Earticle

Complex Regional Pain Syndrome (CRPS) is a chronic neuropathic condition with unclear etiology and pathophysiology, characterized by heightened pain sensitivity and various autonomic disturbances. Due to the lack of a definitive treatment, a multidisciplinary approach is essential for managing symptoms and improving patients’ quality of life. Managing CRPS in pregnant patients presents additional challenges, as many conventional pharmacological treatments and interventional procedures carry risks to maternal and fetal health. This limits therapeutic options, necessitating safer and non-invasive alternatives. Transcutaneous Electrical Nerve Stimulation (TENS) is a proven safe and effective therapy for pregnancy-related low back pain, making it a promising option for managing CRPS in pregnant patients. In our case, TENS provided significant pain relief, demonstrating its potential as a viable, non-invasive modality for CRPS treatment during pregnancy without compromising safety.

Objective Insomnia disorder is a common condition with considerable harmful effects on health. We investigated the therapeutic efficacy and safety of low-frequency transcutaneous electric nerve stimulation (LF-TENS) as an alternative treatment option for insomnia disorder.Methods A 4-week, multi-center, randomized controlled study was conducted. A total of 160 individuals aged 40 to 80 years with insomnia disorder were included and randomized to the experimental group receiving active device (n=81) or control group receiving sham device (n=79). Both groups used the device for four weeks, more than five days a week. The participants also completed pre- and post-intervention assessment with questionnaires, sleep diaries, wrist actigraphy, and blood tests.Results There was no significant between-group difference in the changes of mood and sleep parameters and blood test results among the two study groups. Meanwhile, in the exploratory sub-group analysis of patients aged over 60 years, the experimental group showed better improvement after intervention in the change of Pittsburgh Sleep Quality Index (PSQI) score (-2.63±3.25 vs. -1.20±2.28, p=0.039; Cohen’s d=0.99 vs. 0.45) and blood cortisol level (-1.65±3.37 μg/dL vs. -0.16±3.49 μg/dL, p=0.007; Cohen’s d=0.56 vs. 0.05). In addition, no serious adverse reaction occurred during the study period in both groups.Conclusion The effect of LF-TENS was limited to older patients aged over 60 years, which might be related to the modulation of hypothalamic-pituitary-adrenal axis activity.