High-Tone External Muscle Stimulation for the Treatment of Chronic Sciatica – A Randomized Controlled Crossover Trial

Background: Chronic sciatica is a common pathology with a lifetime prevalence of 84%. Current therapy options are inadequate or not long-lasting. Objectives: Evaluation of short-term application of High-Tone Electrical Muscle Stimulation (HTEMS) compared to Transcutaneous Electrical Nerve Stimulation (TENS) with chronic sciatica. Methods: Patients (n=100, (mean±SD) age=57±14 years, sex=42% male) with chronic sciatica were randomly assigned into two groups treated with either HTEMS or TENS. Each treatment was administered for a period of 45 min per day, 5 times within 7 days, with a 7-day wash-out period before crossover. A 5-day average of sciatic pain was assessed using the visual analog scale (VAS) before and after intervention. Drug administration was stable during the study. Results: Before crossover, pain intensity was significantly reduced by the HTEMS treatment (56±21 (60 [50-70]) to 45±21 (50 [30-60]) mm VAS; p<0.001), while no improvement occurred with TENS (59±19 (60 [50-70]) to 56±19 (60 [45-79]) mm VAS). After crossover, significant pain reduction was observed in both groups (both p <0.01) and did not differ between both groups after the whole intervention. Conclusion: HTEMS showed a higher potential for short-term reduction of pain than TENS and might offer new a therapeutic strategy for the treatment of chronic sciatica.