The Open Pain Journal

ISSN: 1876-3863 ― Volume 13, 2020

High-Tone External Muscle Stimulation for the Treatment of Chronic Sciatica – A Randomized Controlled Crossover Trial

Kerstin Kempf1, #, Martin Röhling1, *, Eslam Darwish2, Stephan Martin1, Sebastian Jander3, Jörg Herdmann2, Susanne Stehr-Zirngibl2
1 West-German Centre of Diabetes and Health, Düsseldorf Catholic Hospital Group, Düsseldorf, Germany
2 St. Vinzenz Krankenhaus, Spine Unit and Center of Pain Management, Düsseldorf, Germany
3 Neurology Department, Heinrich Heine University Hospital, Düsseldorf, Germany



Chronic sciatica is a common pathology with a lifetime prevalence of 84%. Current therapy options are inadequate or not long-lasting.


Evaluation of short-term application of High-Tone Electrical Muscle Stimulation (HTEMS) compared to Transcutaneous Electrical Nerve Stimulation (TENS) with chronic sciatica.


Patients (n=100, (mean±SD) age=57±14 years, sex=42% male) with chronic sciatica were randomly assigned into two groups treated with either HTEMS or TENS. Each treatment was administered for a period of 45 min per day, 5 times within 7 days, with a 7-day wash-out period before crossover. A 5-day average of sciatic pain was assessed using the visual analog scale (VAS) before and after intervention. Drug administration was stable during the study.


Before crossover, pain intensity was significantly reduced by the HTEMS treatment (56±21 (60 [50-70]) to 45±21 (50 [30-60]) mm VAS; p<0.001), while no improvement occurred with TENS (59±19 (60 [50-70]) to 56±19 (60 [45-79]) mm VAS). After crossover, significant pain reduction was observed in both groups (both p <0.01) and did not differ between both groups after the whole intervention.


HTEMS showed a higher potential for short-term reduction of pain than TENS and might offer new a therapeutic strategy for the treatment of chronic sciatica.

Keywords: Chronic sciatica, HTEMS, TENS, VAS, Drug, Therapeutic.

Article Information

Identifiers and Pagination:

Year: 2018
Volume: 11
First Page: 21
Last Page: 30
Publisher Id: TOPAINJ-11-21
DOI: 10.2174/1876386301811010021

Article History:

Received Date: 6/4/2018
Revision Received Date: 28/10/2018
Acceptance Date: 4/11/2018
Electronic publication date: 24/12/2018
Collection year: 2018

© 2018 Kempf et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: ( This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the West-German Centre of Diabetes and Health, Düsseldorf Catholic Hospital Group, Hohensandweg 37, 40591 Düsseldorf, Germany; Tel: +49 (0)211-56 60 360 16; Fax: +49 (0)211-56 60 360 72; E-mail:
# Equal contribution

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