Efficacy of Selected Electrical Therapies on Chronic Low Back Pain: A Comparative Clinical Pilot Study

Abstract

BACKGROUND In the currently available research publications on electrical therapy of low back pain, generally no control groups or detailed randomization were used, and such studies were often conducted with relatively small groups of patients, based solely on subjective questionnaires and pain assessment scales (lacking measurement methods to objectify the therapeutic progress). The available literature also lacks a comprehensive and large-scale clinical study. The purpose of this study was to assess the effects of treating low back pain using selected electrotherapy methods. The study assesses the influence of individual electrotherapeutic treatments on reduction of pain, improvement of the range of movement in lower section of the spine, and improvement of motor functions and mobility. MATERIAL AND METHODS The 127 patients qualified for the therapy (ultimately, 123 patients completed the study) and assigned to 6 comparison groups: A - conventional TENS, B - acupuncture-like TENS, C - high-voltage electrical stimulation, D - interferential current stimulation, E - diadynamic current, and F - control group. RESULTS The research showed that using electrical stimulation with interferential current penetrating deeper into the tissues results in a significant and more efficient elimination of pain, and an improvement of functional ability of patients suffering from low back pain on the basis of an analysis of both subjective and objective parameters. The TENS currents and high voltage were helpful, but not as effective. The use of diadynamic currents appears to be useless. CONCLUSIONS Selected electrical therapies (interferential current, TENS, and high voltage) appear to be effective in treating chronic low back pain.

Figure 1

Flow diagram of the study.

Figure 2

Electrode placement in both TENS, HVES, and diadynamic current groups.

Figure 3

Electrode placement in Inteferiantial current group.

Figure 4

Stabilometric platform measurement method.

Figure 5

Intergroup comparisons of the pain intensity reduction in VAS scoring [%]. P (A,B,C,D,E,F)=0.034. Post hoc analysis: p(A,B)>0.05; p(A,C)>0.05; p(A,D)=0.041; p(A,E)=0.014; p(A,F)=0.016; p(B,C)>0.05; p(B,D)=0.038; p(B,E)=0.012; p(B,F)=0.012; p(C,D)=0.045; p(C,E)=0.012; p(C,F)=0.012; p(D,E)=0.001; p(D,F)=0.001; p(E,F)>0.05.

Figure 6

Intragroup comparisons of the pain intensity reduction in Laitinen scoring [%]. P (A,B,C,D,E,F)=0.026. Post hoc analysis: p(A,B)>0.05; p(A,C)>0.05; p(A,D)=0.018; p(A,E)=0.044; p(A,F)=0.044; p(B,C)>0.05; p(B,D)=0.018; p(B,E)=0.045; p(B,F)=0.044; p(C,D)=0.018; p(C,E)=0.045; p(C,F)=0.045; p(D,E)=0.001; p(D,F)=0.001; p(E,F)>0.05.

Figure 7

Intergroup comparisons of the disability level diminishment in Oswestry scoring [%]. P (A,B,C,D,E,F)=0.012. Post hoc analysis: p(A,B)>0.05; p(A,C)>0.05; p(A,D)=0.028; p(A,E)=0.036; p(A,F)=0.036; p(B,C)>0.05; p(B,D)=0.031; p(B,E)=0.037; p(B,F)=0.038; p(C,D)=0.028; p(C,E)=0.038; p(C,F)=0.038; p(D,E)=0.001; p(D,F)=0.001; p(E,F)>0.05.

Figure 8

Intergroup comparisons of the disability level diminishment in Roland-Morris scoring [%]. p(A,B,C,D,E,F)=0.055 (close to the significant level). Post hoc analysis: p(A,B)>0.05; p(A,C)>0.05; p(A,D)=0.035; p(A,E)>0.05; p(A,F)>0.05; p(B,C)>0.05; p(B,D)=0.038; p(B,E)>0.05; p(B,F)>0.05; p(C,D)=0.033; p(C,E)>0.05; p(C,F)>0.05; p(D,E)=0.037; p(D,F)>0.05; p(E,F)>0.05.

Figure 9

Intergroup comparisons of the hip join mobility improvement in Lasègue testing [%]. p(A,B,C,D,E,F)=0.031. Post hoc analysis: p(A,B)>0.05; p(A,C)>0.05; p(A,D)=0.041; p(A,E)=0.018; p(A,F)=0.018; p(B,C)>0.05; p(B,D)=0.043; p(B,E)=0.017; p(B,F)=0.018; p(C,D)=0.046; p(C,E)=0.018; p(C,F)=0.018; p(D,E)=0.001; p(D,F)=0.001; p(E,F)>0.05.

Figure 10

Intergroup comparisons of the lower Th mobility improvement in Schober testing [%]. p(A,B,C,D,E,F)=0.036. Post hoc analysis: p(A,B)>0.05; p(A,C)>0.05; p(A,D)>0.05; p(A,E)=0.018; p(A,F)=0.020; p(B,C)>0.05; p(B,D)>0.05; p(B,E)=0.015; p(B,F)=0.016; p(C,D)>0.05; p(C,E)=0.018; p(C,F)=0.014; p(D,E)=0.008; p(D,F)=0.008; p(E,F)>0.05.