How effective is the use of TENS machines to treat hamstring injuries in comparison to other methods

Thanks everyone I have re - thought my question as it was quite broad, I would like to know if TENS in particular is effective at treating grade 1 hamstring tears, whether it speeds up the recovery period and reduces pain. I have read many studies that say it is an outdated method and would like some evidence to either prove this or contradict this statement. Once I have got this evidence I can start comparing this method to others. Thanks so much for your guys help so far its much appreciated, this research will allow me to show extra interest in the intended physiotherapy course I hope to get on at university making me a better candidate for the course.

Dear Jamie, I know what it's like when you can't find what you want. And the reality is that there are not many comparative studies of physiotherapy-specific approaches/treatment/techniques. Perhaps this is something that you could one day contribute to?

I have found one study that compares PNF and PNF+TENS for hamstrings flexibility in healthy males. If you have access to PubMed, here's the link (your university librarian may be able to assist you in finding): https://www.minervamedica.it/en/journals/sports-med-physical-fitness/article.php?cod=R40Y9999N00A18052904 There is also another link here to a piece on knee rehab which refers to TENS: https://www.ncbi.nlm.nih.gov/pubmed/2670276

On another point, placebo is not a "bad" thing. Some people call it "expectation" and it's part of the healthcare relationship that we have with our patients/clients. If we develop a good rapport, and provide our patients with an expectation of improvement from physiotherapy, then everything we do can have a potentially positive contribution to outcomes. Surely that's something we can all strive for?

My last comment is reserved for those who hold the opinion that a lack of evidence means that something doesn't work. It simply means that no-one has yet done the research and published it. So, if you cannot find evidence, it does not mean there is a lack of efficacy; it just means there is a lack of evidence (i.e., any evidence, positive or negative)!

Keep studying hard and let us know what you find out. Liisa Laakso

Hi, Jamie, once you are a student, I will help you using the Chinese proverb that says something like this: "If you see someone hungry do not give him a fish, but teach him how to fish." Try to find the answer to your questions in Tripdatabase Autosynthesis: https://www.tripdatabase.com/autosynthesis/search. If you search for "pain", you will see an interesting and comprehensive response. Conlusions .... it's up to you ;-)

Last updated 9 months ago

Hi Jamie, I would like to provide a helpful response to your request but require further detail from you in order to do so. In particular, what are the proposed methods for your 'extended research project' - is this a literature review (rigorous systematic review or narrative) or is it a clinical trial comparing the effectiveness of various interventions that you have listed? This is an important distinction as I am uncertain as to whether you are searching for evidence of effectiveness or comparative effectiveness - the latter is significantly more limited. I am also curious about how 'physical long term impact' for each of the interventions will be defined as this will shape the selection of literature that you may be seeking.

Hi guys, thanks for the responses, I am far off a trained physio and am still in college so my knowledge of electrotherapy is very brief, I have looked online and there seems to be a mixed opinion on whether Electrotherapy methods actually work for pain relief to speed up the recovery process and how effective is the likes of TENS machine in comparison to other methods such as cupping, acupuncture, cryotherapy etc. ?

Hi Jamie. In addition to earlier comments, please also note that TENS as a ‘word’ has different meanings in different parts of the world. For some it is very specific to the small battery-operated devices in previous times known as ‘pain block’. For others, TENS is a more generic and umbrella term that encompasses many if not all of the various forms of eStim that could be used for pain but also muscle stim, for example. Cheers, Liisa

Jamie, I think that before any of us can best respond to your query it would be helpful to know what your intended outcome measures will be. You write "I just want some opinions on how effective electrotherapy actually is for hamstring injuries". TENS is intended for pain and there is ample evidence of the effectiveness of TENS for pain, not just placebo as you write. So if your outcomes measures include pain then that would be appropriate to include TENS. However, with outcome measures such as ROM, function, strength, time away from sport/activity, etc I suggest that these are not the most appropriate outcome measures when administering TENS. Please keep in mind that TENS is just one type of electrotherapy. Other forms of electrotherapy may be indicated as well for hamstring injury (eg NMES).

Jamie, I think that before any of us can best respond to your query it would be helpful to know what your intended outcome measures will be. You write "I just want some opinions on how effective electrotherapy actually is for hamstring injuries". TENS is intended for pain and there is ample evidence of the effectiveness of TENS for pain, not just placebo as you write. So if your outcomes measures include pain then that would be appropriate to include TENS. However, with outcome measures such as ROM, function, strength, time away from sport/activity, etc I suggest that these are not the most appropriate outcome measures when administering TENS. Please keep in mind that TENS is just one type of electrotherapy. Other forms of electrotherapy may be indicated as well for hamstring injury (eg NMES).

Hi Jamie TENS is only going to work on pain and I agree that you need to think about what your therapeutic goals are before starting. I have 100s of research papers on IFT for example where there are completely opposing views as to its efficacy. When you drill down you find there is no explanation as to why they used particular frequencies and the electrode positioning is not regarded as important either, when in fact it can be critical. I note that IFT is not on your list, but then I assume that you regard it as an analgaesic as do so many physios who have no real experience of electrotherapy generally - the norm for some years now!

Hi, Jamie, what do you mean by injuries? What is the therapeutic goal for TENS: pain, strengthening, tissue repair? Can you be more specific. Regards