Transcutaneous electrical nerve stimulation reduces pain, fatigue and hyperalgesia while restoring central inhibition in primary fibromyalgia

Dana L. Dailey, Barbara A. Rakel, Carol G.T. Vance, Richard E. Liebano, Anand S. Amrit, Heather M. Bush, Kyoung S. Lee, Jennifer E. Lee, Kathleen A. Sluka

Research output: Contribution to journalArticlepeer-review

152 Scopus citations


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.

Original languageEnglish
Pages (from-to)2554-2562
Number of pages9
Issue number11
StatePublished - Nov 2013

Bibliographical note

Funding Information:
Supported by a grant from the Orthopedic Section of the American Physical Therapy Association, the Carver College of Medicine at the University of Iowa, College of Nursing at the University of Iowa, NIH R34 AR060378. TENS units were donated by DJO (Vista, CA, USA). Additional assistance provided by Shannon Lehman for coordination of the study and Ann Lawler for secretarial and manuscript assistance.


  • Analgesia
  • Chronic widespread pain
  • Electrical stimulation
  • Fatigue
  • Fibromyalgia
  • Hyperalgesia
  • Pain
  • Transcutaneous electrical nerve stimulation (TENS)

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology
  • Anesthesiology and Pain Medicine


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