Evidence map›Paper›PMID 40901560›Full record

ArticleFrontiers in pain research (Lausanne, Switzerland)2025

Novel multimodal mechanical stimulation is superior to TENS to treat and prevent chronic low back pain: a randomized controlled trial.

Amy Lynn Baxter, Jena L Etnoyer-Slaski, Owen Tucker, Jessica Allia Rice Williams, Kevin Swartout, Lindsey L Cohen, M Louise Lawson

Registry-linked trialAbstract read
In one paragraph

Article in Frontiers in pain research (Lausanne, Switzerland), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04494698 (Addressing Pain and Disability From Low Back Pain With an External Multimodal Neuromodulation Device), which is not on this map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04494698 nacompletednot on this map

Addressing Pain and Disability From Low Back Pain With an External Multimodal Neuromodulation Device

TypeinterventionalSponsorMMJ Labs LLCRan2022 to 2025Enrolled160ConditionsAcute Low-back Pain, Chronic Low-back Pain, Pain, IntractableArmsDuotherm VibraCool Back Device, TENS 8-channel unit
3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Amy Lynn BaxterDepartment of Emergency Medicine, Augusta University, Augusta, GA, United States.
Jena L Etnoyer-SlaskiKaizo Clinical Research Institute, Landover, MD, United States.
Owen TuckerEmory University, Atlanta, GA, United States.
Jessica Allia Rice WilliamsDepartment of Health Policy and Administration, Penn State College, University Park, PA, United States.
Kevin SwartoutDepartment of Psychology, Georgia State University, Atlanta, GA, United States.
Lindsey L CohenDepartment of Psychology, Georgia State University, Atlanta, GA, United States.
M Louise LawsonDepartment of Statistics and Analytical Sciences, Kennesaw State University, Kennesaw, GA, United States.

Funding

Addressing Opioid Use Disorder with an External Multimodal Neuromodulation Device: Development and Clinical Evaluation of DuoTherm for Opioid-Sparing in Acute and Chronic Low Back Pain.R44DA049631 · NIDA · MMJ LABS, LLC · PI BAXTER, AMY LYNN · 2019 to 2023
$1.8M
Creation and Validation of the Dose-Opioid-Source Evaluation tool (DOSE) - a Robust Opioid Use Clinical Outcome Assessment for Qualification as an FDA Medical Device Development Tool (MDDT)R44DA058952 · NIDA · MMJ LABS, LLC · PI Amy Lynn Baxter, Traci J Speed · 2023 to 2026
$962k
NIDA NIH HHS R44 DA049631NIDA NIH HHS R44 DA058952
6 · The paper itself

Abstract

Background: Low back pain (LBP) is the leading cause of disability worldwide. Up to half of moderate-to-severe acute LBP (aLBP) progress to chronic (cLBP), with neuromotor, fascial, and muscle pathology contributing to inoperable mechanical disability. A novel thermomechanical stimulation (M-Stim) device delivering stochastic and targeted vibration frequencies relieved LBP in a pilot. Efficacy versus an active control, for cLBP prevention, or reversing disability was undetermined. Methods: As part of a National Institutes of Health (NIH) double-blind, randomized controlled trial, 159 chiropractic patients with non-radiating moderate-to-severe LBP [Numeric Rating Scale (NRS) ≥4] were randomized to add either the multimodal M-Stim device or 4-lead transcutaneous electrical nerve stimulation (TENS) for 30 minutes daily to other therapies. Between June 2022 and July 2024, pain scores, analgesic use, and device adherence were recorded for 28 days, with weekly follow-up up to 6 months. Primary outcomes included PROMIS Pain Interference scores, NRS pain scores, and transition from aLBP to cLBP (Pain Interference ≥55 at 3 months). Exploratory analyses examined higher-severity subgroups, including those meeting NIH Research Task Force (RTF) criteria, obesity, longer pain duration, and an integrated analysis with common criteria for intractable inoperable mechanical cLBP. Results: For 44 aLBP and 115 cLBP participants [mean age 42.6, 54% female, BMI 30.9 (SD 6.19), NRS 5.51 (SD 2.15)], M-Stim was noninferior to TENS for initial and 10-day relief. Over time, Linear Mixed Models (intention-to-treat) showed M-Stim significantly improved pain and disability for both aLBP and cLBP, ( Conclusions: A multimodal M-Stim device reduced progression to cLBP significantly more than TENS. Both devices reduced pain initially, but M-Stim reduced pain and disability significantly more over time, particularly in cLBP subsets with higher severity, duration, or BMI. Clinical Trial Registration: https://clinicaltrials.gov/study/NCT04494698, identifier NCT04494698.

Indexed as

acute low back pain (aLBP)chronic low back pain (cLBP)focal mechanical vibrationmechanical low back painpreventionPROMIS (patient-reported outcomes measurement information system)spine biomechanicsvibration

Identifiers

PMID40901560
PMCPMC12399623

What Socratic holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.