Fibromyalgia Clinical Trial
Official title:
Fibromyalgia Activity Study With Transcutaneous Electrical Nerve Stimulation
Pain associated with fibromyalgia interferes with daily function, work, and social activities
resulting in a decreased quality of life. People with fibromyalgia also have a significant
amount of fatigue and a fear of movement. People with fibromyalgia show enhanced excitability
of pain neurons in the central nervous system and reduced pain inhibition. Therefore, one of
the main treatments for patients with fibromyalgia must focus on pain relief to allow the
person to function more independently both at home and at work. Transcutaneous electrical
nerve stimulation is used by health professionals to deliver electrical stimulation through
the skin for pain control. Basic science studies, from the PI's laboratory show that TENS
activates descending pain inhibitory pathways to inhibit excitability of pain neurons. Thus
the ideal patient population for the treatment of TENS would be one in which there is
enhanced central excitability and reduced inhibition; fibromyalgia is such a condition.
Hypothesis: The investigators hypothesize that application of Transcutaneous Electrical Nerve
Stimulation (TENS) to patients with fibromyalgia will reduce resting and movement-related
pain and reduce central excitability by restoring diffuse noxious inhibitory controls (DNIC),
and that this decrease in pain and/or central excitability will reduce fatigue and fear of
movement, thereby improving function and quality of life
This is a phase II randomized, double-blind, placebo controlled multi-center clinical trial
involving a device, Transcutaneous Electrical Nerve Stimulation (TENS). TENS is a
non-pharmacological agent which delivers electrical stimulation by a battery operated device
via electrodes placed on the skin. TENS is considered to be a safe, inexpensive and
non-invasive modality used to treat a variety of acute and chronic pain conditions. The
initial phase of the study will randomly allocate subjects to receive active TENS, placebo
TENS or standard care (No TENS). After participating in the 1 month random assignment, all
subjects will receive active TENS for 1 month. The subjects will make 4 visits to the clinic
approximately 2 to 3 1/2 hours each visit. Visits will entail questionnaires, functional
tasks, accelerometry, TENS, pain and fatigue assessments.
Study Aims:
Aim #1: The primary aim of the study is to test the effectiveness of repeated TENS use on
movement-related pain in people with fibromyalgia with random assignment to three treatments:
standard care, placebo TENS and active Aim #2: A secondary aim will test if pain reduction by
TENs results in a concomitant decrease in fatigue and fear of movement, and an increase in
function and quality of life. Outcome measures will include physical function by directly
assessing daily activity with an accelerometer, as well as performing specific functional
tasks
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