NEW YORK, Jan 4, (RTRS):  People with chronic low back pain who seek relief with transcutaneous electric nerve stimulation or TENS are wasting their time and money, according to a published report.
However, the technique can be effective in relieving diabetic nerve pain, also called diabetic neuropathy, the report concludes. About 60 percent of people with diabetes will develop diabetic neuropathy.
According to the new TENS practice guideline — issued by the American Academy of Neurology and published in the academy’s journal Neurology — TENS is “ineffective” for the treatment of chronic low back pain but is “probably effective” in reducing pain from diabetic neuropathy.
Research on TENS for chronic low back pain has yielded conflicting results. The new guideline stems from a comprehensive review of the scientific literature.
Of 263 articles on TENS research identified, Dr Richard M. Dubinsky of the University of Kansas Medical Center and Dr Janis Miyasaki of Canada’s Toronto Western Hospital found five studies that met the scientific standards necessary for meaningful conclusions.
The two studies that had the strongest designs (Class 1) found “no benefit” from TENS in relieving chronic lower back pain — that is, pain that has persisted for three months or longer. Three weaker (Class 2) studies had conflicting results, with “modest” TENS benefits found in two of them and no benefit in the third.
For people suffering from numbness, tingling, or jabbing pain associated with diabetic neuropathy, the results were more promising. Two Class 2 studies found modest reductions in pain, leading Dubinsky and Miyasaki to conclude, “TENS should be considered for the treatment of painful diabetic neuropathy.”
A TENS unit is a portable, pocket-sized, battery-operated device. Electrodes are applied to the skin at the area of pain. When turned on, an electric current is sent through the electrodes causing a tingling sensation in the underlying skin and muscle. The current is adjustable and may be applied in short bursts.
It is thought that electric nerve stimulation blocks the pain signal to the brain, providing short-term relief.
Despite the growing popularity of TENS, proof of its effectiveness is lacking, Dubinsky told Reuters Health in a telephone interview.
Dubinsky and Miyasaki say further vigorous research is needed to validate the technique’s effectiveness against a variety of painful conditions.
In an accompanying editorial, Dr Andreas Binder, a neurologist from Christian-Albrechts-Universit?t Kiel, Germany and co-author Dr Ralf Baron agree that more research is needed but conclude that TENS remains an important weapon against pain.
“In spite of the relatively weak scientific and clinical evidence, TENS still represents a valuable therapeutic alternative,” they wrote.
Binder and Baron point out that TENS offers a non-drug alternative that can be quickly applied, does not interact with other medications and can be discontinued if it doesn’t work.
TENS units are regulated by the Food and Drug administration as medical devices. They can be purchased for home use by individuals with a prescription. Online prices for units range from $30 to $200 dollars.
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Itchy skin:  Chronically itchy skin can take not only a physical toll but a psychological one as well, a new study suggests.
Research has linked various skin conditions, such as severe acne, psoriasis and eczema, to higher risks of depression, anxiety and stress in some individuals. But it has not been clear whether chronic itchiness — a common symptom of skin disorders — can cause its own distress.
The new study, of more than 2,200 Japanese adults age 18 and up, found that 3 percent complained of chronically itchy skin, also known as pruritus. And the more severe the problem, the more likely they were to score high on a measure of psychological stress.
The findings suggest that the symptom itself, and not just the disorders it marks, can take an emotional toll, according to the researchers, led by Dr Yosuke Yamamoto of Kyoto University in Japan.
They report the results in the latest issue of Archives of Dermatology.
The study included 2,224 Japanese adults who kept health diaries over one month and completed a standard questionnaire called the Perceived Stress Scale — which measures, for instance, how often a person has felt “nervous” or “stressed” in the past month.
Participants used the diaries to record the presence and severity of various symptoms, including itchiness.
Overall, Yamamoto’s team found, participants with itchy skin had a higher average score on the stress scale than other participants did. And the more frequent the symptom, the higher the scores.
The link between itchiness and stress was also seen among participants who had more than two health complaints. This, according to the researchers, suggests that itchiness itself has psychological effects independent of other health problems.
A number of skin conditions — including eczema, recurrent hives and psoriasis — are marked by sometimes intensely itchy skin. The current findings suggest that if the symptom is not well-controlled, it can be a source of psychological, as well as physical, hardship, according to the researchers.
They point out that the questionnaire they used in the study cannot diagnose clinical depression or other mental health disorders. But people’s scores do serve as an indicator of general psychological distress.
In turn, the researchers note, chronic stress may affect the immune, hormonal and cardiovascular systems, potentially affecting long-term physical health.
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Drinking problems: The minimum legal drinking age of 21 now in place by all U.S. states may have prevented a significant amount of alcoholism and drug abuse, according to a new study.
In the study, researchers found that adults living in states that permit the purchase of alcohol before age 21 were more apt to have alcohol and drug problems later on than adults living in states that prohibit people under the age of 21 to buy alcohol.
The study, published today in an early online edition of Alcoholism: Clinical and Experimental Research, suggests that lower drinking ages may lead to more problems with alcohol and drugs later in life.
“It seems plausible that frequency and intensity of drinking in late adolescence may have long-term effects on adult substance use patterns,” Dr Karen Norberg, of Washington University in St. Louis and colleagues note in the report.
It’s highly possible, they add, that the higher legal drinking age may help keep a lid on the amount of alcohol consumed before age 21. Until the mid-1980s, many states allowed people to purchase alcohol at the age of 18. However, all states now have a minimum drinking age of 21 because of a 1984 federal law that used eligibility for funding to pressure for the change.
Norberg and colleagues found differences in rates of alcoholism and drug abuse among 33,869 U.S. adults exposed to different minimum legal drinking age laws.
A little more than half of the adults studied (52 percent) would have been allowed to purchase alcohol before their 21st birthday, the investigators note.
After adjusting for factors that might skew the results, the researchers found that people who lived in states that permitted buying and drinking alcohol before age 21 were about 30 percent more likely to have suffered from alcoholism and 70 percent more likely to have had a drug problem in the past year. (For comparison, about 10 percent of all of the people studied met criteria for alcohol abuse in the past year, and about 3 percent met criteria for marijuana or other illegal drug abuse in the past year.)
This was true even among people evaluated in their 40s and 50s.

Norberg and colleagues calculate that had the minimum legal drinking age been set at 21 in all states throughout the 1970s and 1980s, the prevalence of alcohol and substance abuse disorders among aEarlier drinking may mean more drinking problems