Nerve stimulator could ease chronic pain

TENS devices are available over-the-counter for less than $50 and they come with minimal risk—appealing aspects for many users. (For Spectrum Health Beat)

For people with the mysterious chronic pain condition fibromyalgia, researchers say nerve stimulation may offer some relief.

In a recent study, use of TENS—transcutaneous electrical nerve stimulation—during movement or activity was shown to significantly reduce pain associated with fibromyalgia after just four weeks.

Dr. Lesley Arnold, who was not involved with the new study, lauded its outcomes.

“The improvements in pain and fatigue were remarkable,” she said.

Arnold, a professor of psychiatry and behavioral neuroscience at the University of Cincinnati College of Medicine, suggested that the study may help guide physicians in use of TENS for symptom management.

TENS uses a battery-operated machine to deliver electrical currents via electrodes attached to the skin.

This is believed to activate nerve pathways that inhibit pain.

People with fibromyalgia are encouraged to engage in physical activity as a way to manage their symptoms.

But, paradoxically, movement can be painful for them.

In the study, researchers randomly divided more than 300 women with fibromyalgia into three groups: active TENS, placebo (sham) TENS, or no TENS.

Those in the TENS groups were instructed to use the device over four weeks, at home, for two hours daily during activity.

The patients were told to apply the device’s electrodes to two specific areas along the back—one upper and one lower—and to activate the machine at a modulated, or varying, frequency at the highest intensity bearable.

After four weeks, participants in the active-TENS group reported significant reductions in movement-and-resting pain and fatigue, especially compared to the no-TENS group.

Lead study author Kathleen Sluka, a University of Iowa research professor, said this study represents the culmination of years of animal research in which she and co-investigators experimented with variations in the use of TENS.

Over time, the investigators learned that alternating between low and high frequency worked best to provide pain relief. So too did cranking up the machine to its highest intensity possible. “Strong, but not painful,” she said.

While Sluka sees promise in the study’s results, she was careful to note that TENS is not a cure for fibromyalgia.

“This is another tool that’s not a drug that patients can use to manage their pain,” one that may allow someone to reach for something other than ibuprofen or opioids as a first line of defense, Sluka said.

That TENS is readily available and comes with minimal risk also make it appealing.

TENS devices can be bought over-the-counter at pharmacies for less than $50. As far as adverse effects, slight irritation at the site where the electrodes were applied was the primary adverse effect reported. And that is minor and easily adjustable, Sluka noted.

Superstar Lady Gaga shined a light on fibromyalgia when she canceled several concert tour dates in 2017 and 2018 due to reported flare-ups.

The condition is believed to affect about 10 million Americans, according to the National Fibromyalgia Association.

As researchers continue to look for safe and effective ways to alleviate the pain of fibromyalgia, much about it remains a mystery.

Diagnosis is usually based on a patient’s medical history and exam, as there’s no blood test or other biomarker to identify it.

And while its biological origins are unclear, most experts believe it is associated with alterations in the central nervous system that affect how the body responds to pain.

Management of the condition, which affects women disproportionately, has improved in recent years, said Arnold. It’s being identified earlier, general awareness of the condition has improved and, recently, a few medications have been approved by the U.S. Food and Drug Administration to manage it.

“But there’s still a great deal of unmet need,” Arnold said.

The report was recently published online in the journal Arthritis & Rheumatology.

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