The purpose of this project was to examine the variability of post-operative TENS use among physical therapists (PT) in the United States (US), and examine predictors for the usage of TENS for post-operative pain.
Post-operative pain was operationally defined as pain within the first four weeks following surgery for the purpose of this survey. The survey went through three rounds of development using expert researchers in survey development and was anonymous with all data reported in aggregate. The survey was disseminated to PTs in the United States practicing in outpatient orthopedics through the Academy of Orthopaedic Physical Therapy using Qualtrics, and was open for a 3-month period in 2023.
The total response rate was 270 participants. The data was then analyzed by comparing utilizers (those who use TENS for post-operative pain), and non-utilizers (those who do not). Those who were utilizers compromised 42.9% of the sample (57.1% were non-utilizers). Cross-tabulation and chi-square analyses were performed including calculation of odds ratios between utilizers and non-utilizers. Utilizers were more likely to have received formal training on how to use TENS for postoperative pain during their entry-level PT education (OR = 2.2 (95% CI [0.91-5.4], p .07). They were also more likely to have participated in continuing education courses on TENS (OR = 2.4 (95% CI [1.3-4.4], p .003). TENS utilizers were more likely to agree there is strong evidence to support the use of TENS for post-operative pain (OR = 4.1 (95% CI [2.4-7.1], p .001), and also were more likely to believe it can reduce opioid consumption (OR = 3.2 (95% CI [1.4-7.1], p .005).
Physical therapists who received formal training (either in their entry-level education or through continuing education) were more likely to use TENS for post-operative pain. Clinicians utilizing TENS for post-operative pain were more likely to agree there is strong evidence to support the use of TENS for post-operative pain and more likely to believe it can reduce opioid consumption. Future work includes the ongoing development of a clinical practice guidlines on the usage of TENS for postoperative pain to change provider practice patterns and improve clinical outcomes after surgery.
TENS can be a useful adjunct for managing post-operative pain, especially in reducing the need for opioids and providing a non-invasive option with few side effects. Formal education and continuing education were predictors of PTs that incorporate TENS for post-operative pain.
Pain
Electrical Stimulation
