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Chronic Low Back Pain Treatment with Physical Therapy Modalities

The authors reviewed available random controlled trials and controlled clinical trials evaluating the efficacy of physical therapy modalities in the treatment of chronic low back pain (CLBP). These modalities included three electrotherapeutic modalities to include transcutaneous electrical nerve stimulation (TENS); electrical muscle stimulation (EMS); and interferential current (IFC). Physical agents that were evaluated included ultrasound, hot packs, and cold packs.

The search indentified 36 potential articles on electrotherapeutic modalities and physical agents for the treatment of CLBP. All but six were excluded in the analysis. These six studies evaluated the efficacy of TENS for CLBP. Overall, it was found that high and low frequency TENS appears to have an immediate impact on pain intensity. Results favored high-frequency TENS. No short-term or long-term pain benefits or impact on perceived disability were found.

There were no eligible studies to evaluate the efficacy of IFC, EMS, ultrasound, hot and cold packs in the treatment of CLBP.


S. Poitras and L. Brosseau. Evidence-informed management of chronic low back pain with transcutaneous electrical nerve stimulation, interferential current, electrical muscle stimulation, ultrasound, and thermotherapy. The Spine Journal. January/February 2008. Volume 8. Issue 1. Pp. 226-233.

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