TENS Treatment Plus Ibuprofen for the Treatment of Acute Back Pain in the ED

NCT ID: NCT02611583

Last Updated: 2017-05-10

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

WITHDRAWN

Clinical Phase

NA

Study Classification

INTERVENTIONAL

Study Start Date

2016-06-24

Study Completion Date

2016-06-24

Brief Summary

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Patients presenting to the ED with a chief complaint of acute low back pain and whom the providing physician feels symptomatic treatment is appropriate in the ED will be screened for inclusion in the study. The purpose of the study is to compare Transcutaneous Electrical Nerve Stimulation (TENS) as an adjunct to ibuprofen in the treatment of acute low back pain in the emergency department. Therefore, the aim of this prospective, randomized, double blind study is to evaluate the efficacy of ED administered TENS in acute low back pain patients during their ED visit.

Detailed Description

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The study is a double blind, randomized, placebo controlled trial. One group will receive ibuprofen and TENS. The comparison group will receive ibuprofen and sham TENS. The study primary endpoint is change in pain level on Visual Analog Scale score at 45-60 minutes after TENS start.

This is a two-arm, double blind, randomized control trial evaluating the patient perceived improvement in back pain. Patients will first fill out a Visual Analog Scale (VAS).

Patients will be randomized to one of two arms. Ibuprofen 800 mg, plus sham TENS for 45 minutes Ibuprofen 800 mg, plus TENS for 45 minutes

Patients will be given a 2nd VAS scale up to 15 minutes after the end of the TENS session. After the second VAS the patients will be finished with the study procedures and can be continued to be cared as per the discretion of their treating physician.

Our intention is to detect a 20% reduction in pain by VAS with a common standard deviation equal to the difference at the p = 0.05 level with a power of 80% using an analysis of variance (ANOVA). The calculated sample size required 28 patients per group. Considering the uncertain dropout rate, the investigators decided to enroll at least 66 patients. Baseline characteristics will be calculated to determine if groups are equal. A two-way repeated-measures ANOVA will be used to test both a trial effect and a group effect (SPSS 20, SPSS Inc., Chicago, IL). Data will be presented as means with standard deviations with 95% confidence intervals. A p\< 0.05 was considered statistically significant.

Conditions

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Low Back Pain

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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Ibuprofen and TENS plus

Patients will receive 45 minutes of TENS therapy. All patients will receive ibuprofen.

Group Type ACTIVE_COMPARATOR

TENS

Intervention Type DEVICE

Transcutaneous Electrical Nerve Stimulation

Ibuprofen and Sham TENS plus

Patients will receive 45 minutes of sham TENS therapy. All patients will receive ibuprofen.

Group Type PLACEBO_COMPARATOR

TENS

Intervention Type DEVICE

Transcutaneous Electrical Nerve Stimulation

Interventions

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TENS

Transcutaneous Electrical Nerve Stimulation

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

1. Patients 18 years to 65 years of age presenting to the emergency room with a primary complaint of low back pain.
2. Patient is receiving 800mg dose of ibuprofen as part of their treatment regimen for back pain
3. Back pain new in the last 48 hours
4. Deemed by the treating physician to have musculoskeletal back pain, and no central/peripheral nervous system pathology as the cause of their pain.

Exclusion Criteria

1. Allergy to ibuprofen.
2. Hypotension (MAP \<65 or Systolic BP \<100), fever, tachycardia
3. Paresthesias, isolated motor weakness, or objective sensory deficit on physical exam
4. Radicular symptoms
5. Urinary incontinence or retention
6. Bowel incontinence
7. Unexplained weight loss of \>15 lbs in the last 3 months.
8. Multiple primary complaints in the ED.
9. Received Analgesia other than Ibuprofen as part of their ED work up.
10. Taken prescription strength pain medication within the last 12 hours for any condition.
11. History of active malignancy, HIV, organ transplantation, active hemodialysis
12. Currently pregnant
13. Nursing home residents
14. Currently in police custody
Minimum Eligible Age

18 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Albert Einstein Healthcare Network

OTHER

Sponsor Role lead

Responsible Party

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Paul Dominici

MD

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Paul G Dominici, MD

Role: PRINCIPAL_INVESTIGATOR

Albert Einstein Healthcare Network

Locations

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Albert Einstein Healthcare Network

Philadelphia, Pennsylvania, United States

Site Status

Countries

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United States

References

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Cypress BK. Characteristics of physician visits for back symptoms: a national perspective. Am J Public Health. 1983 Apr;73(4):389-95. doi: 10.2105/ajph.73.4.389.

Reference Type BACKGROUND
PMID: 6219588 (View on PubMed)

Patrick N, Emanski E, Knaub MA. Acute and chronic low back pain. Med Clin North Am. 2014 Jul;98(4):777-89, xii. doi: 10.1016/j.mcna.2014.03.005.

Reference Type BACKGROUND
PMID: 24994051 (View on PubMed)

Thorsteinsson G, Stonnington HH, Stillwell KG, Elveback LR. The placebo effect of transcutaneous electrical stimulation. Pain. 1978 Jun;5(1):31-41. doi: 10.1016/0304-3959(78)90022-2.

Reference Type BACKGROUND
PMID: 353652 (View on PubMed)

Marchand S, Charest J, Li J, Chenard JR, Lavignolle B, Laurencelle L. Is TENS purely a placebo effect? A controlled study on chronic low back pain. Pain. 1993 Jul;54(1):99-106. doi: 10.1016/0304-3959(93)90104-W.

Reference Type BACKGROUND
PMID: 8378107 (View on PubMed)

Bertalanffy A, Kober A, Bertalanffy P, Gustorff B, Gore O, Adel S, Hoerauf K. Transcutaneous electrical nerve stimulation reduces acute low back pain during emergency transport. Acad Emerg Med. 2005 Jul;12(7):607-11. doi: 10.1197/j.aem.2005.01.013.

Reference Type BACKGROUND
PMID: 15995091 (View on PubMed)

Other Identifiers

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HN4810

Identifier Type: -

Identifier Source: org_study_id

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