Key Takeaway
TENS significantly reduces knee osteoarthritis pain and stiffness while improving physical function compared to sham treatment.
Summary
This systematic review and meta-analysis evaluated TENS efficacy for knee osteoarthritis across 18 randomized controlled trials with 813 participants.
Key findings:
- Pain reduction: Significant decrease in VAS pain scores (MD: -1.24, 95% CI: -1.81 to -0.67)
- Stiffness: Significant improvement in WOMAC stiffness subscale
- Physical function: Improved WOMAC function scores
- Quality of life: Modest improvements reported
Effective parameters:
- High frequency (80-100 Hz) most studied
- Session duration: 20-40 minutes
- Frequency: 3-5 sessions per week
- Duration: 2-4 weeks for significant benefit
Comparison to other treatments:
- Effect size comparable to NSAIDs for pain relief
- Additive benefit when combined with exercise
- Fewer side effects than pharmacological options
Patient selection:
- Most effective in mild-to-moderate OA
- Benefits both younger and older patients
- Can be used as adjunct to other therapies
Clinical significance:
Strong evidence supporting TENS as non-pharmacological first-line option for knee OA, especially for patients seeking to reduce medication use.