Background & Aims
Chronic pain is a common symptom in endometriosis and negatively impacts physical activity, social functioning, and health-related quality of life. First-line treatments for pain relief are oral contraceptives and nonsteroidal anti-inflammatory drugs, but many patients also receive opioids, incurring serious side effects. Transcutaneous electrical nerve stimulation (TENS) is a self-administered method used in the treatment of acute and chronic pain. Swedish national guidelines recommend TENS and physical activity (PA) as complementary treatment strategies for endometriosis-related pain. However, some patients report challenges engaging in PA due to pain and energy deficiency. There is a lack of knowledge of whether TENS can be used as an effective tool to increase PA in daily life. This study aims to explore enablers and barriers to using TENS for endometriosis-related pain and patients’ experiences of TENS including the treatment effects on PA.
Methods
Nineteen individuals, who participated in a larger, ongoing randomized controlled trial (RCT), assessing TENS for endometriosis-related pain, were consecutively invited to participate in the present focus group interview study. The eligibility criteria for the current study were individuals aged 18 years or older, endometriosis verified by laparoscopy or ultrasound, endometriosis-related chronic pain, and completing the RCT intervention, including TENS demonstration and education, followed by daily use of TENS for 16 weeks. Fifteen participants accepted the invitation and to date 10 participants have been interviewed. Four semi-structured, focus group interviews were recorded between September 2022 – January 2024 (duration 52 min – 80 min; participants in each group n=2, n=2, n=3, n=3). The interviews were transcribed and analysed using qualitative content analysis. Data collection is ongoing, and two more interviews are planned for Spring 2024.
Results
Our preliminary analysis showed that participants consider the regular use of TENS as an effective method to relieve everyday pain and facilitate daily PA by improving their ability to perform daily routines, such as taking care of the household and children, going shopping, and exercising. Participants described having increased control over their own pain management and a greater sense of security. These factors enhanced flexibility in planning and the ability to engage in social activities, resulting in a greater sense of well-being. Participants also felt satisfaction in everyday living due to the reduced need for analgesics. However, during periods of high and intense pain, i.e., acute pain flare-ups, TENS treatment was perceived as insufficient. Factors promoting the use of TENS were education and thorough demonstration of the TENS device. Factors hindering the use of TENS was the length of the wires, which were perceived as too long.
Conclusions
Patients with endometriosis-related pain experienced satisfying pain relief from TENS treatment, leading to increased PA and improved everyday functioning and well-being. TENS is self-administered and, with sufficient patient education, can lead to greater confidence and enhanced control of pain management. Our preliminary findings are encouraging, but more data and additional studies are needed to explore patients´ experiences with TENS treatment and its effectiveness in terms of increasing PA in individuals with endometriosis-related pain.
References
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Presenting Author
Josefin Larsson
Poster Authors
Josefin Larsson
RN
Sahlgrenska Universitetssjukhuset
Lead Author
Birgit Heckemann RN PhD. Associate professor
Institute of Health and Care Sciences, University of Gothenburg
Lead Author
Emma Varkey
Sahlgrenska Universitetsjukhuset/Östra
Lead Author
Axel Wolf
Institute of Health and Care Sciences, University of Gothenburg
Lead Author
Cecilia Ögren CRNA
PhD student
Institute of Clinical Sciences
Lead Author
Karin Sundfeldt MD PhD
Professor
Institute of Clinical Sciences, Gothenburg University
Lead Author
Jenny Vennberg Karlsson RMW
Department of Gynecology, Northern Älvsborg County Hospital
Lead Author
Paulin Andréll
Sahlgrenska University Hospital
Lead Author
Topics
- Specific Pain Conditions/Pain in Specific Populations: Abdominal and Pelvic Pain