Immediate effect of TENS combined with cryotherapy on chronic low back pain: randomised clinical trial.
analgesia; electrical stimulation; cryotherapy; lumbosacral region.
Introduction: Transcutaneous Electric Nervous Stimulation (TENS) and cryotherapy have been used together for analgesic purposes in the clinical practice of physical therapy, with effects not fully elucidated in the scientific literature. Purpose: To verify the immediate effects of conventional and Burst TENS, associated or not with cryotherapy, in non-specific chronic low back pain. Methods: This is a randomized clinical trial. A hundred and twenty volunteers will be recruited, both genders, between 18 and 50 years old, with nonspecific chronic low back pain. Pain assessment will take place at three different times (before, immediately after and 25 minutes after the intervention), in two variables: measurement of subjective pain perception (numerical scale) and quantification of pain threshold (pressure algometry) on the most affected side of the lumbar region, at L3 and L5 level. Volunteers will be randomly allocated in six groups (n = 20 each) to perform the intervention: 1) TENS placebo; 2) Conventional TENS (frequency = 100Hz, PD = 100µs, sensory level); 3) Burst TENS (100Hz, 4Hz Bursts, PD = 200µs, motor level); 4) Cryotherapy; 5) Cryotherapy + Burst TENS; 6) Cryotherapy + conventional TENS. For inter and intragroup comparisons, we will use the Anova mixed model test, with Bonferroni post hoc test, or the Generelized Equation Estimation (GEE) analysis, considering the distribution of variables and a significance level of 5%.