MANAGING fibromyalgia pain may be entering a new phase, as transcutaneous electrical nerve stimulation (TENS) shows clinically meaningful reductions in movement related pain, with sustained benefits reported across a large real world clinical trial.
Fibromyalgia Background and Treatment Need
Fibromyalgia is characterised by chronic widespread pain that is often exacerbated by movement, limiting daily function and quality of life. Effective nonpharmacological strategies are needed, prompting investigation into whether adding TENS to routine physical therapy could improve outcomes in fibromyalgia management.
Methods and Results in Fibromyalgia Trial
The FM TIPS study was a cluster randomised clinical trial conducted across 28 outpatient physical therapy clinics in 6 health systems between February 1 2021 and September 31 2024. Of 958 individuals screened, 459 were enrolled and 384 participants completed baseline data collection, forming the modified intention to treat population. Participants had a mean age of 53 years SD 15 and 351 91% were female. Clinics were randomised to physical therapy plus TENS with 191 participants or physical therapy only with 193 participants. The primary outcome was change in movement evoked pain on a 0 to 10 scale at day 60.
The results revealed that pain was significantly lower in the TENS group with a group mean difference of −1.2 (95% CI −1.6 to −0.7 d = 0.46). Patient reported improvement was higher with TENS (72% versus 51%, P = .001). A 30% or greater pain reduction occurred in 41% versus 13% (P < .001). At day 180, 81% reported TENS helpful and 55% used it daily. There were no serious adverse events, and minor adverse events in 30% of participants.
Clinical Implications for Fibromyalgia Care
These findings demonstrate that TENS is an effective and safe adjunct for reducing movement evoked pain in fibromyalgia, with benefits sustained for at least six months. Clinicians should consider integrating TENS into physical therapy programmes, particularly given its accessibility and favourable safety profile. Future research should explore optimisation of dosing, long term adherence, and broader functional outcomes, while confirming generalisability across diverse patient populations.
Reference
Dailey DL et al. Transcutaneous electrical nerve stimulation and pain with movement in people with fibromyalgia: a cluster randomized clinical trial. JAMA Netw Open. 2026;9(3):e262450.
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