Fibromyalgia syndrome (FM) is a chronic widespread pain condition that is accompanied by fatigue, cognitive disturbances, and dysfunction. Patients suffering from FM also experience decreased quality of life and increased healthcare costs. Presently, FM is managed with a multidisciplinary approach involving drugs, behavioral interventions, physical therapy, and exercise. Neuroimaging results demonstrated abnormal CNS pain processing in FM patients suggesting that targeting these abnormalities may help relieve their symptoms. One novel treatment option for FM includes noninvasive brain stimulation.
Transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS) of the brain are both noninvasive techniques increasingly used for FM management. Wire coils are placed on the patient’s head whose magnetic field can penetrate the skull and brain. TMS applications use a magnetic coil that creates a strong but localized magnetic field in the brain. These treatments target the primary motor cortex, and the dorsolateral prefrontal cortex, which can produce pain inhibitory and antidepressant effects. During tDCS, a weak electrical current is applied to the scalp for approximately 20 minutes per session. Although the analgesic effects are not well understood, these noninvasive brain stimulation methods are gaining momentum as effective treatments for chronic FM pain.
Overall, after TMS or tDCS, most FM patients report significantly decreased pain, compared to placebo. Such pain relief was found to last up to 25 weeks. In many studies, the quality of life increased in FM patients receiving the active treatment. However, in most TMS and tDCS studies, no improvement of depression ratings was observed. In addition, tender points and pain thresholds improved following noninvasive brain stimulation. The main side effects were transient headaches (TMS) and discomfort at the stimulation site (tDCS).
In conclusions, TMS and tDCS seem to provide considerable pain reduction and few side effects and provide and alternative to FDA approved medications for FM. These noninvasive brain stimulation techniques, however, are expensive, costing up to $14,000 per year. Nevertheless, the substantial benefits for FM patients might be worth the price tag.
At the Center for Musculoskeletal Pain Research, we are closely following these new and promising treatments of chronic FM pain. Our own treatment studies for pain and fatigue currently are ongoing. For more information about evalution and treatment options for FM, please contact us at (352) 265-8901 or email us at firstname.lastname@example.org.
Meriem Mokhtech, BS
Senior Laboratory Technician
UF Center for Musculoskeletal Pain Research
- Marlow NM, Bonilha HS, Short EB. Efficacy of Transcranial Direct Current Stimulation and Repetitive Transcranial Magnetic Stimulation for Treating Fibromyalgia Syndrome: A Systematic Review (2012). Pain Practice, Volume 13, Issue 2, 2013 131–145.