Objective:

To evaluate the effectiveness of transcutaneous electrical nerve stimulation (TENS) in reducing movement-evoked pain in patients with fibromyalgia when added to routine physical therapy.

Approach:

Key Findings:

• Movement-evoked pain decreased more in the TENS group compared to the control group at 60 days, with a mean difference of 1.2 points on a 0 to 10 scale.
• 41% of TENS patients achieved at least a 30% reduction in movement-evoked pain versus 13% in the control group.
• 72% of TENS patients reported improvement on the Patient Global Impression of Change compared to 51% in the control group.
• Secondary outcomes favored TENS, showing significant reductions in resting pain, fatigue, and overall disease impact.
• No serious adverse events related to TENS were reported; minor adverse events occurred in about 30% of patients.

Interpretation:

TENS provides small to moderate improvements in pain and related symptoms in fibromyalgia patients, supporting its use as a nonpharmacologic treatment option.

Limitations:

• Variability in physical therapy approaches, which were not standardized or tailored to fibromyalgia.
• Inability to assess changes in medication use.
• Underrepresentation of racial and ethnic minority populations.

Conclusion:

TENS produced effects quickly and remained effective through six months, representing a safe treatment option for fibromyalgia.

Sources:

• JAMA Network
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