needles. The needles used were 32G (0.25mm diameter). This is a very .... are used, local segmental needling is also ... segmental dry needling, is puzzling.
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Review
Percutaneous Electrical Nerve Stimulation – Electroacupuncture by Another Name? A Comparative Review. Mike Cummings
T Mike Cummings medical director BMAS Medical-Director@ medical-acupuncture.org.uk
Summary Percutaneous electrical nerve stimulation (PENS) is a technique that has been described as a ‘novel analgesic therapy’. A review was performed of the published literature in order to compare PENS with the author’s knowledge and experience of the use of EA, specifically with regard to the stimulation parameters, the selection of points, and the reported efficacy. The conclusion of the review is that PENS is neither different in principle nor in practice from EA, and whilst the term accurately reflects the nature of the treatment, there is no substantial justification for referring to PENS as a novel therapy. Keywords Percutaneous electrical nerve electroacupuncture, review.
stimulation,
Introduction During a casual search for recent reviews of TENS (transcutaneous electrical nerve stimulation) in the Cochrane database, the author happened upon the lesser know acronym PENS (percutaneous electrical nerve stimulation) for the first time. At a first glance over several abstracts of RCTs of PENS, there appeared to be a remarkable similarity between this ‘novel technique’ and the more familiar EA (electroacupuncture). The author was concerned that these papers had been missed from his routine literature searches for acupuncture papers, because the abstracts of the PENS papers did not include any text beginning with the stem ‘acup’ – the search term he had regularly employed.
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It was felt that the subject deserved investigation to determine whether there was any difference between PENS and EA, and to bring the matter to the attention of the readership of Acupuncture in Medicine. Methods A computerized text word search of PubMed and the Cochrane database was performed in February 2001 using the search term ‘pens’. No other restrictions were applied to the search. A further text word search of PubMed was performed using the complete term ‘percutaneous electrical nerve stimulation’. Reading the titles and abstracts identified the references of relevance, and these papers were obtained. An analysis of the technique of PENS described in the papers was compared with the author’s knowledge and experience of the use of EA, specifically with regard to the stimulation parameters, both manual and electrical, the selection of points, and the reported efficacy. Results The PubMed search using the text word ‘pens’ produced 1268 references. The subsequent search using the complete term ‘percutaneous electrical nerve stimulation’ revealed only 13 references,1-13 and a search of the Cochrane database did not produce any additional ones. Of the 13 references, there were seven relevant RCTs,1-7 and one case series.8 The other references were to letters,10-13 and one reference was to a systematic review of treatments for herpes zoster9 that mentioned one of the PENS trials already identified.5 The
ACUPUNCTURE IN MEDICINE 2001;19(1):32-35. www.medical-acupuncture.co.uk/aimintro.htm
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Review Table 1 Papers on Percutaneous Electrical Nerve Stimulation (PENS) Clinical area LBP1
Sciatica2
LBP – comparing frequencies of PENS3 LBP – comparing duration of PENS4 Herpes zoster5
Mixed headache6
Diabetic neuropathic pain7 Pain from bony metastases8
