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Panel: Stimulation won't help chronic back pain

Q. I've suffered from persistent low back pain for years. I recently had a repeat MRI, which does not show any abnormality. I hate taking medications. Does nerve stimulation work?

A. Back pain is remarkably common. It affects most people during a lifetime and is the most common reason for job-related disability. While most back pain gets better quickly, chronic back pain (lasting at least 3 months) is also common. Yet, the cause of chronic back pain is often uncertain. Even worse, treatment is often ineffective.

That's why so many people turn to transcutaneous electrical nerve stimulation (TENS). With this technique, an electrical current is delivered by wires plugged into a battery-powered device. It's used for a variety of conditions, such as neuropathy (nerve disease) and back pain. The reason it works isn't clear. One possibility is it interrupts nerve signals.

For many conditions, including chronic back pain, it's not clear how effective it is. That's why a group of experts from the American Academy of Neurology reviewed studies that reported on the success of TENS for chronic back pain. They excluded cases due to an identifiable cause, such as a slipped (herniated) disc or scoliosis (curvature of the spine), and excluded patients with obesity.

The conclusion of this expert panel was that TENS does not work for chronic back pain. As a result, new guidelines from the American Academy of Neurology will discourage use of TENS for chronic back pain. But TENS is not useless. This same panel concluded that TENS is effective for diabetic neuropathy, a painful nerve disease that commonly complicates diabetes.

Here are steps you can take that might decrease your discomfort:

Avoid gaining weight and try to shed a few pounds if needed.

Exercise regularly. Choose exercises that are easy on the back. Good choices include cycling and swimming.

Lift properly. Start in a squatting position. Use your legs and hips, rather than bending over to lift.

Wear shoes that are well-cushioned, low-heeled and soft-soled.

If you carry a briefcase or backpack, keep it light.

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