The C.A.M. Report
Complementary and Alternative Medicine: Fair, Balanced, and to the Point
  • About this web log

    This blog ran from 2006 to 2016 and was intended as an objective and dispassionate source of information on the latest CAM research. Since my background is in pharmacy and allopathic medicine, I view all CAM as advancing through the development pipeline to eventually become integrated into mainstream medical practice. Some will succeed while others fail. But all are treated fairly here.

  • About the author

    John Russo, Jr., PharmD, is president of The MedCom Resource, Inc. Previously, he was senior vice president of medical communications at, a complementary and alternative medicine website.

  • Common sense considerations

    The material on this weblog is for informational purposes. It is not medical advice or counsel. Be smart, consult your health professional before using CAM.

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    TENS to reduce pain intensity in patients with tennis elbow

    tennis_elbow50People with “tennis elbow” (lateral epicondylitis) experience pain over the outer side of the elbow, which may extend down the forearm.

    Researchers at Keele University, in Staffordshire, UK, studied the response to TENS (transcutaneous electrical nerve stimulation) added to typical treatment.

    First, the details.

    • 241 adults with a first or new (no consultation in previous 6 months) diagnosis of tennis elbow were studied.
    • Participants were randomly allocated to a 6-week treatment regimen for pain relief.
      • Primary care management alone, consisting of a consultation with a general practitioner followed by information and advice on exercises
      • Primary care management plus TENS once a day for 45 minutes over 6 weeks (or until symptom resolution).

    And, the results.

    • At 6 weeks, adherence to exercise plus TENS was low: 35%.
    • Both treatment groups showed large improvements in pain, especially during the first 6 weeks of follow-up.
    • However, no clinically or statistically significant differences were seen between groups at any time.
    • At 6 weeks, there was no difference between groups in pain improvement after adjusting for age, gender, and initial pain score.

    The bottom line?

    The authors concluded, “This trial does not provide evidence for additional benefit of TENS as an adjunct to primary care management of tennis elbow.”

    Of course, it would be helpful if more patients had followed the treatment recommendations. But maybe this tells us more about the management of tennis elbow than the study objectives.

    Among primary care physicians in Sweden, TENS does not play a significant role in treating tennis elbow. In the US, treatment relies on rest, applying ice, and taking NSAIDs. Cortisone injections may also be used.

    9/4/13 12:37 JR

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