Efficacy of transcutaneous electrical nerve stimulation as a treatment for phantom limb pain
Roberta Veiga Pestana Visco Costa 1, Pedro Lucca Alves Bastos 2, João Gustavo dos Anjos Morais Oliveira 2, Letícia Escorse Requião 2, Ana Flávia Paiva Bandeira Assis 2, Luís Emanuel Reis dos Santos 3, Gilcielma Gomes de Lemos 3
1 Medical students at the University of Salvador (UNIFACS), Salvador, Bahia, Brazil. 2 Medical students at the Bahiana School of Medicine and Public Health, Salvador, Bahia, Brazil.
3 Medical students at the Federal University of Bahia, Salvador, Bahia, Brazil.
OBJECTIVE: Describe the effectiveness of transcutaneous electrical nerve stimulation (TENS) as a treatment for patients affected by phantom limb pain.
METHODS: This is a systematic review in which the bibliographic search was performed in the Pubmed/Medline database based on the keywords “Phantom limb”, “Pain” and “Transcutaneous Electric Nerve Stimulation” joined by the boolean operator “AND”. Studies from 2010 that investigated transcutaneous electrical nerve stimulation as treatment in amputee patients with phantom limb pain were included.
RESULTS: Of the 13 articles found, 9 were included after evaluation by two independent reviewers to verify their relevance for this review. Of these, approximately 67% of the findings agreed showing some benefit in the use of TENS in the treatment of phantom limb pain, exemplified in a significant clinical pain relief in 14 of 16 analyzed patients in a case series. It was also evidenced in a separate study that, when directing TENS to the main affected area, a pain reduction in the limb, at rest and in movement, was reported. On the other hand, there was some doubt about the effectiveness of this treatment, observed in 3 of the analyzed articles, which can be illustrated by the scarcity of randomized clinical trials, making it impossible to safely measure its effectiveness.
CONCLUSIONS: Although its effectiveness can still be questioned, transcutaneous electrical nerve stimulation demonstrates potential, requiring further supporting studies with greater scientific relevance to legitimize its effectiveness.
KEYWORDS: Transcutaneous Electric Nerve Stimulation, Pain, Phantom limb.
FUNDING/FINANCIAL SUPPORT: None