Research Article

Investigating the Effects of Transcutaneous Electrical Nerve Stimulation on Lumbar Fascia Tissue and Lumbar Curvature in Healthy People

Abstract

Introduction: Transcutaneous electrical nerve stimulation (TENS) is commonly used for pain management. Recent studies have shown that TENS can improve the condition of low back pain by influencing the elastic coefficient of the lumbar fascia and the balance status; however, the effect of TENS on the lumbar fascia of healthy people has not been investigated. Accordingly, this study examines the effect of TENS on the lumbar fascia of healthy people.
Materials and Methods: A total of 60 healthy participants in two groups, underwent 10 sessions of conventional TENS intervention. The first group (intervention group) received TENS with an intensity at the tolerance level, and the second group (control group) received sham TENS. Ultrasonography and a spinal mouse device were assessed lumbar fascia thickness and lumbar curvature before and after the TENS.
Results: Significant changes were observed after TENS in the intervention group in reducing the lumbar fascia thickness (P=0.006) and increasing the lumbar curvature (P=0.000). Between-group changes after the intervention sessions indicated a significant difference between the lumbar fascia thickness and curvature (P≤0.003).
Conclusion: TENS in healthy people can lead to a decrease in the thickness of the lumbar fascia and improve lumbar curvature. Also, a strong correlation was found between lumbar fascia thickness reduction and increased lumbar curvature.

Kreiner DS, Matz P, Bono CM, Cho CH, Easa JE, Ghiselli G, et al. Guideline summary review: An evidence-based clinical guideline for the diagnosis and treatment of low back pain. The Spine Journal. 2020; 20(7):998-1024. [DOI:10.1016/j.spinee.2020.04.006]

Corp N, Mansell G, Stynes S, Wynne-Jones G, Morsø L, Hill JC, et al. Evidence-based treatment recommendations for neck and low back pain across Europe: A systematic review of guidelines. European Journal of Pain. 2021; 25(2):275-95. [DOI:10.1002/ejp.1679]

Urits I, Burshtein A, Sharma M, Testa L, Gold PA, Orhurhu V, et al. Low back pain, a comprehensive review: Pathophysiology, diagnosis and treatment. Current Pain and Headache Reports. 2019; 23(23):1-10. [DOI:10.1007/s11916-019-0757-1]

Nicol V, Verdaguer C, Daste C, Bisseriex H, Lapeyre É, Lefèvre-Colau MM, et al. Chronic low back pain: A narrative review of recent international guidelines for diagnosis and conservative treatment. Journal of Clinical Medicine. 2023; 12(4):1685. [DOI:10.3390/jcm12041685]

Chun SW, Lim CY, Kim K, Hwang J, Chung SG. The relationships between low back pain and lumbar lordosis: A systematic review and meta-analysis. The Spine Journal. 2017; 17(8):1180-91. [DOI:10.1016/j.spinee.2017.04.034]

Dionne CE, Dunn KM, Croft PR. Does back pain prevalence really decrease with increasing age? A systematic review. Age and Ageing. 2006; 35(3):229-34. [DOI:10.1093/ageing/afj055]

Niu S, Yang H, Gao J, Zhang X, Ji X, Huang Y, et al. Correlation between sagittal parameters and disability of patients with nonspecific chronic low back pain: A cross-sectional study of 435 subjects. The Spine Journal. 2024; 24(4):634-43. [DOI:10.1016/j.spinee.2023.11.004]

Wilke J, Schleip R, Klingler W, Stecco C. The lumbodorsal fascia as a potential source of low back pain: A narrative review. BioMed Research International. 2017; 2017:1-6. [DOI:10.1155/2017/5349620]

Tamartash H, Bahrpeyma F. Evaluation of lumbar myofascial release effects on lumbar flexion angle and pelvic inclination angle in patients with non-specific low back pain. International Journal of Therapeutic Massage & Bodywork. 2022; 15(1):15. [DOI:10.3822/ijtmb.v15i1.709]

Tamartash H, Bahrpeyma F, Mokhtari Dizaji M. Ultrasound evidence of altered lumbar fascia in patients with low back pain. Clinical Anatomy. 2023; 36(1):36-41. [DOI:10.1002/ca.23964]

Pillai D, Haral P. Prevalence of low back pain in sitting vs standing postures in working professionals in the age group of 30-60. International Journal of Health Sciences & Research. 2018; 8(10):131-7. [Link]

Cullen KL, Irvin E, Collie A, Clay F, Gensby U, Jennings PA, et al. Effectiveness of workplace interventions in return-to-work for musculoskeletal, pain-related and mental health conditions: An update of the evidence and messages for practitioners. Journal of Occupational Rehabilitation. 2018; 28:1-15. [DOI:10.1007/s10926-016-9690-x]

Yurdakul OV, Beydoğan E, Yalçınkaya EY. Effects of physical therapy agents on pain, disability, quality of life, and lumbar paravertebral muscle stiffness via elastography in patients with chronic low back pain. Turkish Journal of Physical Medicine and Rehabilitation. 2019; 65(1):30. [DOI:10.5606/tftrd.2019.2373]

Fouladi N, Minoonejad H, Rajabi R. Comparing the effects of the postural restoration exercises with and without core stability exercises in patients with non-specific chronic low back pain. Journal of Modern Rehabilitation. 2023; 18(1):41-54. [DOI:10.18502/jmr.v18i1.14728]

Binny J, Wong NLJ, Garga S, Lin CWC, Maher CG, McLachlan AJ, et al. Transcutaneous electric nerve stimulation (TENS) for acute low back pain: Systematic review. Scandinavian Journal of Pain. 2019; 19(2):225-33. [DOI:10.1515/sjpain-2018-0124]

Chen CC, Tabasam G, Johnson MI. Does the pulse frequency of transcutaneous electrical nerve stimulation (TENS) influence hypoalgesia? A systematic review of studies using experimental pain and healthy human participants. Physiotherapy. 2008; 94(1):11-20. [DOI:10.1016/j.physio.2006.12.011]

Sadler SG, Spink MJ, Ho A, De Jonge XJ, Chuter VH. Restriction in lateral bending range of motion, lumbar lordosis, and hamstring flexibility predicts the development of low back pain: A systematic review of prospective cohort studies. BMC Musculoskeletal Disorders. 2017; 18(179):1-15. [DOI:10.1186/s12891-017-1534-0]

Jadidi AF, Stevenson AJT, Zarei AA, Jensen W, Lontis R. Effect of modulated TENS on corticospinal excitability in healthy subjects. Neuroscience. 2022; 485:53-64. [DOI:10.1016/j.neuroscience.2022.01.004]

Menezes MA, Pereira TA, Tavares LM, Leite BT, Neto AG, Chaves LM, et al. Immediate effects of transcutaneous electrical nerve stimulation (TENS) administered during resistance exercise on pain intensity and physical performance of healthy subjects: A randomized clinical trial. European Journal of Applied Physiology. 2018; 118:1941-58. [DOI:10.1007/s00421-018-3919-7]

Campos FV, Neves LM, Da Silva VZ, Cipriano GF, Chiappa GR, Cahalin L, et al. Hemodynamic effects induced by transcutaneous electrical nerve stimulation in apparently healthy individuals: A systematic review with meta-analysis. Archives of Physical Medicine and Rehabilitation. 2016; 97(5):826-35. [DOI:10.1016/j.apmr.2015.08.433]

Gilsenan C, Walsh L. The effect of high- and low-frequency transcutaneous electrical nerve stimulation upon cutaneous blood flow and skin temperature in healthy subjects. Clinical Physiology. 2000; 20(2):150-7. [DOI:10.1046/j.1365-2281.2000.00240.x]

Pérez M, Lucia A, Rivero JL, Serrano A, Calbet JA, Delgado M, et al. Effects of transcutaneous short-term electrical stimulation on M. vastus lateralis characteristics of healthy young men. Pflügers Archiv. 2002; 443:866-74. [DOI:10.1007/s00424-001-0769-6]

Langevin HM, Fox JR, Koptiuch C, Badger GJ, Greenan-Naumann AC, Bouffard NA, et al. Reduced thoracolumbar fascia shear strain in human chronic low back pain. BMC Musculoskeletal Disorders. 2011; 12(203):1-11. [DOI:10.1186/1471-2474-12-203]

Tamartash H, Bahrpeyma F, Dizaji MM. Effect of myofascial release technique on lumbar fascia thickness and low back pain: A clinical trial. Journal of Modern Rehabilitation. 2022; 16(3):244-51. [DOI:10.18502/jmr.v16i3.10148]

Fortin M, Battié MC. Quantitative paraspinal muscle measurements: inter-software reliability and agreement using OsiriX and ImageJ. Physical Therapy. 2012; 92(6):853-64. [DOI:10.2522/ptj.20110380]

López-Miñarro PA, Vaquero-Cristóbal R, Alacid F, Isorna M, Muyor JM. Comparison of sagittal spinal curvatures and pelvic tilt in highly trained athletes from different sport disciplines. Kinesiology. 2017; 49(1.):109-16. [DOI:10.26582/k.49.1.2]

Demir E, Güzel N, Çobanoğlu G, Kafa N. The reliability of measurements with the spinal mouse device in frontal and sagittal planes in asymptomatic female adolescents. Annals of Clinical and Analytical Medicine. 2020; 11(2):146-9. [DOI:10.4328/ACAM.6201]

Tamartash H, Bahrpeyma F, Dizaji MM. The effect of transcutaneous electrical nerve stimulation on pain and electrical stimulation muscle thickness in patients with non-specific chronic low back pain-based ultrasonographic evaluation. Pain Management. 2023; 13(2):87-94. [DOI:10.2217/pmt-2022-0069]

Mokhtari T, Ren Q, Li N, Wang F, Bi Y, Hu L. Transcutaneous electrical nerve stimulation in relieving neuropathic pain: Basic mechanisms and clinical applications. Current Pain and Headache Reports. 2020; 24(4):1-14. [DOI:10.1007/s11916-020-0846-1]

Garry MG, Hargreaves KM. Enhanced release of immunoreactive CGRP and substance P from spinal dorsal horn slices occurs during carrageenan inflammation. Brain Research. 1992; 582(1):139-42. [DOI:10.1016/0006-8993(92)90328-7]

Woolf CJ, Mitchell D, Barrett GD. Antinociceptive effect of peripheral segmental electrical stimulation in the rat. Pain. 1980; 8(2):237-52. [DOI:10.1016/0304-3959(88)90011-5]

Kasat V, Gupta A, Ladda R, Kathariya M, Saluja H, Farooqui AA. Transcutaneous electric nerve stimulation (TENS) in dentistry- A review. Journal of Clinical and Experimental Dentistry. 2014; 6(5):e562-8. [DOI:10.4317/jced.51586] [PMID]

Hollmann L, Halaki M, Kamper SJ, Haber M, Ginn K. Does muscle guarding play a role in range of motion loss in patients with frozen shoulder? Musculoskeletal Science and Practice. 2018; 37:64-8. [DOI:10.1016/j.msksp.2018.07.001]

Campbell JN, Taub A. Local analgesia from percutaneous electrical stimulation: A peripheral mechanism. Archives of Neurology. 1973; 28(5):347-50. [DOI:10.1001/archneur.1973.00490230083012]

Salter M, Henry J. Evidence that adenosine mediates the depression of spinal dorsal horn neurons induced by peripheral vibration in the cat. Neuroscience. 1987; 22(2):631-50. [DOI:10.1016/0306-4522(87)90359-9]

Marchand S, Li J, Charest J. Effects of caffeine on analgesia from transcutaneous electrical nerve stimulation. New England Journal of Medicine. 1995; 333(5):325-6. [DOI:10.1056/NEJM199508033330521]

Fields HL. Central nervous system mechanisms of pain modulation. Wall and Melzack’s Textbook of Pain. 2005; 125-42. [DOI:10.1016/B0-443-07287-6/50012-6]

Han J, Chen X, Sun S, Xu X, Yuan Y, Yan S, et al. Effect of low-and high-frequency TENS on Met-enkephalin-Arg-Phe and dynorphin A immunoreactivity in human lumbar CSF. Pain. 1991; 47(3):295-8. [DOI:10.1016/0304-3959(91)90218-M]

Salar G, Job I, Mingrino S, Bosio A, Trabucchi M. Effect of transcutaneous electrotherapy on CSF β-endorphin content in patients without pain problems. Pain. 1981; 10(2):169-72. [DOI:10.1016/0304-3959(81)90192-5]

Tamartash H, Bahrpeyma F, Dizaji MM. Effect of remote myofascial release on lumbar elasticity and pain in patients with chronic nonspecific low back pain: A randomized clinical trial. Journal of Chiropractic Medicine. 2023; 22(1):52-9. [DOI:10.1016/j.jcm.2022.04.002]

Pirri C, Pirri N, Guidolin D, Macchi V, Porzionato A, De Caro R, et al. Ultrasound imaging of thoracolumbar fascia thickness: Chronic non-specific lower back pain versus healthy subjects; A sign of a “frozen back”? Diagnostics. 2023; 13(8):1436. [DOI:10.3390/diagnostics13081436]

Diab AA, Moustafa IM. Lumbar lordosis rehabilitation for pain and lumbar segmental motion in chronic mechanical low back pain: A randomized trial. Journal of Manipulative and Physiological Therapeutics. 2012; 35(4):246-53. [DOI:10.1016/j.jmpt.2012.04.021]

Murrie V, Dixon A, Hollingworth W, Wilson H, Doyle T. Lumbar lordosis: Study of patients with and without low back pain. Clinical Anatomy. 2003; 16(2):144-7. [DOI:10.1002/ca.10114]

Shayesteh Azar M, Talebpour F, Alaee A, Hadinejad A, Sajadi M, Nozari A. Association of low back pain with lumbar lordosis and lumbosacral angle. Journal of Mazandaran University of Medical Sciences. 2010; 20(75):9-15. [Link]

Sato A. The impact of somatosensory input on autonomic functions. Reviews of Physiology, Biochemistry and Pharmacology. 1997; 130:139-42. [Link]

Shamsi M, Vaisi-Raygani A, Rostami A, Mirzaei M. The effect of adding TENS to stretch on improvement of ankle range of motion in inactive patients in intensive care units: A pilot trial. BMC Sports Science, Medicine and Rehabilitation. 2019; 11(15):1-8. [DOI:10.1186/s13102-019-0129-5]

Anderson SI, Whatling P, Hudlicka O, Gosling P, Simms M, Brown MD. Chronic transcutaneous electrical stimulation of calf muscles improves functional capacity without inducing systemic inflammation in claudicants. European Journal of Vascular and Endovascular Surgery. 2004; 27(2):201-9.[DOI:10.1016/j.ejvs.2003.10.003]

Costa D, Cancelliero K, Campos G, Salvini T, Da Silva C. Changes in types of muscle fibers induced by transcutaneous electrical stimulation of the diaphragm of rats. Brazilian Journal of Medical and Biological Research. 2008; 41(9):809-11. [DOI:10.1590/S0100-879X2008000900011]

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IssueVol 18 No 4 (2024) QRcode
SectionResearch Article(s)
DOI https://doi.org/10.18502/jmr.v18i4.16918
Keywords
Lumbar fascia Transcutaneous electrical nerve stimulation Ultrasonography Lumbar region Spinal curvatures

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1.
Tamartash H, Dadarkhah A, Najafi S, Kargar Shouraki J, Tabatabaee SM, Azizi S. Investigating the Effects of Transcutaneous Electrical Nerve Stimulation on Lumbar Fascia Tissue and Lumbar Curvature in Healthy People. jmr. 2024;18(4):489-498.