TENS Reduced Fibromyalgia Pain and Fatigue in Women

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Findings from a 2019 randomized controlled trial published in Arthritis & Rheumatology showed that transcutaneous electrical nerve stimulation—better known as TENS—reduced movement-related pain and fatigue in women with fibromyalgia.

TENS adhesive patches applied to a woman's neck and upper backIn the move-related pain and fatigue fibromyalgia study, TENS electrode patches were applied to both the neck/upper back and lower back spinal regions. Photo Source: iStock.com.

Fibromyalgia (sometimes called fibrositis) is a chronic pain disorder characterized by widespread musculoskeletal pain and fatigue. Many people with the condition experience more pain with movement and activity, so this research offers hope for women who want to stay active while managing their fibromyalgia symptoms.

Although these findings are among the latest to support nerve stimulation for fibromyalgia management, Kathleen A. Sluka, PT, PhD, FAPTA, who co-authored the study, said the research team has studied TENS for more than 20 years. Dr. Sluka is Professor of Physical Therapy and Rehabilitation Science at the University of Iowa Carver College of Medicine, in Iowa City, IA.

“We started by looking at how TENS relieves pain, and showed it works by increasing our body’s own pain-inhibiting chemicals and reducing activity in the pain-producing pathways,” Dr. Sluka said. “Since fibromyalgia is associated with a loss of pain inhibition and increased activity in the nervous system, we thought that TENS would work well in this population.”

What Is TENS, and How Can It Reduce Pain?

Transcutaneous electrical nerve stimulation, or TENS, sounds more extreme than it is. This treatment decreases pain perception by activating nerve pathways via mild electrical currents. The electrical currents are sent to your nerves via electrode patches that adhere temporarily to your skin.

The therapy may sound intense, but it’s safe, painless, and can be performed at home or as a passive treatment during physical therapy. TENS also boasts a low rate of side effects, and it may be used in combination with other fibromyalgia treatments (eg, medications, exercise, massage).

A Closer Look at the Fibromyalgia Study

The study participants were women with fibromyalgia. The participants were randomly assigned to 1 of 3 treatment groups:

  1. Active TENS (103 participants)
  2. Placebo TENS (99 participants)
  3. No TENS (99 participants)

The researchers asked the TENS participants to use a TENS unit at home for 2 hours per day during movement or activity for 4 weeks. The electrodes were applied to both the low back and neck/upper back spinal regions, and the women were asked to use the device at the highest intensity without compromising comfort. TENS was used alongside other standard treatments for fibromyalgia (eg, medication).

Before and during TENS sessions, the participants rated their movement-related pain and fatigue on an 11-point numeric pain scale where zero was no pain and 10 was the worst pain imaginable. This allowed the research team to gauge pain levels when the participants were at rest versus when they were moving.

Fibromyalgia Study Outcomes Important

At the completion of the 4-week study period, the women in the active TENS group reported greater improvements in movement-related pain and fatigue than both the placebo TENS and no TENS groups.

  • 44% of the active-TENS group reported a 30% pain reduction, which was deemed “clinically important”
  • 45% of the active TENS group reported reduced fatigue
  • 29% of the active TENS group saw improvements in both pain and fatigue

The authors noted that the pain reductions reported by the TENS users are similar to those attributed to fibromyalgia medications: “The responder rates for pain are similar to FDA-approved pharmaceutical agents for [fibromyalgia] such as duloxetine or pregabalin which show responder rates of between 31-41% for a 30% reduction in pain.”

TENS Helps Ease Fibromyalgia Patients’ Exercise-Related Pain

Dr. Sluka and her team discovered that TENS itself not only eased fibromyalgia symptoms, but it may also help women with fibromyalgia engage in other beneficial treatments for the condition, including exercise and physical therapy. Movement-related therapies are effective at managing fibromyalgia pain, but many people with the condition avoid them because they experience a spike in pain whenever they engage in activity.

TENS may help lessen the pain associated with increased activity, helping women with fibromyalgia exercise easier and better manage their condition.

“The use of TENS could be a great treatment to work on movement-evoked pain in this population to allow people to exercise with less pain,” Dr. Sluka said.

TENS and Fibromyalgia Study: 3 Key Takeaways for Patients

For women with fibromyalgia struggling to manage their widespread nerve pain, Dr. Sluka said this research showed that TENS has several benefits for managing fibromyalgia pain.

  • “First, TENS works to reduce movement-evoked pain and could be particularly useful to use while doing activities to allow patients to do more activities they enjoy and participate in an exercise program,” Dr. Sluka said.
  • Second, she noted that TENS works best by applying it at a strong but comfortable intensity. Even at a strong intensity, TENS has minimal side effects. The researchers found that less than 5% of study participants reported pain with TENS or irritation with electrodes.
  • Third, TENS may be a worthwhile treatment if you have fatigue-related fibromyalgia symptoms. “TENS also has an effect in reducing fatigue in individuals with fibromyalgia,” Dr. Sluka said. “Few treatments have a direct effect on fatigue.”

If you or a loved one struggles with managing fibromyalgia pain and symptoms, this study offers support for TENS as a safe, inexpensive, and effective treatment option to discuss with your doctor.

Updated on: 02/10/20
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Transcutaneous Electrical Nerve Stimulation May Help Reduce Neck and Back Pain
Kathleen A. Sluka, PT, PhD, FAPTA
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Transcutaneous Electrical Nerve Stimulation May Help Reduce Neck and Back Pain

TENS works to decrease pain perception and may be used to control acute and chronic pain. It may also be used with other treatments such as exercise.
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