TRANSCUTANEOUS ELECTRICAL NERVE-STIMULATION IN THE TREATMENT OF CHRONIC PAIN - PREDICTIVE FACTORS AND EVALUATION OF THE METHOD

Objective: Transcutaneous electrical nerve stimulation (TENS) is a wid ely used therapeutic approach in acute and chronic pain syndromes. The aim of this study was to investigate the influence of patient managem ent as well as other factors on the outcome of TENS treatment. Design: The study was carried out as a retrospective analysis of the course o f treatment and the therapeutic results of transcutaneous electric ner ve stimulation (TENS) in 482 patients with chronic pain of various ori gins. The follow-up period was up to 48 months. Two groups with differ ing patient management were compared. Results: Competent patient evalu ation and education (i.e., a long testing and learning phase as well a s regular comprehensive after-care) was found to be important, Our ana lysis of the reasons for the discontinuation of long-term TENS therapy showed that the most important feature was the discrepancy between ef fort and therapeutic result, Other causes were intermittent depressive states and progression of the underlying disease followed by an aggra vation of pain. In addition, numerous factors were identified that adv ersely affected the outcome of TENS treatment. These factors were list ed in order of importance and were included in a prognostic score. Con clusions: The prognostic score permits an efficient selection of patie nts. Moreover, a comprehensive documentation of pain syndromes and the ir organic, psychogenic, and social features is presented. On the basi s of this documentation, an appropriate therapeutic concept may be est ablished. The prognostic score was validated in a subsequent study inc luding 99 patients with chronic pain treated with TENS.