TRANSCUTANEOUS ELECTRICAL NERVE STIMULATION AS AN ADJUNCTIVE INTERVENTION FOR PAIN, FATIGUE, AND FUNCTION IN FIBROMYALGIA: A LITERATURE REVIEW
DOI:
https://doi.org/10.31435/ijitss.3(51).2026.6052Keywords:
Transcutaneous Electrical Nerve Stimulation, TENS, Fibromyalgia, Movement-evoked Pain, Fatigue, Clinical TolerabilityAbstract
Introduction: Fibromyalgia is a chronic pain disorder characterized by widespread pain, fatigue, sleep disturbances, cognitive impairment, and reduced quality of life. Current management emphasizes patient education and non-pharmacological interventions, particularly physical activity. Transcutaneous electrical nerve stimulation (TENS) may be relevant as an adjunctive approach because of its potential to modulate pain mechanisms and support activity tolerance.
Methodology: A structured search of the PubMed database was conducted to identify studies evaluating TENS in fibromyalgia, published between 2011 and 2026. Randomized controlled trials were prioritized, particularly those assessing pain, movement-evoked pain, fatigue, physical function, quality of life, and clinical tolerability. Clinical trials, observational studies, secondary analyses, systematic reviews, and meta-analyses were also included when clinically relevant. Only English-language free full-text articles were included. The selected publications were analyzed qualitatively.
Results: The most consistent findings were observed for reductions in movement-evoked pain and fatigue, particularly when conventional TENS was applied regularly at a strong but comfortable intensity during physical activity. Effects on rest pain, objective physical function, activity levels, and quality of life were less consistent. Secondary analyses suggested that early response to TENS may help predict later clinical benefit. TENS was generally well tolerated, with mostly mild adverse events. Related transcutaneous neuromodulation approaches showed variable outcomes.
Conclusions: TENS may serve as an adjunctive non-pharmacological intervention for patients with fibromyalgia, especially for movement-evoked pain and fatigue. Further rigorously designed studies are needed to optimize stimulation protocols and identify patients most likely to benefit.
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