The influence of transcutaneous electrical nerve stimulation parameters on the level of pain perceived by participants with painful diabetic neuropathy: A crossover study

Aims: This pilot study aimed to investigate and compare the perceived pain relief effectiveness of two different modes of TENS in people with painful diabetic neuropathy (PDN).

Methods: A cross-over study was conducted at Charles Sturt University, Orange. Five participants with PDN were assessed with a McGill Pain Questionnaire before and after each of the two TENS treatments. Participants were randomly allocated to Traditional TENS (80 Hz, 200 ms) or Acupuncture-like TENS (2 Hz, 200 ms) and the treatments were applied daily for 30 minutes over ten days. Following a seven day washout period, the alternate mode of TENS was carried out using the same method. Wilcoxon Signed Rank tests were used to statistically analyse the results.

Results: All five participants reported personally meaningful pain relief during one or both of the TENS treatments. The Wilcoxon signed rank testing showed no statistical significance, p = 1, likely due to the small sample size. Acupuncture-like TENS had a large effect size (z = −1.625, r = 0.514), whilst Traditional TENS produced a medium effect size (z = −1.214, r = 0.384). No adverse effects were reported.

Conclusion: Acupuncture-like TENS may be more effective for PDN than traditional TENS. A larger scale replication of this pilot study is warranted.