TITLE: A pilot study of the effectiveness of ENAR over TENS therapy for the treatment of chronic neck pain in an Australian adult population. Preliminary results.


  • Andrew L. Vitiello BSc(Anat)., MChiro., PhD(cand)
    Macquarie University, Chiropractic School
  • Associate Professor Rod Bonello DC., DO., MHA, FICC
    Macquarie University, Chiropractic School
  • Dr Henry Pollard BSc., Grad Dip Chiro., MSportsSc., PhD
    Macquarie University, Chiropractic School


The ENAR (Energo Neuro Adaptive Regulator) is a TENS-like device that utilizes a sophisticated computer controlled, feedback modulated, electro-stim ulus for the treatment of a wide variety of painful syndromes. First developed in the 1970s for the Russian Space program, scientists have since reported promising although preliminary evidence to support its use. As a result SCENAR and ENAR is now popular in Russia and Eastern Europe as an alternative to more conventional pain control strategies.

We devised a randomized, single blinded controlled trial to compare the clinical effects of ENAR with TENS for the treatment of non complicated chronic neck pain within an Australian adult population.


Adults (n=26) were recruited by advertising in two local newspapers in Sydney. The main inclusion criteria were; uncomplicated chronic neck pain which lasted for more than 6 weeks and no acute exacerbation in the 3 weeks prior to commencement of the trial.

The participants were randomly allocated to either TENS or ENAR treatment groups or a Control (placebo) group, where an inactive (switched off) ENAR unit was applied lightly to the skin. All participants attended a total of 12 visits over a six week period (phase 1) in which they received 20 minute treatments. Phase 2 of the trial is a followup period in which reassessment of the outcome measures is to be conducted at 6, 12 and 24 weeks

The outcome measures included; cervical spine range of motion (measured by the double inclinometer method), subjective pain (using a visual analogue scale (VAS)), specific disability and functional based questionnaires (the Neck Disability Index (NDI) and Patient Specific Functional Questionnaire (PSFS)) and general health and quality of life (as using the SF-36 self report questionnaire). This presentation will focus on the Pain VAS results gathered during phase 1 of this study


  • Initial analysis of VAS scores shows statistically significant benefits of ENAR over TENS and control subjects.
  • Clinically speaking, a number of subjects reported dramatic and unexpected improvement within the ENAR group.
  • More extensive follow-up data is currently being collected in the follow up phase.


The phase 1 results suggest a significant benefit associated with use of ENAR compared to TENS for the treatment of chronic neck pain. Phase 2 of the study aims to explore how well this benefit is maintained after active treatment has ceased.

This promising outcome indicates a need for further, larger trials of ENAR to more accurately determine the degree of benefit, exact clinical role and breadth of clinical application of this potential new modality for the treatment of chronic pain.