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Direct and indirect benefits reported by users of transcutaneous electrical nerve stimulation for chronic musculoskeletal pain: Qualitative exploration using patient interviews

Gladwell, Peter William; Badlan, Kathryn; Cramp, Fiona (Alice); Palmer, Shea

Authors

Peter William Gladwell

Kathryn Badlan kathryn.badlan@uwe.ac.uk

Fiona Cramp Fiona.Cramp@uwe.ac.uk
Professor in Long Term Conditions

Shea Palmer Shea.Palmer@uwe.ac.uk
Professor in Allied Health Professions



Abstract

© 2015 American Physical Therapy Association. Background. There is no consensus regarding the effectiveness of transcutaneous electrical nerve stimulation (TENS) for management of chronic musculoskeletal pain or chronic low back pain. A recent review of previous trial methodology identified significant problems with low treatment fidelity. There is little information available to guide selection of patient-reported outcome measures appropriate for TENS evaluation. Objectives. The purpose of this study was to explore the experiences of patients at a secondary care pain clinic who successfully used TENS to help manage chronic musculoskeletal pain. These key informants were selected because they had the potential to generate knowledge that could inform research design and clinical practice. Design. A qualitative method using individual semistructured interviews with open questions was selected for its capacity to generate rich data. Methods. A mini focus group informed the development of a discussion guide for semistructured interviews with 9 patients (6 women, 3 men). Thematic analysis was used as the primary data analysis method, and this analysis was enhanced by a case-level analysis of the context and processes of TENS use of each individual. Results. Data analysis indicated that distraction from pain and a reduction in the sensations associated with muscle tension or spasm should be considered as separate outcomes from pain relief. These direct benefits led to a wide range of indirect benefits dependent on patient decision making, including medication reduction, enhanced function, psychological benefits, and enhanced ability to rest. Conclusions. The findings indicate that evaluating TENS using a unidimensional pain scale is likely to overlook potential benefits. The complex pattern of TENS usage, as well as multiple direct and indirect outcomes, indicates that TENS could be considered as a complex intervention.

Journal Article Type Article
Publication Date Jan 1, 2015
Journal Physical Therapy
Print ISSN 0031-9023
Electronic ISSN 1538-6724
Publisher Oxford University Press (OUP)
Peer Reviewed Peer Reviewed
Volume 95
Issue 11
Pages 1518-1528
APA6 Citation Gladwell, P. W., Badlan, K., Cramp, F. (., & Palmer, S. (2015). Direct and indirect benefits reported by users of transcutaneous electrical nerve stimulation for chronic musculoskeletal pain: Qualitative exploration using patient interviews. Physical Therapy, 95(11), 1518-1528. https://doi.org/10.2522/ptj.20140120
DOI https://doi.org/10.2522/ptj.20140120
Keywords transcutaneous electrical nerve stimulation, chromic muscoloskeletal pain, qualitative, patient interviews
Publisher URL http://dx.doi.org/10.2522/ptj.20140120
Additional Information Additional Information : This article is Copyright [2015] American Physical Therapy Association. Article on publisher's website available at http://dx.doi.org/10.2522/ptj.20140120

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