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Technique to Relieve Low Back Pain

Technique to Relieve Low Back Pain

A treatment that blends the ancient practice of Chinese acupuncture with the newer Western technique of electrical nerve stimulation is bringing superior relief to people with chronic low back pain (LBP), according to the results of a study conducted by anesthesiologists at the University of Texas Southwestern Medical Center at Dallas.

The technique, known as percutaneous electrical nerve stimulation (PENS), reduced the need for pain medication by half for LBP patients, the researchers reported at the annual meeting of the American Society of Anesthesiologists.

That could be good news for many of the millions of Americans who suffer from LBP, because the most common treatment, oral or injected pain medication, can have negative side effects, principal investigator Paul F. White, M.D., Ph.D., said. Traditional treatment can include narcotic pain relievers but they can cause drowsiness and chemical dependence if used long-term. Other treatments involving the use of non-narcotic analgesics can interfere with bowel and bladder function, he said.

"Used as part of a comprehensive treatment plan, PENS offers a highly effective supplement to these traditional pain relievers," Dr. White said. PENS has been used for several years, but its effectiveness as a pain reliever has never been studied, he said.

The technique relies on the same basic approach as transcutaneous electrical nerve stimulation (TENS), a pain management method that delivers low levels of electrical current to the nerves supplying the affected area. One theory holds that electrical stimulation works by interrupting pain signals in the central nervous system.

Unlike TENS, which delivers electrical current through special pads positioned on the skin surface, PENS penetrates the skin via a series of ultra-fine, acupuncture-like needles. Anesthesiologists use Western, not Eastern, principles of neuroanatomy in determining where to place the needles, however, Dr. White noted. A study of 60 patients with chronic LBP found PENS to be significantly more effective in decreasing pain than either sham-PENS (a placebo), TENS or exercise alone. Patients received each treatment for 30 minutes three times per week for three weeks. They rated their level of pain, physical activity and quality of sleep on a scale of 0 to 10 after completing each type of treatment. After receiving all four treatments, they completed an overall questionnaire.

Ninety-one percent of patients rated PENS as the most effective pain reliever, Dr. White reported. Patients also scored PENS significantly higher than the other treatments for its ability to improve physical activity, quality of sleep and their sense of "well-being."

In addition, 80 percent of patients said they would be willing to pay "out of pocket" to receive PENS therapy. "PENS is more effective than conventional TENS or exercise in improving short-term outcome in patients with LBP," Dr. White said. "Now we need to look at its long-term effectiveness."