Electroanalgesia: Historical and Contemporary Developments

Aims and Objectives: This thesis makes an in-depth examination of the historical, including the eighteenth-century pioneering electrical treatments of the Rev John Wesley, together with contemporary developments in electroanalgesia from the late twentieth-century, including the author's own pilot study, in order to provide a sound, scientific basis for their continuing use.

The problem and the hypothesis: Controversy still surrounds the effectiveness of electrical treatments, even after 250 years of application. This is seen in its most researched form as TENS (transcutaneous electrical nerve stimulation) and ALTENS (acupuncture-like transcu taneous electrical nerve stimulation) for chronic back pain. The empirical research making up the main part of the thesis sets out to provide clear evidence to reject the null hypothesis, i.e. that there are no significant clinical effects from the use of electrical treatments for chronic back pain.

Methods and findings: The empirical tertiary research centred on a systematic review and meta-analysis, within the framework of the Cochrane Collaboration, of all randomised controlled trials of TENS/ ALTENS for chronic back pain found during rigorous searches of the medical literature. Pooling their results in a meta-analysis established that effective clinical benefits are to be found in the use of ALTENS/TENS for chronic back pain, at least in the short term.

Conclusions and recommendations: This wide ranging PhD thesis demonstrates for the first time significant clinical benefits of TENS/ ALTENS for treating patients with chronic back pain and if implemented on a global basis, then considerable numbers of chronic back pain sufferers could benefit.