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In their May JADA article, "Using Transcutaneous Electrical Nerve Stimulation to Prevent Postoperative Pain," Drs. Wayne Herman, Joseph Konzelman and Robert Comer neglected to mention some very important research. Although they are correct that transcutaneous electrical nerve stimulation, or TENS, is widely used, these devices have not been found to work any better than placebo therapy.¹

In 1997, Feine and colleagues² reviewed the scientific support for the use of a number of treatment options, including TENS, low-intensity laser, thermal agents such as hot and cold packs, and ultrasound. The study drew on research from both the medical and dental literature. The study concluded that "no good evidence exists that any of the treatments under review are capable of curing or even significantly reducing symptoms of chronic musculoskeletal conditions including TMDs [temporomandibular disorders]."

The well-established efficacy of placebos in the management of pain should make dentists suspicious of all anecdotal reports of pain reduction.

	REFERENCES

TOP REFERENCES

1. Deyo RA, Walsh NE, Martin DC, Schoenfeld LS, Ramamurthy S. A controlled trial of transcutaneous electrical nerve stimulation (TENS) and exercise for chronic low back pain. N Engl J Med 1990;322(23): 1627–34.[Abstract]
   
   
2. Feine JS, Widmer CG, Lund JP. Physical therapy: a critique. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1997;83(1):123–7.[Medline]
   
   

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