Percutaneous Electrical Nerve Stimulation for Low Back Pain

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Abstract
Despite the fact that low back pain (LBP) is one of the most common medical problems in our society,1 current analgesic therapies remain largely unsatisfactory. Conservative treatment with anti-inflammatory drugs and exercise is effective for many patients with acute LBP.2 However, when the pain symptoms persist, they can interfere with both physical activity and sleep patterns. While analgesic medications can provide temporary pain relief, these drugs may not improve physical function and are associated with well-known adverse effects. Interest in nonpharmacologic alternatives has led to evaluations of transcutaneous electrical nerve stimulation (TENS),3 acupuncture,4,5 electroacupuncture,6 spine manipulation,7-9 and exercise therapy9-12 in the management of LBP. However, controversy exists regarding the relative efficacy of these nonpharmacologic therapies in the management of LBP because most of the published studies lacked appropriate control (sham) groups or failed to include relevant comparators.