The Potential of Transcutaneous Electrical Nerve Stimulation to Improve Pain Experienced During Posterior Branch Blocks in Patients With Lumbar Posterior Joint Syndrome

The Value of Transcutaneous Electrical Nerve Stimulation (TENS) for Improving Pain Experienced During Posterior Branch Blocks in Patients With Lumbar Posterior Joint Syndrome: a Single-center, Randomized, Double-blind, Parallel-group, Controlled, Superiority Trial

Procedural pain is inadequately managed in two-thirds of patients undergoing invasive medical procedures. Several techniques exist for managing procedural pain, but they all present implementation challenges and are not without side effects. Therefore, a new, non-pharmacological, inexpensive, and easy-to-use approach would be of significant benefit. Transcutaneous electrical nerve stimulation (TENS) for pain relief could represent this alternative. Few studies have been conducted on the benefits of TENS in managing procedural pain, for example, in shoulder arthrodistension. This project proposes to study it in the context of posterior ramus infiltration in patients eligible for this indication, in the context of chronic low back pain associated with posterior joint syndrome.

Inclusion Criteria:

• Chronic low back pain (lasting more than 3 months)
• Patient followed in a Chronic Pain Unit (CETD, Toulouse University Hospital)
• Clinical and radiological diagnosis (CT scan or MRI) of posterior joint syndrome
• Patient with an indication for infiltration therapy, feasible under standard conditions

Exclusion Criteria:

• Spinal surgery

• Contraindications for TENS:

  • Wearing an electronic medical device (pacemakers, defibrillators, etc.)
  • Pregnancy
  • Area of cutaneous anesthesia
  • Patient with an active malignant tumor
  • Patient with deep vein thrombosis
  • Patient with damaged or fragile skin

• Insulin-dependent or uncontrolled diabetes

• Uncontrolled hypertension

• Allergy to the local anesthetics used

• Severe psychiatric disorder

• Lumbar injection within the previous 6 months