The Effects of Transcutaneous Electrical Nerve Stimulation on Pain and Function in Patients with Knee Osteoarthritis: A Critically Appraised Topic

Purp o se: Knee osteoarthritis (OA) is a common condition that impacts upwards of 40% of patients over the age of 70, and transcutaneous electrical stimulation (TENS) is a common treatment protocol. To date, there is no consensus on the effectiveness of TENS as a modality for knee OA. Thus, this critically appraised topic (CAT) aims to determine the impact of TENS on the pain and functional outcome of patients with knee OA. Metho d s : To assess the therapeutic efficacy of TENS, a systematic search of the available literature was conducted, focusing on pain and function in knee osteoarthritis. Online databases were searched for studies involving TENS and knee OA with regard to pain and functional status. The original search reported 136 studies. However, after utilizing inclusion and exclusion criteria, 3 studies were selected for this CAT. R es ul ts: Three studies demonstrated that TENS intervention did not lead to additional clinical benefits beyond placebo in clinicallyand radiologically-significant knee OA. In pre -radiographic, radiologically-insignificant knee OA, TENS intervention led to a reduction in pain and improvement in functional outcomes such as walking distance. Conclusions: Findings suggest that TENS is not a viable option for significant pain reduction or functional improvement in the setting of clinicallyand radiologically-significant knee OA. However, there may be a small window of therapeutic effectiveness in early, pre -radiographic knee OA. Based on the evidence presented in this study, we do not recommend the incorporation of TENS into the comprehensive management strategy for clinicallyand radiologicallysignificant knee OA.