12/31/2023 0 Comments Tinge unit for pain![]() ![]() ![]() Transcutaneous electrical nerve stimulation (TENS) has been used across the world for the management of acute and chronic pain irrespective of cause, including pain related to cancer and its treatment. Early pain management is critical to reduce the likelihood of acute pain developing into chronic pain. The goal of treatment is to relieve pain and improve physiological functioning associated with activities of daily living, role functioning associated with jobs and hobbies, and emotional, cognitive and social functioning associated with quality of life. 10 Desirable pain-management strategies adopt a biopsychosocial approach using pharmacological and non-pharmacological interventions tailored to the individual. In Europe, Breivik et al 9 estimated the national healthcare and socioeconomic costs of chronic pain to be 3%–10% of gross domestic product.Īpproximately 40% of people living with chronic pain report inadequate pain management and over 60% report that medication does not adequately control pain. This was greater than heart disease (US$309 billion), cancer (US$243 billion), and diabetes (US$188 billion). 7 8 Gaskin and Richard 7 estimated that annual costs related to healthcare and loss of worker productivity in the USA was between US$560 and US$635 billion. 2–6 Pain is financially expensive in terms of medical consultations, treatments and time lost from work, and socially expensive in terms of suffering and impaired quality of life. 1 Estimates of the worldwide prevalence of chronic pain in the general adult population suggest it may affect up to 45% of people, with up to 15% reporting severe disabling pain. Estimates of the prevalence of acute pain in adults suggest that it may be as high as 70.7% in accident and emergency departments and 50% in hospital inpatients, with up to 35% of patients reporting severe pain. This concern will be managed by conducting preplanned subgroup analyses of specific medical conditions based on International Statistical Classification of Diseases and Related Health Problems-11th Revision categories, and optimal TENS techniques. The main concern of this protocol is that the variety of types of pain and types of TENS interventions has potential for clinical and statistical heterogeneity. The main strength of this protocol is the assessment of TENS on pain associated with a variety of conditions and this will provide clinicians, policy-makers, and patients with a source of information on the effects of TENS for any type of pain. This protocol defines a systematic review with meta-analysis of randomised controlled clinical trials to evaluate the clinical efficacy and safety of TENS for any type of acute and chronic pain in adults. There has been a longstanding debate about the efficacy of transcutaneous electrical nerve stimulation (TENS) because systematic reviews for specific medical conditions have been inconclusive due to insufficient data. Subgroup analyses will include different pain conditions (eg, acute vs chronic), TENS intensity, during versus after TENS, TENS as a sole treatment versus TENS in combination with other treatments and TENS administered as a single dose versus repetitive dose. We will conduct meta-analyses to determine risk ratio for dichotomous data, and mean difference (MD) or standardised MD for continuous data for TENS versus placebo TENS, no treatment or waiting list control, standard of care, and other treatments. Primary outcomes will be: (i) participant-reported pain relief of ≥30% expressed as frequency (dichotomous) data and (ii) participant-reported pain intensity expressed as mean (continuous) data. Two reviewers will independently undertake RCT selection, data extraction and risk of bias assessment. We will screen the RCTs against eligibility criteria for inclusion in our review. Methods and analysis We intend to search electronic databases (Cochrane Library, MEDLINE, Embase, CINAHL, PsycINFO, LILACS, PEDRO, Web of Science, AMED and SPORTDiscus) from inception to the present day to identify all randomised controlled trials (RCT) on the use of TENS in adults for any type of pain including acute pain, chronic pain and cancer-related pain.
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