<b>Comparative Effectiveness of High and Low-Intensity Transcutaneous Electrical Nerve Stimulation</b> <b> on Pain and Functional Recovery in Knee Osteoarthritis</b>

Background: Knee osteoarthritis is a prevalent degenerative joint disorder, especially among the elderly population. It is characterized by chronic pain, stiffness, and impaired ability to perform routine activities, ultimately affecting mobility and overall quality of life. Consequently, there is a need for effective, safe, and non-invasive interventions to alleviate symptoms and enhance functional outcomes. Objective: To compare the effects of high-intensity versus low-intensity transcutaneous electrical nerve stimulation on pain relief and functional improvement in individuals with knee osteoarthritis. Methodology: A randomized controlled trial was carried out involving 52 patients diagnosed with knee osteoarthritis. Patients with a history of knee joint surgery, intra-articular steroid injection within the last three months, neurological disorders, uncontrolled systemic diseases, use of pacemakers or other implants, severe deformity, or inflammatory joint diseases were excluded from the study. Participants were randomly assigned to two groups: one treated with high-intensity transcutaneous electrical nerve stimulation and the other with low-intensity. Each group underwent eight physiotherapy sessions, conducted three times per week over a specified duration. Pain levels and functional status were measured before and after the intervention using reliable and validated assessment tools. Within-group changes in pain and functional outcomes were assessed using paired t-tests. For comparisons between the study groups, independent t-tests or Mann–Whitney U tests were applied. Results: Both intervention groups exhibited significant reductions in pain and improvements in functional performance following treatment. The group receiving high-intensity transcutaneous electrical nerve stimulation showed a statistically greater decrease in pain compared to the low-intensity group (p<0.05). Functional gains were comparable between the two groups, with no significant difference observed. Conclusion: Transcutaneous electrical nerve stimulation, whether applied at high or low intensity, is beneficial in managing pain and enhancing functional capacity in knee osteoarthritis. High-intensity transcutaneous electrical nerve stimulation may offer superior analgesic effects. These findings reinforce the role of this stimulation as an effective, economical, and non-invasive option in the rehabilitation of knee osteoarthritis.