Transcutaneous Electrical Nerve Stimulation Improves Pain, Fatigue in Women With Fibromyalgia

Transcutaneous electrical nerve stimulation (TENS) improves pain and fatigue, compared with no treatment, in women with fibromyalgia, according to a study presented here at the 2018 Annual Scientific Meeting of the American College of Rheumatology/Association of Rheumatology Health Professionals (ACR/ARHP).

“Most women who received active TENS reported global improvement in their condition,” reported Leslie Crofford, MD, Vanderbilt University Medical Center, Nashville, Tennessee.

For the study, women aged 18 to 70 years with fibromyalgia were randomised to receive at-home TENS (n = 103), sham TENS (n = 99), or no treatment at all (n = 99).

Active TENS was applied on the upper and lower back at a mixed frequency, with a strong but comfortable intensity (200musec pulse duration).

“TENS activates endogenous central inhibitory pathways and decreases central excitability,” the authors explained.

Sham TENS delivered electrical current for 45s with a ramp to 0 in the last 15s.

The women used TENS at home at least 2 hours per day. Pain and fatigue during activity and at rest were reported before and during TENS at baseline and 1 month after use using the brief pain inventory (BPI), the multidimensional assessment of fatigue (MAF), and the revised FM impact questionnaire.

After 1 month, women in the TENS group had a significant mean reduction in activity-induced pain — the primary endpoint — of 1.82. Those in the sham group had a reduction of 0.85 and women who received no treatment had a reduction of 0.56.

Women in the TENS group also had a mean reduction of 1.53 in activity-induced fatigue. The sham group only had a .08 reduction and the no treatment group had no reduction.

Participants who received active TENS had significant improvements in resting pain, BPI interference, and MAF compared with sham and no treatment (P< .05 for all).

“As a safe, inexpensive, home based-treatment, TENS may be included as part of the management strategy for women with fibromyalgia,” the authors concluded.