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

J, Pasternok M, Rajfur K, Walewicz K, Fras B, Bolach B, Dymarek R, Rosinczuk J,
Halski T, & Taradaj J. Med Sci Monit. 23:
85-100. doi: 10.12659/MSM.899461

Take Home Message: Various electrical stimulation treatments
over the course of 3 weeks resulted in improved low back pain.  Interferential stimulation seemed to have the
best outcomes in patients with low back disc degeneration. 

Low back pain can be very
debilitating and cause significant pain. 
Clinicians often use various transcutaneous electrical nerve stimulation
(TENS) techniques to help manage chronic low back pain.  There is little research to support TENS use,
therefore these authors compared the effects of various electrical stimulation
treatments on pain, range of motion, and function among individuals with low
back pain.  Patients with low back pain
due to disc degeneration were randomized to treatment groups for approximately
3 weeks: conventional TENS (20 participants), Acupuncture-like TENS (20
participants), high-voltage electrical stimulation (20 participants), interferential
(21 participants),
diadynamic (22 participants), & control/rehabilitation-only (21
participants).   All participants,
regardless of group, performed basic rehabilitation exercises.  Their pain, disability, mobility, and
postural stability were measured before and after the 3-week treatment
period.  All groups improved in pain,
disability, mobility, and postural stability. 
Upon closer investigation, the authors reported better results for participants
in the interferential treatment group in all areas, and the least amount of
improvements for the patients in the diadynamic treatment group.  While there were improvements over the 3
weeks, the largest disparity appeared to be that diadynamic and control groups
showed significantly lower improvements than the other 4 electrical stimulation

These findings are interesting
because it shows that there are significant improvements after 3 weeks of
treatment with various electrical stimulation treatments or rehabilitation
alone.  Interestingly, the authors
appeared to have the best outcomes among participants who received a 20-minute interferential
treatment 3 times per week, with the theory that this treatment penetrates
deeper into the tissues.  This is
somewhat surprising since the interferential treatment parameters were only
sensory in nature, and was the shortest treatment time – with other treatments
ranging from 50 to 60 minutes.  It would
be interesting to see what clinical outcomes might be if a clinician performed
an interferential treatment with a lower frequency to try to stimulate the a-delta nerve fibers.  The theory about
interferential treatment penetrating deeper into tissues is one that is often
referenced, but it would be interesting if a research study could prove this
more definitively.  The authors also noted
that the diadynamic therapy appeared to have the least effect and failed to provide
much of a clinical benefit, especially with other options available.  Diadynamic therapy was one that I was less familiar
with, and it appears that it is not a valuable addition into clinical
practice.  Overall, electrical
stimulation treatments appear to improve symptoms and function over the course
of a 3-week time frame, with interferential having the most optimal
outcomes.  However, these results should
be interpreted with caution given the exploratory nature of this study.      

for Discussion:  What are your thoughts
on sensory electrical stimulation?  What
modalities do you typically use for chronic low back pain? 

Nicole Cattano
by: Jeffrey Driban


Rajfur, J., Pasternok, M., Rajfur, K., Walewicz, K., Fras, B., Bolach, B., Dymarek, R., Rosinczuk, J., Halski, T., & Taradaj, J. (2017). Efficacy of Selected Electrical Therapies on Chronic Low Back Pain: A Comparative Clinical Pilot Study Medical Science Monitor, 23, 85-100 DOI: 10.12659/MSM.899461