Elsevier

EXPLORE

Volume 18, Issue 1, January–February 2022, Pages 108-113
EXPLORE

Review Article
The effect of TENS for pain relief in women with primary dysmenorrhea: A systematic review and meta-analysis

https://doi.org/10.1016/j.explore.2020.08.005Get rights and content

Highlights

Abstract

Objective

Primary dysmenorrhea (PD) is a chronic health condition that affects primarily young women and interferes with daily activities, causes loss of work productivity, and reduces quality of life. Transcutaneous electrical nerve stimulation (TENS) is a complementary and alternative therapy used to reduce pain related to PD. The purpose of this meta-analysis study was to evaluate the effectiveness of TENS in the treatment of pain in women with PD.

Methods

A search of the English literature in the Cochrane Library, MEDLINE (EBSCO), Physiotherapy Evidence Database (PEDro), CINAHL (EBSCO), PUBMED, OVID, Science Direct, Scopus, Academic Search Complete databases was conducted using combinations of the following search terms: ‘primary dysmenorrhea’, ‘pain’, ‘transcutaneous electrical nerve stimulation’, ‘TENS’, and ‘electrical stimulation’. All content from database inception through April 2020 was included in the search.

Results

The initial search strategy based on date range and language yielded 571 relevant records and 4 of them were about both TENS and PD. A total of 260 patients were enrolled in the included studies. In all of the included studies, the comparison intervention consisted of sham TENS. The primary outcome of interest was pain intensity. Our analysis indicated that TENS was statistically more effective than sham TENS in reducing PD-related pain (SMD=1.384; 95% CI=0.505, 2.262; p = 0.002).

Conclusion

TENS is a safe and well-tolerated electrophysical therapy that may be effective for relieving pain in PD.

Section snippets

Background

Dysmenorrhea is a gynecological problem that refers to menstruation with pelvic pain.1 Dysmenorrhea can be classified as primary and secondary dysmenorrhea based on the pathophysiology.2 Primary dysmenorrhea is defined as painful menstruation that occurs in the absence of any detectable pelvic pathology. The pain starts before or within a few hours of menstrual bleeding and can continue for 12 to 72 h.3 Uterine contractions triggered by progesterone withdrawal result in uterine ischemia,

Methods

This systematic review was reported according to principles of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.15

Study selection

The initial search strategy based on date range and language yielded 571 records. After duplicates were removed, the titles and abstracts of 17 articles were screened for applicability. Of these, 15 full-text articles were retrieved for review, with 4 studies meeting the final inclusion criteria. The flow of study selection and reasons for exclusion at the final stage are summarized in a PRISMA diagram (Fig. 1).

Description of included studies

Three of the 4 studies included in this review were randomized controlled trials

Discussion

To our knowledge, this is the most recent systematic review and meta-analysis study to evaluate the effectiveness of TENS in pain reduction in PD. Four studies met the inclusion criteria and were included in the study. The results of our analysis indicate that TENS may be an effective non-pharmacological method for pain relief in women with PD.

According to latest published overview about TENS and PD, the best clinical recommendations for TENS parameters were biphasic waveform, high-frequency

Strengths and limitations

To the best of our knowledge, this is the first systematic review and meta-analysis evaluating the effectiveness of TENS in reducing pain in PD. The study was conducted by 4 experienced physiotherapists and followed a structured study protocol to guide the search strategy, study selection, data extraction, and statistical analysis in order to reduce bias and error. Another strength of the study was that only randomized controlled and randomized crossover controlled studies were included.

The

Conclusions

TENS is a safe and well-tolerated electrophysical therapy that may be effective for relieving pain in women with PD.

Funding

The authors received no financial support for the research, authorship, and/or publication of this article.

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    • Cited by (14)

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