TENS Helps Reduce Symptoms of Fibromyalgia
/By Pat Anson
In the first clinical study of its kind, researchers at the University of Iowa found that transcutaneous electrical nerve stimulation (TENS) significantly reduces pain and fatigue in patients with fibromyalgia, when combined with physical therapy.
Fibromyalgia is a poorly understood and difficult-to-treat disorder that causes widespread body pain, fatigue, insomnia, and brain fog.
The study involved 384 people with fibromyalgia, and was conducted at 28 outpatient physical therapy clinics in the Midwest. Participants were broken into two groups, with half receiving physical therapy (PT) with TENS or physical therapy alone. TENS units send mild electric currents into sore muscles and tissues to temporarily relieve pain.
TENS electrodes were placed on the upper and lower backs of patients, and delivered a mixed frequency signal at an intensity as strong as the participant could tolerate. Patients were asked to use TENS for two hours a day for six months. The treatments could be split into short periods or done all at once.
The study findings, published in JAMA Network Open, show patients in the TENS/PT group had significant improvement in their movement-based pain and fatigue after 60 days, while those who only received physical therapy had no change in their pain. The improvements in the TENS/PT group were dose-dependent, with people using TENS daily having the best outcomes.
After 60 days, patients in the physical therapy group were also given TENS units, and all the participants continued in the study for another four months.
“When we gave the PT-only patients the TENS unit and they started using it, we also saw the same improvements as the PT with TENS patients,” said lead author Kathleen Sluka, PhD, a Professor of Physical Therapy and Rehabilitation Science at University of Iowa.
The improvements in fatigue were notable, because reduced fatigue makes people more willing and able to have physical therapy.
“We were excited to see that patients also had less fatigue,” Sluka added. “Right now, there are no good treatments for fatigue. So, the fact that we had anything that touched the fatigue was pretty powerful.”
After six months, 81% of participants found TENS helpful and over half (55%) were still using TENS daily.
Researchers say it’s important for people to realize that the benefit of TENS comes from using it as a part of a total treatment plan.
“Using TENS on its own will not give the same benefits,” said first author Dana Dailey, PhD, an Assistant Research Scientist at the University of Iowa. “All the study participants were also using pain medications and receiving physical therapy, yet TENS still provided additional relief.”
Until recently, the only three medications were FDA-approved for fibromyalgia: duloxetine (Cymbalta), pregabalin (Lyrica), and milnacipran (Savella). Many patients consider the drugs ineffective or have too many side effects.
Last year, the FDA approved Tonmya, a fourth drug for the treatment of fibromyalgia in adults. Tonmya is a new formulation of an old drug: cyclobenzaprine hydrochloride (Flexeril), a muscle relaxant that was originally developed as an antidepressant.
