Transcutaneous Electrical Nerve Stimulation Effective in Reducing Fibromyalgia Pain

A recent study published in The Journal of Pain found that Transcutaneous Electrical Nerve Stimulation (TENS) reduce pain effectively in individuals with fibromyalgia (FM). This Fibromyalgia Activity Study with TENS trial examined the impact of TENS on pressure pain thresholds (PPT) and conditioned pain modulation (CPM) in FM patients.

The trial assigned individuals with FM randomly to three groups, a active TENS group, a placebo TENS group and a control group with no TENS treatment over a 4-week period. Among the total 238 females who completed the study, 76 participants received active TENS, 68 participants received placebo TENS, and 94 participants had no TENS treatment.

After the initial 4-week period, the active TENS group continued with active treatment for an additional 4 weeks making a total of 8 weeks. The placebo and no TENS groups transitioned to receive 4 weeks of active TENS (delayed TENS, n = 161).

The assessment included various pain measures such as resting pain, movement-evoked pain (MEP), pressure pain thresholds (PPT), and conditioned pain modulation (CPM) before and after the TENS treatments. No significant changes in PPT or CPM were observed among these groups after the initial 4 week period.

Individuals who reported clinically relevant improvements (≥30% decrease) in MEP demonstrated significant increases in PPT (P < .001) but not in CPM when compared to MEP non-responders. This study highlights the clinical relevance of PPT for understanding pain mechanisms, specially in individuals who show improvement in MEP. Also, CPM was not observed to be a reliable indicator of treatment response in MEP responders. These findings open opportunities to understand the underlying mechanisms that contribute to fibromyalgia pain and emphasize the potential of TENS as an effective treatment.

Reference:

Berardi, G., Dailey, D. L., Chimenti, R., Merriwether, E., Vance, C. G. T., Rakel, B. A., Crofford, L. J., & Sluka, K. A. (2023). Influence of Transcutaneous Electrical Nerve Stimulation (TENS) on Pressure Pain Thresholds and Conditioned Pain Modulation in a Randomized Controlled Trial in Women With Fibromyalgia. In The Journal of Pain. Elsevier BV. https://doi.org/10.1016/j.jpain.2023.12.009