Use of Transcutaneous Electrical Nerve Stimulation Device in Early Osteoarthritis of the Knee

Some have suggested the use of transcutaneous electrical nerve stimulation (TENS) as an adjunct to the current standard of care in treatment of osteoarthritis knee pain. The objective of this study was to evaluate the effects of TENS on the following issues in patients who have early-stage osteoarthritis of the knee: (1) pain reduction; (2) subjective and (3) objective functional improvements; (4) quality-of-life (QOL) measure improvements; and (5) isokinetic strength. A prospective, randomized, and single-blinded trial was performed on 23 patients who were randomized to either novel TENS device or standard of care. Metrics analyzed consisted of stair-climb test; timed-up-and-go test (TUGT); 2-minute walk test; 20 times, single leg 6-inch step test; five-repetition chair-rise test; active and passive range-of-motion (ROM) score; short form health survey-36 scores (SF-36) score; Knee Society Score (KSS); lower extremity functional scale (LEFS); visual analog scale (VAS); and isokinetic quadriceps and hamstring strength. In objective functional scores, TENS showed significant improvements in TUGT and objective KSS when compared with the matching cohort. Subjective functional and QOL outcomes patients had a significant improvement of their LEFS and SF-36 physical component with the use of TENS brace. The TENS device significantly improved the quadriceps strength when compared with standard therapy. In evaluation for improvement within the TENS cohort, patients had a significant improvement at 3-month follow-up in the TUG test, timed stair-climb test, 20-times single leg, KSS, LEFS, and SF-36 physical component compared to their first visit. Also, within the TENS cohort, patients had a significant reduction in pain via VAS at their 3-month follow-up.

The use of TENS for 3 months has exhibited promising results to improve pain, function, and QOL in patients with painful osteoarthritic knees, and could positively contribute as an adjunct to current nonoperative treatment of knee arthritis. However, due to the small sample size, larger randomized studies are required to further evaluate these outcomes.