Mesotherapy Vs Transcutaneous Electrical Nerve Stimulation for Chronic Low Back Pain in Patients With Radiculopathy Publisher

Summary: Which helps chronic back pain more: mesotherapy or TENS? In a 60-patient open-label trial, mesotherapy improved pain and disability more; replication is warranted. #BackPain #Rehabilitation

Taheri P ; Hoseinzade F ; Maghroori R
Source: Iranian Rehabilitation Journal Published:2026

Abstract

Objectives: Chronic low back pain (CLBP) with radiculopathy is a disabling condition, and conventional treatments often provide limited relief. Transcutaneous electrical nerve stimulation (TENS) and mesotherapy are promising modalities; however, their comparative efficacy is not well established. This study aimed to compare the effects of mesotherapy versus TENS on pain and functional disability in patients with magnetic resonance imaging-confirmed lumbar radiculopathy. Methods: This open-label randomized clinical trial included 60 patients with CLBP. Patients were allocated to either a TENS group (10 sessions of 100 Hz stimulation) or a mesotherapy group (six sessions of subcutaneous piroxicam and lidocaine injections). Pain intensity was measured using the visual analog scale (VAS) and functional disability with the Roland-Morris disability questionnaire (RMDQ) at baseline, immediately post-treatment, and at one- and two-month follow-ups. Results: Both TENS (P<0.001) and mesotherapy (P<0.001) groups showed significant improvements in VAS and RMDQ scores compared to their respective baselines. Immediately following the interventions, patients in the mesotherapy group demonstrated a significantly greater reduction in both pain VAS and RMDQ scores than those in the TENS group. This superiority was maintained at the one- and two-month follow-up assessments, where the mesotherapy group continued to show significantly better outcomes. The therapeutic effect of TENS was transient, with scores at one and two months not being significantly different from baseline. Discussion: Mesotherapy provides a more potent and durable reduction in pain and disability compared to TENS for patients with CLBP. The sustained benefit of mesotherapy suggests it is a more robust therapeutic option for this condition, potentially creating a meaningful therapeutic window that allows patients to more effectively engage in active rehabilitation programs. © 2026 The Author(s); This is an open access article distributed under the terms of the Creative Commons Attribution License (CC-BY-NC 4.0: https://creativecommons.org/licenses/by-nc/4.0/legalcode.en), which permits use, distribution, and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.