Summary of findings 1. TENS versus sham TENS.

TENS versus sham TENS for neuropathic pain in adults
Patient or population: adults with neuropathic pain Settings: secondary care Intervention/comparison: TENS vs sham TENS Outcome: Pain intensity (VAS)
Outcomes	Effect estimate (95% CI)	No of participants (studies)	Quality of the evidence (GRADE)	Comments
Post‐intervention pain intensity (VAS 0‐10)	Favoured TENS. Mean difference ‐1.58 (95% CI ‐2.08 to ‐1.09)	207 (5)	⊕⊝⊝⊝ Very lowa	Downgraded 3 levels due to multiple sources of potential bias, small number and size of studies.
Health related quality of life	No data	‐	‐	‐
Participant global impression of change	No data	‐	‐	‐
Analgesic medication use	Not estimable	‐	‐	‐
Incidence/nature of adverse events	Not estimable	‐	‐	‐
CI: confidence interval; TENS: transcutaneous electrical nerve stimulation; VAS: visual analogue scale.
GRADE Working Group grades of evidence High quality: we are very confident that the true effect lies close to that of the estimate of the effect. Moderate quality: we are moderately confident in the effect estimate; the true effect is likely to be close to the estimate of effect, but there is a possibility that it is substantially different. Low quality: our confidence in the effect estimate is limited; the true effect may be substantially different from the estimate of the effect. Very low quality: we have very little confidence in the effect estimate; the true effect is likely to be substantially different from the estimate of effect.

^aDowngraded twice for limitations of studies and once for imprecision.