Transcutaneous electrical nerve stimulation (TENS)

QUESTIONS UNDER STUDY: To evaluate the effectiveness of transcutaneous electrical nerve stimulation (TENS) in treatment of Herpes zoster (HZ), and prevention of postherpetic neuralgia (PHN) compared with antiviral drugs. PHN is frequent complication of HZ and may last for months, its treatment isn't very successful. Nonpharmacological regimens for treatment of HZ and prevention of PHN haven't been evaluated.

METHODS: Retrospective observational study of medical records of patients of three family physicians in Health centre Litija, Slovenia was done. 109 of 6613 patients on their lists had HZ from 1999 to 2008. 102 medical records were analyzed (6 could not be reached; one patient with corneal HZ was excluded).

RESULTS: Four treatment groups were compared: only TENS therapy, only antiviral drug, antiviral drug and TENS, no therapy (neither antiviral drug or TENS). All groups were similar with respect to demographic characteristics of patients with HZ. Patients treated only with TENS had no PHN, 28.6% of patients treated with antiviral drugs had PHN. Less analgesic drugs have been prescribed to patients treated only with TENS.

CONCLUSION: Study suggests TENS may be safe adjunct or even alternative to antiviral drugs for treatment of acute HZ. It looks that TENS may be at least as good as antiviral drugs for treatment of HZ, and it may be better in reducing and preventing PHN - such conclusion would necessitate controlled, prospective study. Use of TENS provided pain relief and resolution of skin lesions with no higher rate of other HZ complications compared to antiviral therapy.