Manual Therapy, Posturology & Rehabilitation Journal
Manual Therapy, Posturology & Rehabilitation Journal
Research Article

The effect of transcutaneous electrical nerve stimulation (TENS) and cryotherapy in the relief of pain during labor

Regis, Mariana Meurer; Honório, Gesilani Julia da Silva; Santos, Keyla Mara dos; Luz, Soraia Cristina Tonon da; Luz, Clarissa Medeiros da; Roza, Thuane da


Background: The delivery pain is an unpleasant experience which may generate some insecurity for the woman. Thus, some methods of analgesia need to be studied in order to generate greater comfort for the woman during labor. Objective: to evaluate the effect of transcutaneous electrical nerve stimulation (TENS) and cryotherapy (CRYO) on labor pain. Method/Design: quasi experimental study, randomized sample in two groups: TENS and CRYO. Pregnant women were selected in the Carmela Dutra Maternity (Florianópolis (SC), Brazil) according to inclusion criteria: women which are pregnant for the first time, age (18-40 years) and initial cervical dilatation of 4-5cm. The Visual Analogue Scale (VAS) was used to evaluate pain before and after each intervention. Results: 24 parturient women were studied (TENS = 11, CRYO = 13). In the TENS group, there was a significant result in pain relief after the first application (p = 0.002). VAS was reduced from 8 to 5.5, but not significant. In the CRYO group there was reduction of pain during the first application (p = 0.008), and in the second there was an increase in pain (p = 0.008). There was a significant difference between the techniques in the evaluation performed before the second application, with a lower value attributed to the CRYO group (p = 0.034). Conclusions: CRYO and TENS were effective in relieving pain during the first phase of the initial phase of labor. However, during the treatment, in the parturient women studied, there was maintenance of pain response by the CRYO group and decrease in the TENS group without reduction significant.


Labor, TENS, Cryotherapy, Pain, Physiotherapy.


1. Orange FA, Amorim MMR, Lima L. Uso da eletroestimulação transcutânea para alívio da dor durante o trabalho de parto em uma Maternidadeescola: ensaio clínico controlado. Rev Bras Ginecol Obstet, 2003; 25(1): 45-52.

2. Davim RMB, Torres GV, Melo ES. Estratégias não farmacológicas no alívio da dor durante o trabalho de parto: pré-teste de um instrumento. Rev. Latino-Am. Enfermagem. 2007; 15(6): 1-7.

3. Lowe NK. The nature of labor pain. Am J Obstet Gynecol. 2002; 186(5): 16-24.

4. Pimenta CAM, Teixeira, MJ. Questionário de dor McGill: proposta de adaptação para a língua portuguesa. Rev Esc Enferm. 1996; 30(3): 473-483.

5. Chao AS, et al. Pain relief by applying transcutaneous electrical nerve stimulation (tens) on acupuncture points during the first stage of labor: A randomized double-blind placebo-controlled. Pain; 2007; 127: 214–220.

6. Pitangui AC, Araújo RC, Bezerra MJ, Ribeiro CO, Nakano AM. Low and highfrequency TENS in post-episiotomy pain relief: a randomized, double-blind clinical trial. Braz J Phys Ther. 2014;18(1):72-8.

7. Allaire, A.D. Complementary and alternative medicine in the labor and delivery suite. Clin Obstet Gynecol. 2001; 44(1): 681-91.

8. Haynes JM. Randomized controlled trial of cryoanalgesia (ice bag) to reduce pain associated with arterial puncture. Respir Care. 2015; 60(1):1-5.

9. Nugraha B, Günther JT, Rawert H, Siegert R, Gutenbrunner C. Effects of whole body cryo-chamber therapy on pain in patients with chronic low back pain: a prospective double blind randomised controlled trial. Eur J Phys Rehabil Med. 2015;51(2):143-8.

10. Santuzzi CH, Gonçalves WLS, Rocha SS et al. Efeitos da crioterapia, estimulação elétrica transcutânea e da sua associação na atividade elétrica do nervo femoral em ratos. Rev. Bras. Fisioter. 2008; 12(6): 441-446.

11. Bergeron-Vézina K, Corriveau H, Martel M, Harvey MP, Léonard G. Highand low-frequency transcutaneous electrical nerve stimulation does not reduce experimental pain in elderly individuals. Pain. 2015; 156(10):2093- 9.

12. Park C, Choi JB, Lee YS, Chang HS, Shin CS, Kim S, et al. The effect of intra-operative transcutaneous electrical nerve stimulation on posterior neck pain following thyroidectomy. Anaesthesia. 2015;70(4):434-9. doi: 10.1111/anae.12933.

13. Straube A, Ellrich J, Eren O, Blum B, Ruscheweyh R. Treatment of chronic migraine with transcutaneous stimulation of the auricular branch of the vagal nerve (auricular t-VNS): a randomized, monocentric clinical trial. J Headache Pain. 2015;16(1):543.

14. Ferreira CHJ, Beleza ACS. Abordagem fisioterapêutica na dor pósoperatória: a eletroestimulação nervosa transcutânea (ENT). Rev. Col. Bras. Cir. 2007; 34(2) 127-130.

15. Miquelutti MA, Cecatti JG, Morais SS, Makuch MY. Posição vertical durante o trabalho de parto: dor e satisfação. Rev. Bras. Saúde Mater. Infant. 2009; 9(4): 393-398.

16. Marques AP, Peccin SM. A Pesquisa em fisioterapia: a prática baseada em evidências e modelos de estudo. Fisioter. Pesqui. 2005; 11(1): 43-48.

17. Niven CA, Murphy-black T. Memory for labor pain: a review of the literature. Birth. 2000; 27(4): 244-253.

18. Pimenta CAM, Teixeira MJ. Questionário de dor McGill: proposta de adaptação para a língua portuguesa. Rev Esc Enferm. 1996; 30(3) 473-83.

19. Melo de Paula G, Molinero de Paula VR, Dias RO, Mattei K. Estimulação Elétrica Nervosa Transcutânea (TENS) no pós-operatório de cesariana. Rev. Bras. de Fisioter. 2006; 10(2): 219-224.

20. Hubbard TJ, Aronson SL, Denegar CR. Does Cryotherapy Hasten Return to Participation? A Systematic Review. J Athl Train. 2004; 39(1): 88-94.

21. Kanlayanaphotporn R, Janwantanakul P. Comparison of skin surface temperature during the application of various cryotherapy modalities. Arch Phys Med Rehabil. 2005; 86(7): 1411-5.

22. Ratna T, Rekha P. Comparative Study of Transcutaneous Electrical Nerve Stimulation (TENS) and Tramadol Hydrochloride for Pain Relief in Labor. J Obstet Gynaecol India. 2004; 54(4): 346-350.

23. Van der Spank JT, Cambier DC, De Paepe HM. Pain relief in labour by transcutaneous electrical nerve stimulation (TENS). Archives of Gynecol and Obstetrics. 2000; 264(10): 131-136.

24. Tyhopkins J. Cryotherapy and Transcutaneous Electric Neuromuscular Stimulation Decrease Arthrogenic Muscle Inhibition of the Vastus Medialis After Knee Joint Effusion. J Athl Train. 2001; 37(1): 25-31.

25. Dehcheshmeh FS, Rafiei H. Complementary and alternative therapies to relieve labor pain: A comparative study between music therapy and Hoku point ice massage. Complement Ther Clin Pract. 2015;21(4):229-32.

26. Rezende M. Obstetrícia Fundamental. 9.ed. Rio de Janeiro: Guanabara Koogan, 2003.

27. Guyton AC, Hall JE. Tratado de Fisiologia Médica. 11ª ed. Rio de Janeiro, Elsevier Ed., 2006.

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