Brazilian Journal of Pain
https://brjp.org.br/article/doi/10.5935/2595-0118.20210005
Brazilian Journal of Pain
Original Article

Effect of transcutaneous electrical nerve stimulation and hypnosis on chronic low back pain

Efeito da estimulação elétrica nervosa transcutânea e hipnose na dor lombar crônica

Carolina Weizemann; Nathielly Flores Camargo; Taise Vieira Barboza; Alberito Rodrigo de Carvalho; Gladson Ricardo Flor Bertolini

http://dx.doi.org/10.5935/2595-0118.20210005 BrJP, vol.4, n1, p.26-30, 2021
PDF English
PDF Português
SciELO
Downloads: 2
Views: 578

Abstract

BACKGROUND AND OBJECTIVES: Among the main non-pharmacological analgesic techniques are physical therapies such as electrotherapy and cognitive-behavioral techniques, such as hypnosis. The objective of this study was to compare the analgesic effect of transcutaneous electrical nerve stimulation (TENS) and hypnosis in the control of chronic low back pain.

METHODS: A crossover study that included 19 young adults of both genders with chronic low back pain who underwent TENS and hypnosis, and pain education as a control group. The quality of pain was assessed by the McGill’s questionnaire; pain intensity and threshold were assessed by the visual analog scale. The intensity of spontaneous pain, the threshold and intensity of pain induced by cold and the pressure pain threshold before the interventions, immediately after the interventions and 30 minutes after the end of the interventions were evaluated. Statistical analysis was performed with Generalized Mixed Linear Models, with 5% significance, and Cohen’s G effect sizes.

RESULTS: There was a statistically significant decrease in the intensity of spontaneous and cold induced pain in the hypnosis and TENS groups compared to the pain education group. There was a statistically significant reduction of pain in the sensory and evaluation categories in the intervention groups compared to the control group. There was no significant difference for the pressure pain threshold and latency time for cold induced pain.

CONCLUSION: Hypnosis and TENS decreased the intensity of chronic low back pain with no statistically significant difference between them, but statistically different from the pain education control group.

Keywords

Hypnosis, Low back pain, Physical therapy modalities, Transcutaneous electrical nerve stimulation

Resumo

JUSTIFICATIVA E OBJETIVOS: Entre as principais técnicas analgésicas não farmacológicas estão as terapias físicas como a eletroterapia e técnicas cognitivo-comportamentais, como a hipnose. O objetivo deste estudo foi comparar o efeito analgésico da estimulação elétrica nervosa transcutânea (TENS) e hipnose no controle da dor lombar crônica.

MÉTODOS: Estudo do tipo cruzado que incluiu 19 adultos jovens de ambos os sexos portadores de dor lombar crônica, submetidos a TENS, hipnose e educação em dor como grupo controle. A qualidade da dor foi avaliada pelo questionário de McGill, a intensidade e o limiar da dor pela escala analógica visual. Foi avaliada a intensidade da dor espontânea, o limiar e a intensidade de dor ao frio e o limiar da dor à pressão, imediatamente após as intervenções e 30 minutos depois do final das intervenções. A análise estatística foi realizada com modelos lineares generalizados mistos, com 5% de significância, e tamanhos de efeito G de Cohen.

RESULTADOS: Houve diminuição estatisticamente significativa da intensidade da dor espontânea e ao frio nos grupos hipnose e TENS comparados ao grupo de educação em dor. Ocorreu redução do quadro álgico estatisticamente significativo nas categorias sensorial e avaliativa nos grupos intervenção comparados ao grupo controle. Não houve diferença significativa para o limiar de dor à pressão e o tempo de latência para a dor ao frio.

CONCLUSÃO: A hipnose e a TENS diminuíram a intensidade da dor lombar crônica sem diferença estatisticamente significativa entre si, porém estatisticamente diferentes em relação ao grupo controle.

Palavras-chave

Dor lombar, Estimulação elétrica nervosa transcutânea, Hipnose, Modalidades de fisioterapia

References

Hoy D, Bain C, Williams G, March L, Brooks P, Blyth F. A systematic review of the global prevalence of low back pain. Arthritis Rheum. 2012;64(6):2028-37.

Hoy D, Brooks P, Blyth F, Buchbinder R. The epidemiology of low back pain. Best Pract Res Clin Rheumatol. 2010;24(6):769-81.

Maher C, Underwood M, Buchbinder R. Non-specific low back pain. Lancet. 2017;389(10070):736-47.

Igwesi-Chidobe CN, Amarachukwu C, Sorinola IO, Godfrey EL. Translation, cultural adaptation and psychometric testing of Igbo fear avoidance beliefs questionnaire in mixed rural and urban Nigerian populations with chronic low back pain. PLoS One. 2019;14(5).

Furtado RN, Ribeiro LH, Abdo Bde A, Descio FJ, Martucci CE Jr CE, Serruya DC. Nonspecific low back pain in young adults: associated risk factors. Rev Bras Reumatol. 2014;54(5):371-7.

Piccoliori G, Engl A, Gatterer D, Sessa E, in der Schmitten J, Abholz HH. Management of low back pain in general practice - is it of acceptable quality: an observational study among 25 general practices in South Tyrol (Italy). BMC Fam Pract. 2013;14:148.

Wellington J. Noninvasive and alternative management of chronic low back pain (efficacy and outcomes). Neuromodulation. 2014;17(Suppl 2):24-30.

Yurdakul OV, Beydogan E, Yalçinkaya EY. Effects of physical therapy agents on pain, disability, quality of life, and lumbar paravertebral muscle stiffness via elastography in patients with chronic low back pain. Turkish J Phys Med Rehabil. 2019;65(1):30-9.

Garaud T, Gervais C, Szekely B, Michel-Cherqui M, Fischler M. Randomized study of the impact of a therapeutic education program on patients suffering from chronic low-back pain who are treated with transcutaneous electrical nerve stimulation. Medicine. 2018;97(52).

Wu LC, Weng PW, Chen CH, Huang YY, Tsuang YH, Chiang CJ. Literature review and meta-analysis of transcutaneous electrical nerve stimulation in treating chronic back pain. Reg Anesth Pain Med. 2018;43(4):425-33.

Facci LM, Nowotny JP, Tormem F, Trevisani FVM. Effects of transcutaneous electrical nerve stimulation (TENS) and interferential currents (IFC) in patients with nonspecific chronic low back pain?: randomized clinical trial. São Paulo Med J. 2011;129(4):206-16.

Jensen M, Patterson DR. Hypnotic treatment of chronic pain. J Behav Med. 2006;29(1):95-124.

Azizmohammadi S, Azizmohammadi S. Hypnotherapy in management of delivery pain: a review. Eur J Transl Myol. 2019;29(3):210-7.

Tan G, Fukui T, Jensen MP, Thornby J, Waldman KL. Hypnosis treatment for chronic low back pain. Int J Clin Exp Hypn. 2010;58(1):53-68.

Noergaard MW, Hakonsen SJ, Bjerrum M, Pedersen PU. The effectiveness of hypnotic analgesia in the management of procedural pain in minimally invasive procedures: a systematic review and meta - analysis. J Clin Nurs. 2019;28(23-24):4207-24.

Verhagen AP, Downie A, Popal N, Maher C, Koes BW. Red flags presented in current low back pain guidelines: a review. Eur Spine J. 2016;25(9):2788-802.

Verruch CM, Fréz AR, Bertolini GR. Comparative analysis between three forms of application of transcutaneous electrical nerve stimulation and its effect in college students with non-specific low back pain. BrJP. 2019;2(2):132-6.

Dillworth T, Jensen MP. The role of suggestions in hypnosis for chronic pain: a review of the literature. Open Pain J. 2010;8(1):39-51.

Clarke CL, Ryan CG, Martin DJ. Pain neurophysiology education for the management of individuals with chronic low back pain: A systematic review and meta-analysis. Man Ther. 2011;16(6):544-9.

Vlaeyen JWS, Maher CG, Wiech K, Zundert Van J, Meloto CB, Diatchenko L. Low back pain. Nat Rev Dis Primers. 2018;4(1):52.

Cao S, Song G, Zhang Y, Xie P, Tu Y, Li Y, Yu T, Yu B. Abnormal local brain activity beyond the pain matrix in postherpetic neuralgia patients: A resting-state functional MRI study. Pain Physician. 2017;20(2):E303-14.

Gosling AP. Physical therapy action mechanisms and effects on pain management. Rev Dor. 2013;13(1):65-70.

Marchand S. The physiology of pain mechanisms From the periphery to the brain. Rheum Dis Clin N Am. 2008;34(2):285-409.

Ossipov MH, Dussor GO, Porreca F. Central modulation of pain. J Clin Invest. 2010;120(11):3779-87.

Knudsen L, Petersen GL, Nørskov KN, Vase L, Finnerup N, Jensen TS. Review of neuroimaging studies related to pain modulation. Scand J Pain. 2011;2(3):108-20.

Brugnoli MP, Pesce G, Pasin E, Basile MF, Tamburin S, Polati E. The role of clinical hypnosis and self-hypnosis to relief pain and anxiety in severe chronic diseases in palliative care: a 2-year long-term follow-up of treatment in a nonrandomized clinical trial. Ann Palliat Med. 2018;7(1):17-31.

Castañeda E, Krikorian A. Clinical hypnosis in Latin America: systematic review of the literature. Av Psicol Latinoam. 2018;36(2):269-83.

Kramer S, Zims R, Simang M, Rüger L, Irnich D. Hypnotic relaxation results in elevated thresholds of sensory detection but not of pain detection. BMC Complement Altern Med. 2014;14:496.

Kong X, Gozani SN. Effectiveness of fixed-site highfrequency transcutaneous electrical nerve stimulation in chronic low back pain: a large-scale, observational study. J Pain Res. 2018;11:703-14.

Ebadi S, Ansari NN, Ahadi T, Fallah E, Forogh B. No immediate analgesic effect of diadynamic current in patients with nonspeci fi c low back pain in comparison to TENS. J Bodyw Mov Ther. 2018;22(3):693-9.

Puentedura EJ, Flynn T. Combining manual therapy with pain neuroscience education in the treatment of chronic low back pain a narrative review of the literature. Physiother Theory Pract. 2016;32(5):408-14.

Saper RB, Lemaster C, Delitto A, Sherman KJ, Herman PM, Sadikova E. Yoga, physical therapy, or education for chronic low back pain A randomized noninferiority trial. Ann Intern Med. 2019;167(2):85-94.

Submitted date:
05/03/2020

Accepted date:
01/04/2021

6087392ea9539575af459683 brjp Articles
2595-3192 (Electronic) 2595-0118 (Printed)
BrJP ©2024 All rights reserved.

BrJP

Share this page
Page Sections