Cancer-related pain is complex and multidimensional but is mostly managed using drug therapy. There is increasing recognition of the need for non-drug approaches and TENS may have a significant role to play. Only two studies met eligibility criteria for this review. TENS was given to five participants in one study and 41 participants in the other. Consequently, there is insufficient evidence to judge whether TENS should be used in adults with cancer-related pain. Further research using well designed clinical trials is needed to improve knowledge in this field.

This is a Cochrane review abstract and plain language summary, prepared and maintained by The Cochrane Collaboration, currently published in The Cochrane Database of Systematic Reviews 2010 Issue 7, Copyright © 2010 The Cochrane Collaboration. Published by John Wiley and Sons, Ltd.. The full text of the review is available in The Cochrane Library (ISSN 1464-780X).
This record should be cited as: Robb KA, Bennett MI, Johnson MI, Simpson KJ, Oxberry SG. Transcutaneous electric nerve stimulation (TENS) for cancer pain in adults. Cochrane Database of Systematic Reviews 2008, Issue 3. Art. No.: CD006276. DOI: 10.1002/14651858.CD006276.pub2

Editorial Group: Pain, Palliative and Supportive Care Group

This version first published online: July 16. 2008
Last assessed as up-to-date: April 21. 2008

Abstract

Background

Cancer-related pain is complex and multi-dimensional but the mainstay of cancer pain management has predominately used a biomedical approach. There is a need for non-pharmacological and innovative approaches. Transcutaneous Electric Nerve Stimulation (TENS) may have a role for a significant number of patients but the effectiveness of TENS is currently unknown.

Objectives

The aim of this systematic review was to determine the effectiveness of TENS for cancer-related pain in adults.

Search strategy

We searched The Cochrane Library, MEDLINE, EMBASE, CINAHL, PsychINFO, AMED and PEDRO databases (11/04/08).

Selection criteria

Only randomised controlled trials (RCTS) investigating the use of TENS for the management of cancer-related pain in adults were included.

Data collection and analysis

The search strategy identified 37 possible published studies which were divided between two pairs of review authors that decided on study selection. A study eligibility form was used to screen each abstract and where study eligibility could not be determined from the abstract, the full paper was obtained and assessed by one pair of review authors. A standardised data extraction sheet was used to collect information on the studies and the quality of the studies was assessed independently by two review authors using the validated five-point Oxford Quality Scale. Final scores were discussed and agreed between all four review authors. The small sample sizes and differences in patient study populations of the two included studies prevented meta-analysis.

Main results

Only two RCTs met the eligibility criteria (64 participants). These studies were heterogenous with respect to study population, sample size, study design, methodological quality, mode of TENS, treatment duration, method of administration and outcome measures used. In one RCT, there were no significant differences between TENS and placebo in women with chronic pain secondary to breast cancer treatment. In the other RCT, there were no significant differences between acupuncture-type TENS and sham in palliative care patients; this study was underpowered.

Authors' conclusions

The results of this systematic review are inconclusive due to a lack of suitable RCTs. Large multi-centre RCTs are required to assess the value of TENS in the management of cancer-related pain in adults.

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