Skip to main content

Research Repository

Advanced Search

Problems, solutions, and strategies reported by users of TENS for chronic musculoskeletal pain: A qualitative exploration using patient interviews

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


Peter William Gladwell

Fiona Cramp

Peter Gladwell

Fiona Cramp
Professor in Long Term Conditions

Kathryn Badlan

Profile Image

Shea Palmer
Occasional Associate Lecturer - HAS - HSW


BACKGROUND: Transcutaneous Electrical Nerve Stimulation (TENS) could offer a non-drug form of pain relief, but there is no consensus regarding its effectiveness for 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 inform the development of a pragmatic implementation design for a TENS evaluation.
OBJECTIVES: To explore the experiences of secondary care Pain Clinic patients with expertise in using TENS to manage chronic musculoskeletal pain. These key informants were selected as they had the potential to generate knowledge which could inform research design and clinical practice.
DESIGN: A qualitative method using individual semi- Structured interviews with open questions was selected for its capacity to generate rich data.
METHODS: Semi-structured interviews were conducted with nine patients (6 women). Thematic analysis was used as the primary data analysis method, and this was enhanced by a case level analysis of the context and processes of TENS use of each individual.
FINDINGS: Data analysis indicated that patients learned to address a range of problems in order to optimise TENS use. Patients may need to personalise the positioning of electrodes, and the TENS settings, and to re-adjust these over time. Patients learned to use TENS in a strategic manner, and the outcomes of each strategy varied.
CONCLUSIONS: The findings indicated that a pragmatic TENS evaluation may need to incorporate a learning phase to allow patients to optimise this complex pattern of TENS usage, and evaluation may need to be sensitive to the outcomes of strategic use. These findings also have implications for clinical practice.


Gladwell, P., Badlan, K., Cramp, F. (., & Palmer, S. (2016). Problems, solutions, and strategies reported by users of TENS for chronic musculoskeletal pain: A qualitative exploration using patient interviews. Physical Therapy, 96(7), 1039-1048.

Journal Article Type Article
Acceptance Date Dec 6, 2015
Publication Date Dec 17, 2016
Journal Physical Therapy
Print ISSN 0031-9023
Publisher Oxford University Press (OUP)
Peer Reviewed Peer Reviewed
Volume 96
Issue 7
Pages 1039-1048
Keywords musculoskeletal pain, TENS, interviews
Public URL
Publisher URL
Additional Information Additional Information : Copyright 2016 American Physical Therapy Association


You might also like

Downloadable Citations