A real-world evaluation of Transcutaneous Electrical Nerve Stimulation (TENS) and osteoarthritis of the knee.

Osteoarthritis (OA) is characterised by damage to joints in the body causing them to become painful and stiff; this is progressive and gets worse over time. Pain from OA can be difficult to study because the magnitude of symptoms often fluctuates and changes. In the context of OA of the knee, replacement surgery is one of the most commonly undertaken and cost-effective musculoskeletal (MSK) surgical procedures (Price et al., 2018). Current treatment of most OA relies primarily on a pharmacologic approach to pain management. Recently, it has been suggested that pharmacologic interventions in OA of the knee have limited benefit, causing a shift in strategy to nonpharmacologic methods (Sharma, 2021). Previous NICE guidelines have suggested transcutaneous electrical nerve stimulation (TENS) devices should be considered as an adjunct to standard care for pain relief of OA (NICE, 2014), however, the guidelines were updated in October 2022 and now state that TENS should not be used due to the lack of evidence (NICE, 2022). To address the current lack of evidence around TENS use in OA of the knee a ‘real world’ evaluation was carried out within Prince Philip Hospital (PPH) orthopaedic department, Hywel Dda University Health Board (HDUHB) from 01/11/21 to 11/04/22. The evaluation assessed the potential benefits of a neuromodulation device for patients who had a diagnosis of OA in at least one knee, and who were also on the waiting list for total knee arthroplasty.