Fibromyalgia : TENS nerve stimulation improve movement-related pain and fatigue

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A treatment involving electrical nerve stimulation helped women with fibromyalgia in a recent clinical trial. The findings are published in Arthritis & Rheumatology.

Fibromyalgia is characterized by pain and fatigue, particularly during physical activity.

Transcutaneous electrical nerve stimulation (TENS) delivers electrical currents through the skin to activate nerve pathways in the body that inhibit pain.

In this trial, TENS resulted in significant improvements in movement-related pain and fatigue compared with placebo or no TENS.

The TENS treatment was given along with standard treatments for fibromyalgia. Thus, it can provide people with a tool to help manage pain and fatigue without taking additional pain medications.

In this trial, TENS resulted in significant improvements in movement-related pain and fatigue compared with placebo or no TENS.

“TENS is available over the counter, is inexpensive, and is safe and easy to use,” said senior author Kathleen A. Sluka, PT, PhD, FAPTA, of the University of Iowa.

“It can provide a self-management option for people with chronic pain, particularly fibromyalgia, to provide an additional level of pain relief.


Objective

Fibromyalgia (FM) is characterized by pain and fatigue, particularly during physical activity. Transcutaneous electrical nerve stimulation (TENS) activates endogenous pain inhibitory mechanisms. We evaluated if using TENS during activity would improve movement‐evoked pain and other patient‐reported outcomes in women with FM.

Methods

Participants were randomly assigned to receive active‐TENS (n=103), placebo‐TENS (n=99) or no‐TENS (n=99) and instructed to use it at home 2h/day during activity for 4‐ weeks. TENS was applied to the lumbar and cervicothoracic regions using a modulated frequency (2‐125Hz) at the highest tolerable intensity.

Participants rated movement‐evoked pain (primary outcome) and fatigue on an 11‐point scale before and during application of TENS. Primary and secondary patient‐reported outcomes were assessed at randomization and 4weeks.

Results

After 4‐weeks, the active‐TENS group reported a greater reduction in movement‐evoked pain and fatigue than placebo‐TENS (Pain, Group mean difference(95% CI): ‐1.0(‐1.8, ‐0.2), p=0.008; Fatigue: ‐1.4(‐2.4, ‐0.4), p=0.001) and no‐TENS groups (Pain: ‐1.8(‐2.6. ‐1.0), p<0.0001; Fatigue: ‐1.9(‐2.9, ‐0.9), p=<0.0001). A greater percentage of the active‐TENS group reported improvement on the global impression of change when compared to placebo‐TENS (70% vs. 31%, p<0.0001) and no‐TENS (9%, p<0.0001). There were no TENS‐related serious adverse events and less than 5% of participants experienced minor adverse events from TENS.

Conclusion

Among women with FM and stable medication, 4‐weeks of active‐TENS use compared with placebo‐TENS or no‐TENS resulted in a significant improvement in movement‐evoked pain and other clinical outcomes. Further research is needed to examine effectiveness in a real world, pragmatic setting to establish clinical importance of these findings.


Source:
Wiley
Media Contacts:
Penny Smith – Wiley

Original Research: Open access
“A Randomized Controlled Trial of TENS for Movement‐Evoked Pain in Women with Fibromyalgia”. Kathleen A. Sluk et al.
Arthritis & Rheumatology doi:10.1002/art.41170.

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