TDNet Discover

Background: With 5-10% of the global population affected by fibromyalgia, research has investigated the most effective combination of treatments for its constellation of symptoms. Current guidelines do not discuss recent breakthroughs in research, which suggest use of newer treatment modalities, such as transcutaneous electrical nerve stimulation (TENS). Purpose: The purpose of this study was to define the role of TENS in fibromyalgia treatment through evidence-based clinical review of current literature. Thus, this review searched for common findings supporting the use of TENS across various clinical manifestations of fibromyalgia, such as depression, anxiety, pain, sleep disturbance, severe disability, and reduced quality of life. Methods: Three independent researchers reviewed articles from ScienceDirect, Research Gate, ProQuest, Google Scholar, and PubMed, searching for literature that followed specific inclusion criteria. After the initial search, an article review was performed to assess for quality and applicability. 3 meta-analyses were selected for further data extraction and analysis. Results: Of the 3 studies included, all 3 found moderate to high evidence that TENS provides significant pain relief for fibromyalgia patients. One study specifically found that high frequencies, specifically 10-200 Hz, provided the most significant pain relief, were more comfortable for patients, and were less prone to tolerance over longer regimens. Another metaanalysis found that TENS was effective in relieving fibromyalgia pain both in isolation and in combination with other guideline-recommended treatments. The article also found that TENS boosted quality of life by improving tolerance for exercise, activities of daily living, psychological treatment, and titration of certain medications. v Conclusion: TENS is an affordable, non-invasive, and convenient fibromyalgia treatment that can be used on its own or as an effective adjunct without producing any of the side effects associated with pharmacologic treatment. In isolation and combination, TENS has been shown to improve pain, disability, and quality of life. Therefore, this article recommends its inclusion in current guidelines. To verify these conclusions, future studies should aim to reduce heterogeneity and specify which settings of TENS parameters or combinations of therapies are responsible for their results. In this way, future research can better establish the most effective methods, roles, and combinations of TENS in targeting specific fibromyalgia symptoms.