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Poster Gallery

747 - Transcutaneous Electrical Nerve Stimulation for the Treatment of Hypertonic Neurogenic Thoracic Outlet Syndrome: A Review of Current Literature and Call for Further Research

Friday, February 23, 2024
5:00 PM – 6:30 PM EDT
Objectives: Neurogenic Thoracic Outlet Syndrome (TOS) accounts for over 95% of TOS cases, occurring when the brachial plexus gets compressed. While PT and surgery are the most common treatments for TOS, another possibility to consider is Transcutaneous Electric Nerve Stimulation (TENS) for patients who do not wish to pursue surgery or for those where Physical Therapy did not alleviate their symptoms.

Design: A review of the current literature was completed. Articles were included if they contained the key words “Neurogenic Thoracic Outlet Syndrome ” AND “Transcutaneous Electric Nerve Stimulation or TENS”. Databases such as PubMed, CDC, Embase, JOM, and SCOPUS were used as primary sources for literature. Outcome measures included patient-reported intensity of pain, Modified Ashworth Scale to measure muscle spasticity, and EMG-measured H-reflex.

Results: A prior meta-analysis of 91 RCTs showed that TENS therapy leads to lower pain levels during or immediately after, compared to placebo in 4841 patients (95% CI -1·14 to -0·78). An additional meta-analysis of 10 RCTs showed that TENS led to lower pain levels compared to no treatment (95% CI −1·18,–0·46), or to Standard of Care according to one last meta-analysis of 61 RCTs (95% CI −0.95 to −0.5) Another meta-analysis using a random effects model shows that TENS along with physical therapy is more effective than physical therapy alone when it comes to lower limb spasticity (95% CI, -1.51 to -0.15).

Conclusions: TENS therapy is proven therapeutic across multiple etiologies such as fibromyalgia, neck pain, and strokes to alleviate pain and improve overall symptoms including muscle hypertonicity and spasticity. Additional benefits include low barriers to use such as low cost, easy for patients to use, and limited adverse effects. No current literature explores the potential benefits of adding TENS therapy to the current treatment standards for neurogenic TOS, and should be a consideration for future research.