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Transcutaneous Electrical Nerve Stimulation and Pain With Movement in People With Fibromyalgia: A Cluster Randomized
Dana L Dailey1,2, Carol G T Vance1, Barbara J Van Gorp1,3
1Department of Physical Therapy and Rehabilitation Science, University of Iowa, Iowa City.
JAMA Network Open
|March 27, 2026
Summary
Transcutaneous electrical nerve stimulation (TENS) added to physical therapy significantly reduced movement-evoked pain in fibromyalgia patients. This safe and accessible treatment demonstrated sustained effectiveness for six months, improving daily function.
Area of Science:
- Pain Management
- Neurology
- Rehabilitation Medicine
Background:
- Fibromyalgia is a chronic condition characterized by widespread pain exacerbated by movement, significantly impacting daily activities.
- Effective treatments for movement-evoked pain are crucial for improving functional outcomes in fibromyalgia patients.
Purpose of the Study:
- To evaluate the efficacy of transcutaneous electrical nerve stimulation (TENS) as an adjunct to outpatient physical therapy (PT) for reducing movement-evoked pain in fibromyalgia.
- To assess the impact of TENS on patient-reported outcomes and adverse events in fibromyalgia management.
Main Methods:
- A cluster-randomized clinical trial (FM-TIPS study) involving 384 participants across 28 outpatient PT clinics.
- Participants were randomized to either PT plus TENS (PT-TENS) or PT-only. TENS was applied for 2 hours daily.
- Movement-evoked pain was assessed using a 5-times sit-and-stand task, with primary endpoint at 60 days. Patient-reported outcomes and adverse events were also monitored.
Main Results:
- The PT-TENS group showed significantly lower movement-evoked pain at 60 days compared to the PT-only group (mean difference: -1.2; P < .001).
- A dose-response effect was observed, with greater patient-reported improvement and a higher proportion of responders in the PT-TENS group.
- TENS remained effective for 6 months, with 81% finding it helpful, and demonstrated a favorable safety profile with no serious adverse events.
Conclusions:
- Transcutaneous electrical nerve stimulation (TENS) is an effective, safe, and inexpensive addition to physical therapy for reducing movement-evoked pain in fibromyalgia.
- The findings support TENS as a readily available treatment option to improve function and quality of life for individuals with fibromyalgia.
- Sustained effectiveness for up to 6 months highlights the long-term benefits of incorporating TENS into fibromyalgia management.
