ArticleTranscutaneous electrical nerve stimulation reduces pain, fatigue and hyperalgesia while restoring central inhibition in primary fibromyalgiaDailey, Dana L.a; Rakel, Barbara A.a,b; Vance, Carol G.T.a; Liebano, Richard E.c; Amrit, Anand S.d; Bush, Heather M.e; Lee, Kyoung S.e; Lee, Jennifer E.a,b; Sluka, Kathleen A.a,b,* Author Information aDepartment of Physical Therapy and Rehabilitation Science, Carver College of Medicine, University of Iowa, Iowa City, IA, USA bCollege of Nursing, University of Iowa, Iowa City, IA, USA cUniversity of the City of Sao Paulo, Physical Therapy Department, Sao Paulo, Brazil dDepartment of Rheumatology, University of Iowa, Iowa City, IA, USA eDepartment of Biostatistics, University of Kentucky, College of Public Health, Lexington, KY, USA *Corresponding author. Address: Department of Physical Therapy and Rehabilitation Science, Carver College of Medicine, University of Iowa, Iowa City, IA 52422-1089, USA. E-mail: [email protected] Submitted October 22, 2012; revised July 8, 2013; accepted July 24, 2013. ☆ ClinicalTrials.Gov: NCT00932360, C9366, Transcutaneous Electrical Nerve Stimulation (TENS) and Fibromyalgia (FM). Pain 154(11):p 2554-2562, November 2013. | DOI: 10.1016/j.pain.2013.07.043 Buy Metrics Abstract Summary Pain and fatigue during movement, but not at rest, are reduced by a onetime 30-m treatment with active transcutaneous electrical nerve stimulation (TENS) in individuals with fibromyalgia. Because transcutaneous electrical nerve stimulation (TENS) works by reducing central excitability and activating central inhibition pathways, we tested the hypothesis that TENS would reduce pain and fatigue and improve function and hyperalgesia in people with fibromyalgia who have enhanced central excitability and reduced inhibition. The current study used a double-blinded randomized, placebo-controlled cross-over design to test the effects of a single treatment of TENS with people with fibromyalgia. Three treatments were assessed in random order: active TENS, placebo TENS and no TENS. The following measures were assessed before and after each TENS treatment: pain and fatigue at rest and in movement; pressure pain thresholds, 6-m walk test, range of motion; 5-time sit-to-stand test, and single-leg stance. Conditioned pain modulation was completed at the end of testing. There was a significant decrease in pain and fatigue with movement for active TENS compared to placebo and no TENS. Pressure pain thresholds increased at the site of TENS (spine) and outside the site of TENS (leg) when compared to placebo TENS or no TENS. During active TENS, conditioned pain modulation was significantly stronger compared to placebo TENS and no TENS. No changes in functional tasks were observed with TENS. Thus, the current study suggests TENS has short-term efficacy in relieving symptoms of fibromyalgia while the stimulator is active. Future clinical trials should examine the effects of repeated daily delivery of TENS, similar to the way in which TENS is used clinically on pain, fatigue, function, and quality of life in individuals with fibromyalgia. © 2013 Lippincott Williams & Wilkins, Inc.