Effectiveness of Transcutaneous Electrical Nerve Stimulation (TENS) as a sole treatment for acute pain in adults

TENS is a form of electrical current that can be applied to the skin with the aim of providing pain relief. The objective of this review was to determine how effective TENS was in relieving acute pain in adults when applied as a sole treatment. The database searches identified 1775 studies; of these, 12 met the inclusion criteria for the review with a total of 919 participants. Analysis of the combined results of these 12 studies was not possible due to insufficient extractable data. There is insufficient evidence to draw any conclusions about the effectiveness of TENS for the treatment of acute pain in adults.

Authors' conclusions: 

There are no changes to the conclusions since the original version of the review was published in issue 2, 2009. Due to insufficient extractable data in the studies included in this review, we are unable to make any definitive conclusions about the effectiveness of TENS as an isolated treatment for acute pain in adults.

Read the full abstract...

This is an updated version of the original Cochrane review published in Issue 2, 2009. Transcutaneous Electrical Nerve Stimulation (TENS) is a non-pharmacological agent, based on delivering low voltage electrical currents to the skin. TENS is used for the treatment of a variety of pain conditions.


To assess the analgesic effectiveness of TENS for acute pain in adults to see if it had any analgesic effect in its own right.

Search strategy: 

The following databases were searched: Cochrane Pain, Palliative and Supportive Care Group Specialised Register; the Cochrane Central Register of Controlled Trials, CENTRAL (in The Cochrane Library); MEDLINE; EMBASE; CINAHL; AMED; PEDro; OTseeker; OpenSIGLE; and, reference lists of included studies. The most recent search was undertaken on January 7th 2011.

Selection criteria: 

Randomised controlled trials (RCTs) of adults with acute pain (less than 12 weeks) were included if they examined TENS given as a sole treatment and assessed pain with subjective pain scales. Studies were eligible if they compared TENS to placebo TENS, no treatment controls, pharmacological interventions or non-pharmacological interventions. Studies on experimental pain, case reports, clinical observations, letters, abstracts or reviews were excluded. Studies on TENS and labour pain, pain due to dental procedures and primary dysmenorrhoea were excluded. Studies where TENS was given with another treatment as part of the formal study design were also excluded. No restrictions were made regarding language.

Data collection and analysis: 

Two review authors independently assessed study eligibility and extracted data. Data were extracted on the following: types of participants and pain condition, study design and methods, treatment parameters, adverse effects, and outcome measures. Study authors were contacted for additional information if necessary.

Main results: 

No new included studies were included in this update, however, two new studies are awaiting classification. Of 1775 studies identified in the search, 163 were identified as relevant. Of these, 145 were excluded; the vast majority of these were excluded due to TENS being given with another treatment. Six studies were categorised as awaiting classification as the information provided in the full text failed to clarify their eligibility. Twelve RCTs involving 919 participants at entry were included. The types of acute pain conditions included procedural pain, e.g. cervical laser treatment, venipuncture, screening flexible sigmoidoscopy and non-procedural pain, e.g. postpartum uterine contractions, rib fractures. It was not possible to perform a meta-analysis due to insufficient data.