Transcutaneous electrical nerve stimulation as adjunct to primary care management for tennis elbow: pragmatic randomised controlled trial (TATE trial).

A meta-analysis of the use of TENS in chronic musculoskeletal conditions (38 studies; 1227 participants), which explicitly considered methodological rigour and fidelity of TENS application, reported highly significant reductions in pain with the use of TENS compared with placebo. 21 Abundant laboratory studies also show identifiable and dose dependent physiological pain reducing effects of TENS compared with placebo, although the vast majority of these studies reported only very short term effects (1-24 hours). 29 30 31 32 33 34 35 36 37 Despite this support for efficacy of treatment, in our pragmatic trial TENS failed to show additional pain relieving effects even in the very short term, over and above the effect of primary care management alone.

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