Low Level Continuous Heat Wraps can Increase the Efficiency of Transcutaneous Electrical Nerve Stimulation for Pain Management

Abstract

Both transcutaneous electrical nerve stimulation and superficial heat have been used for pain management. While heat has been shown to have a beneficial effect on pain, transcutaneous electrical nerve stimulation remains controversial. The purpose of the present study was to see if heat, when added to transcutaneous electrical nerve stimulation, would provide more consistent relief. A total of 180 subjects participated in this study and were randomly divided into 12 groups. Low level continuous heat was applied while electrical stimulation was applied at 2 intensities, 2 frequencies and with 2 waveforms for 4 h. Outcome measures were subjective pain scale, range of motion of the back and skin blood flow of the back. The control groups had no significant difference in pain, range of motion or skin blood flow comparing the data at the beginning and 4 h after (p> 0.05). There was a small reduction in pain with transcutaneous electrical nerve stimulation alone while all other groups had a significant improvement in range of motion free of pain, reduction in pain, and increase in skin blood flow from the beginning to the end of the 4-hour period. Since transcutaneous electrical nerve stimulation with low level continuous heat showed better outcomes then transcutaneous electrical nerve stimulation alone or low level continuous heat alone, combining the 2 interventions seems to offer better outcomes for pain management for health care professionals.

Zusammenfassung

In der Schmerztherapie wird bereits die transkutane elektrische Nervenstimulation und auch Wärmeauflagen einsetzt. Während Wärme nachweislich eine positive Wirkung auf Schmerzen hat, bleibt die transkutane elektrische Nervenstimulation umstritten. In der vorliegenden Studie sollte untersucht werden, ob die transkutane elektrische Nervenstimulation in Verbindung mit Wärme eine länger anhaltende schmerzreduzierende Wirkung hat. An dieser Studie nahmen insgesamt 180 Patienten teil; diese wurden zufällig in 12 Gruppen eingeteilt. Die Teilnehmer erhielten Langzeit-Wärmeauflagen und wurden gleichzeitig 2 Stunden lang mit elektrischer Stimulation in 2 Intensitäten, 2 Frequenzen und 2 Kurvenformen behandelt. Endpunkte waren die subjektive Schmerzskala, der Bewegungsumfang des Rückens und die Hautdurchblutung des Rückens. Die Kontrollgruppen zeigten keine signifikanten Unterschiede in der Schmerzintensität, dem Bewegungsumfang oder der Hautdurchblutung beim Vergleich der zu Beginn und 4 Stunden nach der Behandlung erhobenen Daten (p> 0.05). Die transkutane elektrische Nervenstimulation zeigte eine geringfügige Schmerzlinderung, während alle anderen Gruppen eine signifikante Verbesserung im schmerzfreien Bewegungsumfang, der Schmerzreduzierung und der verbesserte Hautdurchblutung nach der 4-stündigen Behandlungszeit zeigten. Da die transkutane elektrische Nervenstimulation in Verbindung mit Langzeit-Wärmeauflagen eine bessere Wirkung zeigte als ohne diese oder als Langzeit-Wärmeauflagen als alleinige Therapie, scheint eine Kombination dieser beiden Therapiemöglichkeiten ein besseres Outcome in der Schmerztherapie für Angestellte im Gesundheitswesen zu bieten.

Keywords

electrical stimulation - back pain - low level continuous heat - blood flow

Schlüsselwörter

elektrische Stimulation - Rückenschmerzen - Langzeit- und Tiefenwärme - Durchblutung

Publication History

Received: 10 September 2019

Accepted: 30 January 2020

Article published online:
19 March 2020

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