Hi sdkashif.

Thank you for providing those links.

I took these from your references above.

Ref #1 (Spine - Cochrane on TENS)
The results of the meta-analysis present no evidence to support the use or nonuse of TENS alone in the treatment of chronic low back pain.
Ref #2 (CSP on U/S)
What is the potential effectiveness of the intervention / impact of the issue?
The current state of evidence suggests that the physiological effects of US observed in vitro,
either do not occur in vivo, or have not been proven to have a clinical effect under these
conditions.1 There is therefore insufficient evidence to support the use of US in the treatment of
musculoskeletal injury. It has been argued that knowledge of cellular mechanisms and results
from in vitro studies coupled with judicial use of clinical reasoning constitutes good practice.9 It
is however important to establish its clinical effect, both related to different types of injury, and
with regards to the exact application of the treatment. This will allow for the most optimal
treatment and recovery, and should help to eliminate unnecessary costs both of equipment and
treatment time.
Ref #3 didn't link - don't know why (??????)

Ref #4 (A report on researching laser effectiveness on lateral epicondylalgia)
Based on the available evidence, especially
the studies by Basford et al and Papadopoulos et al, I
decided that LLLT would not be an effective intervention
for my patient with lateral epicondylitis.
Ref #5 (APA shoulder position statement)
Evidence for...
* Laser and pulsed electromagnetic field for RC tendinopathy
* U/S for short term pain relief for adhesive capsulitis
* U/S and pulsed electromagnetic field for calcific tendinitis
Evidence against...
* U/S not better than exercise for general shoulder pain
Insufficient Evidence...
*Any modality for RC tear, Instab/Hypermob of GH joint, RA or OA of the shoulder, AC joint injuries
Ref #6 (research report into C/S electrotherapy)
Overall, it can be concluded that, at present, there is no evidence on the effectiveness of electrotherapy in treating mechanical neck disorders.
Ref #7 (?insurance company's summary of the evidence of elect stim for pain)

There are too many quotes from this website but the general gist of it is that there is not much evidence to support its use or that it is to be used when every else has failed to alleviate the pain.

Ref #8 (Self care article 2002)

There is no proof that modalities improve the outcome of low back pain. However, as a short term relief and as an aid for activity resumption some of them, such as moist heat and ice can be easily taught to the patient. It is important that patients (and therapists) understand that these modalities are for controlling symptoms only and that an active approach will produce the best results.
.

So, the above "evidence" actually doesn't present any evidence at all supporting the use of Electrotherapy for most musculoskeletal conditions. There is some reported evidence for some shoulder conditions. Otherwise the evidence is equivocal at best or non-supportive at worst. Electrotherapy, as summed up in the last reference, is about symptom control, not improving the actual condition of the patient.

I am happy for people to show me where i am wrong but take the time to look these references up yourself to see that i am not being biased about this.

By the way, i do believe that the absence of evidence does not equate to evidence of failure but in this case, the available evidence shows that electrotherapy use is not supported.

Also, would it be fair to say that in Western countries, electrotherapy is less of a focus than from countries in asia, mid-east etc? Or is that a terrible generalisation? I am only garnering this information from reading the responses of participants on this forum (in other posts)...

Your thoughts would be appreciated...

Edited for poor formatting!