Tens Therapy Reduces Movement Pain And Fatigue In Fibromyalgia Patients

Adding TENS (transcutaneous electrical nervus stimulation) to outpatient beingness therapy reduced movement-based pain and fatigue successful patients pinch fibromyalgia, and the effects lasted for astatine least six months, according to a caller study led by researchers at University of Iowa Health Care. 

The study, led by Kathleen Sluka, PT, PhD, is the first real-world proceedings of TENS for fibromyalgia. The findings, published connected March 27 in nan journal JAMA Network Open, show that TENS is simply a safe, effective, inexpensive, and readily disposable curen for fibromyalgia, a chronic condition that causes pain, tenderness, and fatigue passim nan body. 

It is 1 of nan fewer treatments that specifically targets movement-evoked symptom and fatigue, which are major barriers to information successful regular activities."

Kathleen Sluka, PT, PhD, UI professor of beingness therapy and rehabilitation science

TENS uses a small device with adhesive electrodes to send mild electrical pulses through the skin to artifact or reduce pain. The study recovered that nan effect of TENS for reducing symptom was similar, if not better, than current FDA-approved medications for fibromyalgia. 

"We were excited to spot that patients also had little fatigue," Sluka added. "Right now, there are nary bully treatments for fatigue. So, the truth that we had thing that touched nan fatigue was pretty powerful." 

Fibromyalgia: complicated, misunderstood, and difficult to treat 

Fibromyalgia affects astir 4% to 7% of nan population. It significantly impacts a person's beingness function, cognitive abilities, and sleep. In summation to chronic pain, a cardinal characteristic of nan information is whole-body fatigue, which interferes pinch day-to-day life and contributes to patients' inability to ore and perform functional activities. 

Exercise is often nan first statement of curen recommended to people pinch fibromyalgia, and investigation has shown that it tin beryllium beneficial. However, fibromyalgia causes fatigue and pain, which is a key reason why the investigation squad focused connected alleviating symptom pinch movement. 

"Pain pinch activity hinders a person's ability to participate successful an effective workout programme and do their day-to-day activities." Sluka says. 

Science translated to real-world benefit 

Sluka and her colleagues person spent decades studying the biologic mechanisms affected by TENS, processing nan perfect parameters of TENS stimulation and testing the efficacy of TENS for treating chronic pain and fatigue in human trials. 

They have previously shown that under nan perfect conditions of a randomized, controlled objective trial, TENS successful conjunction pinch beingness therapy tin importantly alteration activity pain. 

The new Fibromyalgia TENS successful Physical Therapy (FM-TIPS) study was designed to test nan effect of TENS under real-world conditions. The study was conducted successful 28 outpatient beingness therapy clinics crossed six wellness attraction systems in nan Midwest, and included 384 people of different ages, acquisition levels, and socioeconomic backgrounds. Almost 50% of nan participants were from agrarian areas. 

"It was a challenge to enlistee participants for this study, but nan clinics and nan beingness therapists we worked pinch were great. This would ne'er person happened without them," Sluka says. 

The clinics were randomized to supply either beingness therapy (PT) with TENS aliases beingness therapy alone. In the PT-TENS group, participants were asked to usage TENS for 2 hours a day for six months. That clip could beryllium divided into short periods aliases done each astatine once. The TENS electrodes were placed connected nan precocious and lower back and delivered a mixed wave awesome astatine an strength as strong arsenic nan subordinate could tolerate. 

After 60 days, movement-evoked symptom during TENS curen was significantly improved in nan PT-TENS group. Adding TENS besides importantly reduced resting symptom and resting and movement-fatigue. In contrast, participants who received only physical therapy had nary alteration in their movement-evoked pain. 

The consequence besides was dose-dependent, with group who utilized TENS regular for 60 days having nan champion outcomes. 

Unlike galore pain-relieving drugs that tin go little effective complete clip arsenic nan assemblage develops a tolerance for nan medication, nan study shows that complete time, TENS maintained its expertise to amended symptom and fatigue astatine a important level. 

After nan superior endpoint astatine time 60, nan PT-only group was besides given TENS, and all the participants continued in nan study for another four months. 

"When we gave nan PT-only patients nan TENS portion and they started utilizing it, we besides saw nan aforesaid improvements as nan PT pinch TENS patients, which is powerful," Sluka says. 

Overall, the study showed that 80% of patients recovered TENS helpful. At six months, 80% were still utilizing TENS erstwhile a week, and complete 70% reported they felt better aft utilizing TENS. 

TENS adds benefit 

Dana Dailey, PT, PhD, UI adjunct investigation intelligence and the first author of the study, notes that it's important for group to recognize that nan use of TENS comes from utilizing it arsenic a portion of a full curen planthat includes physical therapy. 

"Using TENS connected its ain will not springiness nan aforesaid benefits," Dailey says. "However, nan study shows that TENS provides an added use connected apical of immoderate alleviation from different treatments. All the study participants were besides utilizing symptom medications and receiving beingness therapy, yet TENS still provided additional relief." 

Fibromyalgia often needs aggregate interventions to thief patients consciousness little symptom and fatigue and amended their wide function. The new findings propose that TENS could beryllium peculiarly adjuvant arsenic a portion of a multipronged attack because it tin be safely and easily utilized arsenic a self-management instrumentality that uniquely targets movement-associated symptom and fatigue. 

"Often, when you move a randomized, controlled objective proceedings into a real-world setting, it doesn't work because there are too many confounding factors. But this involution still works," Sluka says. "Not only did nan curen trim activity symptom and fatigue during nan testing period, but patients continued to usage it astatine six months." 

The study squad included researchers from University of Iowa Health Care and the University of Iowa College of Public Health; University of Illinois Chicago and UI Health; Advanced Physical Therapy & Sports Medicine; Kepros Physical Therapy & Performance; Advanced Physical Therapy Associates; Big Stone Therapies; Rock Valley Physical Therapy; Iowa City VA Healthcare System; Grand Valley State University; and Vanderbilt University Medical Center. 

The investigation was funded arsenic portion of nan HEAL Initiative by the National Institute of Arthritis and Musculoskeletal and Skin Diseases.