minutes; whirlpool bath for 15 minutes; assisted active and passive range of motion, and static stretching exercises up to the pain threshold, was also conducted in both groups. Therapy was scheduled for 15 sessions. A visual analogue scale (VAS) was used to assess spontaneous pain. The Leeds Assessment of Neuropathic Signs and Symptoms (LANSS) scale and the Douleur Neuropathique en 4 Questions (DN-4) were used to assess neuropathic pain. In addition, range of motion (ROM) was measured using a goniometer and volumetric measurements were taken to assess edema. Functional capacity was assessed using a hand dynamometer and the Duruöz Hand Index (DHI). All measurements were performed at baseline and after therapy.
  
  
  RESULTS
  Significant improvements were achieved in spontaneous and neuropathic pain scores, edema, ROM, and functional capacity in both groups (p< 0.05). However, improvement was found to be significantly greater in group 1 regarding pain intensity, neuropathic pain assessed using LANNS, edema, and in the 2nd-3rd finger ROM measurements (p< 0.05). No significant difference was detected between groups regarding improvements in 4th-5th finger and wrist ROM measurements, grip strength, and DN4 and DHI scores (p> 0.05).
  
  
  CONCLUSIONS
  The addition of TENS to the physical therapy program was seen to make a significant contribution to clinical recovery in CRPS Type 1.
authors.affiliation: Physical Medicine and Rehabilitation Clinics, Iğdır State Hospital, Iğdır, Turkey.
authors.forename: Adem
authors.initials: A
authors.lastname: Bilgili
authors.affiliation: Physical Medicine and Rehabilitation Clinics, Antalya Training & Research Hospital, Antalya, Turkey.
authors.forename: Tuncay
authors.initials: T
authors.lastname: Çakır
authors.affiliation: Physical Medicine and Rehabilitation Clinics, Antalya Training & Research Hospital, Antalya, Turkey.
authors.forename: Şebnem Koldaş
authors.initials: ŞK
authors.lastname: Doğan
authors.affiliation: Department of Algologia, Physical Medicine and Rehabilitation Clinics, School of Medicine, Marmara University, Istanbul, Turkey.
authors.forename: Tülay
authors.initials: T
authors.lastname: Erçalık
authors.affiliation: Physical Medicine and Rehabilitation Clinics, Antalya Training & Research Hospital, Antalya, Turkey.
authors.forename: Meral Bilgilisoy
authors.initials: MB
authors.lastname: Filiz
authors.affiliation: Physical Medicine and Rehabilitation Clinics, Antalya Training & Research Hospital, Antalya, Turkey.
authors.forename: Füsun
authors.initials: F
authors.lastname: Toraman
mesh_terms: D020918:Complex Regional Pain Syndromes / Q000628:therapy*; D004311:Double-Blind Method; D004487:Edema / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009437:Neuralgia / Q000628:therapy; D011446:Prospective Studies; D004561:Transcutaneous Electric Nerve Stimulation; D064232:Visual Analog Scale
keywords: Complex regional pain syndrome; functional capacity; pain; transcutaneous electrical nerve stimulation