TENS Efficacy in Fibromyalgia Save

A randomized clinical trial of transcutaneous electrical nerve stimulation (TENS) in fibromyalgia showed meaningful improvement in pain for 6 months when combined with physical therapy (PT). 

The Fibromyalgia TENS in Physical Therapy (FM-TIPS) study was a cluster-randomized clinical trial of 459 fibromyalgia patients from 28 outpatient PT clinics were randomized to PT plus TENS (PT-TENS) and PT-only groups. Outcomes were captured on days 1, 30, 60 (primary end point, randomized phase), 90, and 180. Participants in the PT-only group received TENS after day 60 (extension phase). TENS was applied to the upper and lower back with instructions to use 2 hours daily with parameters of modulating frequency of 2 to 125 Hz for 100 to 180 microseconds at a strong but comfortable intensity.  The primary outcome was a change in movement-evoked pain (scale of 0-10) during a 5-times sit-and-stand task.

A total of 384 FM-TIPS participants (mean age 53 years; 91%] female) were enrolled. 

Movement-evoked pain at day 60 was significantly lower in the PT-TENS group compared with the PT-only group (group mean difference, −1.2; 95 CI, −1.6 to −0.7; d = 0.46). 

Additional benefits were seen with other secondary outcomes: 

• Patient Global Impression of Change favored PT-TENS (72% vs 51%, P = .001)
• >30% reduction in movement-evoked pain (responder analysis) (41% vs 13%; P < .001)

At day 180, 81% found TENS helpful and 55% used TENS daily. There were no serious adverse events.