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Age Group Comparisons of TENS Response Among Individuals With Chronic Axial Low Back Pain.

Publication ,  Journal Article
Simon, CB; Riley, JL; Fillingim, RB; Bishop, MD; George, SZ
Published in: J Pain
December 2015

UNLABELLED: Chronic low back pain (CLBP) is a highly prevalent and disabling musculoskeletal pain condition among older adults. Transcutaneous electrical nerve stimulation (TENS) is commonly used to treat CLBP, however response to TENS in older adults compared with younger adults is untested. In a dose-response study stratified by age, 60 participants with axial CLBP (20 young, 20 middle-aged, 20 older) received four 20-minute sessions of high-frequency high-intensity TENS over a 2- to 3-week period in a laboratory-controlled setting. Experimental measures of pain sensitivity (mechanical pressure pain detection threshold) and central pain excitability (phasic heat temporal summation and heat aftersensations) were assessed before and after TENS. Episodic or immediate axial CLBP relief was assessed after TENS via measures of resting pain, movement-evoked-pain, and self-reported disability. Cumulative or prolonged axial CLBP relief was assessed by comparing daily pain reports across sessions. Independent of age, individuals experienced episodic increase in the pressure pain detection threshold and reduction in aftersensation after TENS application. Similarly, all groups, on average, experienced episodic axial CLBP relief via improved resting pain, movement-evoked pain, and disability report. Under this design, no cumulative effect was observed as daily pain did not improve for any age group across the 4 sessions. However, older adults received higher TENS amplitude across all sessions to achieve TENS responses similar to those in younger adults. These findings suggest that older adults experience similar episodic axial CLBP relief to that of younger individuals after high-frequency, high-intensity TENS when higher dose parameters are used. PERSPECTIVE: This study examined age group differences in experimental and axial CLBP response to TENS, delivered under the current recommended parameters of strong, but tolerable amplitude. Older adults had comparable TENS response although at higher TENS amplitude than younger adults, which may have important mechanistic and clinical implications.

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Published In

J Pain

DOI

EISSN

1528-8447

Publication Date

December 2015

Volume

16

Issue

12

Start / End Page

1268 / 1279

Location

United States

Related Subject Headings

  • Transcutaneous Electric Nerve Stimulation
  • Self Report
  • Pressure
  • Pain Threshold
  • Pain Measurement
  • Pain Management
  • Middle Aged
  • Male
  • Low Back Pain
  • Humans
 

Citation

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Simon, C. B., Riley, J. L., Fillingim, R. B., Bishop, M. D., & George, S. Z. (2015). Age Group Comparisons of TENS Response Among Individuals With Chronic Axial Low Back Pain. J Pain, 16(12), 1268–1279. https://doi.org/10.1016/j.jpain.2015.08.009
Simon, Corey B., Joseph L. Riley, Roger B. Fillingim, Mark D. Bishop, and Steven Z. George. “Age Group Comparisons of TENS Response Among Individuals With Chronic Axial Low Back Pain.J Pain 16, no. 12 (December 2015): 1268–79. https://doi.org/10.1016/j.jpain.2015.08.009.
Simon CB, Riley JL, Fillingim RB, Bishop MD, George SZ. Age Group Comparisons of TENS Response Among Individuals With Chronic Axial Low Back Pain. J Pain. 2015 Dec;16(12):1268–79.
Simon, Corey B., et al. “Age Group Comparisons of TENS Response Among Individuals With Chronic Axial Low Back Pain.J Pain, vol. 16, no. 12, Dec. 2015, pp. 1268–79. Pubmed, doi:10.1016/j.jpain.2015.08.009.
Simon CB, Riley JL, Fillingim RB, Bishop MD, George SZ. Age Group Comparisons of TENS Response Among Individuals With Chronic Axial Low Back Pain. J Pain. 2015 Dec;16(12):1268–1279.
Journal cover image

Published In

J Pain

DOI

EISSN

1528-8447

Publication Date

December 2015

Volume

16

Issue

12

Start / End Page

1268 / 1279

Location

United States

Related Subject Headings

  • Transcutaneous Electric Nerve Stimulation
  • Self Report
  • Pressure
  • Pain Threshold
  • Pain Measurement
  • Pain Management
  • Middle Aged
  • Male
  • Low Back Pain
  • Humans