• Jennifer E Lee, Carryn M Anderson, Yelena Perkhounkova, Brittany M Sleeuwenhoek, and Rebecca R Louison.
• Author Affiliations: Department of Psychology, Mount Mercy University (Dr Lee and Ms Louison), Cedar Rapids, Iowa; College of Nursing, The University of Iowa (Drs Lee and Perkhounkova and Ms Sleeuwenhoek), Iowa City; and Radiation Oncology, The University of Iowa Hospitals and Clinics (Dr Anderson), Iowa City.
• Cancer Nurs. 2019 May 1; 42 (3): 218-228.

BackgroundIndividuals receiving radiation for head and neck cancer (HNC) often develop painful oral mucositis that impairs function, possibly leading to feeding tubes, hospitalization, and treatment delays. Although pharmacologic medications provide some relief, many report inadequate analgesia and adverse effects. Transcutaneous electrical nerve stimulation (TENS) is a safe, nonpharmacologic intervention; it decreases pain and analgesics and improves function, yet no studies examined TENS for HNC.ObjectiveThe aim of this study was to examine the efficacy of TENS for pain and function in HNC patients.MethodsThis study used a randomized, double-blinded crossover design; participants received 3 TENS treatments during weeks 4 to 6 of radiation: active, placebo, and no TENS over the temporomandibular joint and upper cervical region. Pain (McGill Pain Questionnaire, visual analog scale [VAS] resting and function), function (mouth opening, tongue movement, speaking), fatigue (VAS), and treatment effectiveness (VAS) were assessed before and after TENS at 3 visits.ResultsResting pain (McGill Pain Questionnaire and VAS) decreased significantly more after active TENS than placebo or no TENS; changes in function and pain with function did not differ between conditions. Active TENS decreased fatigue significantly more than no TENS and was rated as more effective than placebo TENS.ConclusionTranscutaneous electrical nerve stimulation improves pain in HNC patients receiving radiation but not function or pain with function relative to placebo or no TENS.Implications For PracticeTranscutaneous electrical nerve stimulation may be a viable tool for radiation-induced HNC pain to complement pharmacologic approaches. This nonpharmacologic intervention could decrease the debilitating effects of radiation and analgesics, and improve quality of life. Clinical trials should examine the effects and safety of repeated, daily TENS in HNC patients receiving radiation.

16 keywords...

hide…