PT Critically Appraised Topics
 

Document Type

Critically Appraised Topic

Publication Date

2011

Clinical Scenario

In clinic, I see a large number of patients who have worker’s compensation injuries. Many of those patients experienced an injury at work to their lower back, leaving them with pain, muscle guarding, and inflammation. After completing my initial evaluation, I am struggling to find treatment options that are appropriate for patients with acute, highly severe and irritable conditions. Beyond a basic exercise program that consists of gentle stretching and light strengthening, I usually use interferential current as an intervention to decrease their pain.

Clinical Question

Does the literature support the use of interferential current to reduce acute low back pain following work injuries?

Clinical Bottom Line

Based on the outcomes from Herman et al. and Hurley et al. electrotherapy consisting of TENS or IFC is not an effective modality to use in combination with exercise or manual therapy when treating patients with subacute low back pain. Both studies had weaknesses in methodological quality that would limit a clinician’s ability to generalize the results to a larger population. Regardless, neither study found outcomes indicating a positive effect of electrotherapy in this population. Neither study answered my clinical question specifically, as the patients were far more subacute than the patients I treat. Also the exclusion criteria may have restricted the study populations in a way not to match my clinical case load. Future research with high methodological quality is needed to look at the effect of TENS use on pain and mobility in patients with acute low back pain, occurring in the past two to three weeks’ time. Special notice should be made regarding blinding of patients and therapists if possible, as well as accounting for study losses over the treatment period.

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