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7th EFSMA – European Congress of Sports Medicine, 3rd Central European Congress of Physical Medicine and Rehabilitation, Annual Assembly of the German and the Austrian Society of Physical Medicine and Rehabilitation

Austrian Society of Physical Medicine and Rehabilitation

26.-29.10.2011, Salzburg, Austria

Electrotherapy for the treatment of low back pain: a literature review

Meeting Abstract

  • author presenting/speaker Paul Kunsch - Department of Physical Medicine and Rehabilitation, Wilhelminenspital, Vienna, Austria
  • corresponding author Othmar Schuhfried - Department of Physical Medicine and Rehabilitation, Medical University of Vienna, Austria
  • Claudia Burmester - Department of Physical Medicine and Rehabilitation, Wilhelminenspital, Vienna, Austria
  • author Tatjana Paternostro-Sluga - Department of Physical Medicine and Rehabilitation, Medical University of Vienna, Austria
  • author Helmut Kern - Departement of Physical Medicine and Rehabilitation, Wilhelminenspital, Vienna, Austria

7th EFSMA – European Congress of Sports Medicine, 3rd Central European Congress of Physical Medicine and Rehabilitation. Salzburg, 26.-29.10.2011. Düsseldorf: German Medical Science GMS Publishing House; 2011. Doc11esm189

DOI: 10.3205/11esm189, URN: urn:nbn:de:0183-11esm1896

Published: October 24, 2011

© 2011 Kunsch et al.
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Outline

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Objective: The objective was a literature review of electrotherapy for the treatment of unspecific low back pain.

Material/Methods: A structured literature search in the electronic database Medline was conducted. The period of the literature search was from the time of the initiation of this database to June 2010. The key words low back pain, sciatic, lumbar spine, lumbar spinal were each connected with the following interventions electrotherapy, interferential current, interferential therapy, PEMF, pulsed electromagnetic fields, iontophoresis, transcutaneous electrical nerve stimulation, TENS, muscle stimulation, short wave therapy, diathermy. Only papers in English and German were reviewed. References of the included studies and literature reviews were also checked. For analysis only randomized controlled trials whose outcome measure was pain assessment were included. As a control application either a placebo or another physical modality or non medicamentous therapy has been accepted.

Results: The computer-assisted literature search produced 4523 papers. Of which 34 studies finally met our search criteria. The following data were extracted from each study: author, design, number of patients, age, acuity, intervention (type, intensity, duration) and control intervention, and results in particular with regard to pain assessment.

22 studies of TENS, 4 studies on Electrical Muscle Stimulation (EMS), 3 papers on interference current therapy, a study of PEMF (pulsing magnetic field therapy), 3 studies on short wave therapy (diathermy) and a paper on micro current therapy were analyzed.

Regarding TENS in 7 of 22 studies a significant reduction in pain was reported compared to the control group. In some of the remaining studies focusing on TENS a significant decrease in pain was found in the before-after comparison, compared to the control group (2x acupuncture, 1x percutaneous nerve stimulation) this decrease was equivalent. Regarding EMS in 3 of 4 trials a significant pain reduction compared to the control group was reported. For the interference current therapy, with none of 3 trials a significant reduction in pain compared to the control group was registered. In these studies in the before-after comparison, a clinically relevant pain reduction was apparent, which was equivalent in comparison to the control group (manipulation, combination massage and traction). In 2 of 3 studies on short-wave therapy a significant reduction in pain compared to the control group was reported. In the study concerning PEMF, but not in the study concerning microcurrent therapy, a significant pain reduction was observed in comparison to the control group.

Detailed results of each study will be presented in the congress.

Conclusion: A significant reduction of pain in non-specific low back pain can be found in 3 of 4 trials on EMS, in 2 of 3 trials on short-wave therapy and in the only study for pulsed magnetic field therapy. Therefore the use of these methods within the treatment concept for low back pain should be considered. On the most commonly studied method TENS no general statement about its use in non-specific low back can be made.

Eine signifikante Schmerzreduktion beim unspezifischen Kreuzschmerz zeigte sich in 3 von 4 Studien für die EMS, in 2 von 3 Studien über Kurzwellen-Therapie und in der einzigen Studie für die gepulste Magnetfeldtherapie. Der Einsatz dieser Methoden im Rahmen des Behandlungskonzept für den unspezifischen Kreuzschmerz kann daher empfohlen werden. Über die am häufigsten untersuchte Methode TENS kann derzeit keine allgemein gültige Aussage über den Evidenz-basierten Einsatz beim unspezifischen Kreuzschmerz getroffen werden.