Applications of transcutaneous electrical nerve stimulation in the management of patients with pain. State-of-the-art update.

Numerous publications devoted to the topic of transcutaneous electrical nerve stimulation (TENS) have appeared since the presentation of a special issue of Physical Therapy (December, 1978). This update article addresses contemporary information on efficacy, mode of application, treatment outcomes, and neurophysiological mechanisms relevant to this modality. Investigators have become far more specific when presenting this information in the current literature on treating acute pain conditions with TENS than they were in the literature for the 1978 special issue. Improvement has been made in providing specific details to enable replication of TENS stimulating characteristics among patients with chronic pain; yet several clinical researchers still fail to evaluate treatment outcomes adequately. Perhaps the greatest advances in our understanding of TENS involve the recent development of mechanisms that might account for how different types of TENS work. Suggestions for predicting patient responses to TENS and for avenues of future inquiry are offered.