Anyone who suffers from the widespread pain of fibromyalgia knows how difficult even the simplest daily tasks can be. If you experience pain flare-ups and other common symptoms of fibromyalgia, you’re likely looking for a treatment that actually works. If you are considering trying a TENS unit for fibromyalgia, here’s your guide to what it is, how it works, and how it might ease your fibromyalgia pain. Let’s get started.

What is a TENS unit?

TENS is an acronym for transcutaneous electrical stimulation. A non-invasive pain treatment option, a TENS unit uses small electrical pulses to replace pain signals. Electrical leads on electrodes (self-sticking patches) are placed on your skin in the area where the pain signals originate. These leads are attached to a cellphone-sized, battery-powered, patient-controlled device that controls the frequency and intensity of these electrical pulses.

You may have two or four electrodes placed on your body. Each set of two is controlled by two channels. How many electrodes you use depends on your pain condition and your overall treatment plan.

Because a TENS unit (and its leads) are housed on the outside of the body, this is a great option for those who are looking to avoid more invasive treatments. TENS units have very few (if any) risks. Use is generally well-tolerated and can be safely combined with other treatments.

How can a TENS unit for fibromyalgia help me?

If you are looking at a TENS unit for fibromyalgia treatment, you are in good company. One of the main issues with research into many pain conditions is the challenge of designing a scientifically valid study. However, there have been several high-quality studies in the last few years that point to the effectiveness of a TENS unit for fibromyalgia.

  • January 2020: Researchers in a large, randomized, blinded, placebo-controlled trial found that 50% of participants had a significant reduction in pain and other symptoms of fibromyalgia with use
  • March 2019: A study looking at the effects of TENS on the brain found decreased pain levels as the alpha power in the frontal lobe increased
  • October 2018: In another randomized trial, 44% of study participants experienced a 30% or greater reduction in their pain when using a TENS unit for fibromyalgia

Most researchers and study reviewers agree that more research is needed, but for many people, a TENS unit for fibromyalgia decreases their pain and increases their quality of life. Because this treatment is non-invasive and can be typically used with other approaches, it’s a great option for many patients.

How to use a TENS unit for fibromyalgia

If you are ready to try a TENS unit and are thinking about buying one over the counter, it makes sense to do a little research before you get started. The type of TENS unit you buy matters, as does the placement of the electrodes and the settings you use.

As always, the best source of information will be your doctor. They can ensure proper placement and help you find the intensity and settings that work for you. Always work with them while setting up your TENS unit or ask them for product information. They can answer any questions you have and advise on the best settings for you. Further, they can discuss how TENS units can complement your other fibromyalgia treatments.

This is our general guide to give you an idea of what to look for and expect during treatment.

Find the best TENS unit for fibromyalgia

As noted above, a TENS machine for fibromyalgia can be simply purchased over the counter at your local pharmacy. There are benefits to getting one prescribed for you, though. For example, in many cases, a TENS unit for fibromyalgia (including replacement electrodes) will be covered by your insurance.

Another benefit to getting a prescription is that your doctor is likely familiar with the brand they prescribe. This means that they can help you troubleshoot your treatment if you need it.

If you are looking to buy a TENS unit on your own, consider looking for ones with the following features.

  • Wiring: Some TENS units come wireless, while others feature leads connected to the controller
  • Control buttons: They should be easy to access and adjust, but not so easy that you accidentally change the settings
  • Display: The display should be easy to read with large text (and a backlit screen is a bonus)
  • Levels of stimulation: Look for TENS units that have a variety of settings, frequency, and intensity so you can get the exact level you need for pain relief
  • Warranty: Make sure your TENS unit is protected against flaws or damage
  • Price: The cheapest is not necessarily the best, but the best isn’t necessarily the most expensive

Finally, consider things like how many electrodes the unit comes with and how easy the controller is to carry or store. Your unit should come with at least four electrodes, but more is better (no need to order spares). If the controller is bulky or hard to stow on your person, you will be less likely to use it—and consistency is key.

TENS unit placement for fibromyalgia

The correct TENS unit placement for fibromyalgia is the key to finding relief. Your doctor is the best determiner of where to place the electrodes. The TENS unit stimulates specific nerves, replacing the pain signals with a mild electrical buzz. Place the electrodes over the wrong area and nothing will happen but a mild tingle. If electrode pairs are too far away from each other, you will also not find any relief.

In general, TENS unit placement for fibromyalgia (example here) features two electrodes on either side of the spine just at the tops of the shoulder blades, with another two on either side of the lower back. This placement targets widespread nerve pain that is characteristic of fibromyalgia.

Of course, if you have specific pain in one area, your placement might be very different. Some people find fibromyalgia relief with electrodes on the front of the body or just down one side. It may take a few tries to get the correct placement for you.

Keep in mind that the electrodes should not touch each other on the body. Keep them spaced apart for safety and best results (more on that below).

TENS settings for fibromyalgia

Finding your perfect TENS settings for fibromyalgia may take some trial and error, too.

First, you will need to consider three main TENS settings:

  • Amplitude
  • Pulse width
  • Pulse rate

Amplitude references how intense the electrical current is. Pulse width is how long each pulse lasts. Pulse rate determines how often an electrical pulse is sent.

Depending on your TENS unit, you may also have three standard settings.

  • Conventional: This delivers a short-lived, high-frequency pulse at a low amplitude
  • Acupuncture: The acupuncture setting uses a high amplitude current (at the top of your tolerance) delivered with long pauses in between
  • Pulsed or burst: Often the least used setting, a pulsed setting delivers a low-intensity pulse with the briefest of pauses in between

Your setting will be as individual as your experience of pain and may take a while to dial in.

TENS unit safety: Dos and don’ts

Although using a TENS unit for fibromyalgia is remarkably safe, there are some dos and don’ts you should follow to improve the chance of a successful treatment.

Follow these guidelines

Here are some guidelines to follow when using your TENS unit for fibromyalgia.

  • Ensure that the batteries in the controller are working (or the unit is charged) before using
  • Clean and dry the skin on the area where you will place the electrodes
  • Before you attach (or detach) your electrodes, make sure your TENS unit is powered off
  • Place electrodes at least one inch apart from each other
  • The larger the area you are covering, the more electrodes you will use

There is a possibility that after a few days of relief, your pain may return. This is entirely normal. Taking a break from treatment for a few days allows the nerves to rest. This also helps to make sure that the placement is correct and your treatment levels do not need adjustment.

Avoid with TENS units

Again, using a TENS unit for fibromyalgia is remarkably safe. There is no risk for drug interactions, and the treatment is non-invasive. However, there are some precautions to take to increase the chance of a successful treatment and ensure your safety.

  • Don’t allow the electrodes to touch each other
  • Don’t place electrodes on a joint (or anywhere they might become dislodged with movement)
  • Keep the electrodes clear of metal jewelry (or metal of any kind)
  • Keep the unit dry—do not shower with your TENS electrodes in place
  • Don’t wear your TENS electrodes to bed
  • Don’t apply electrodes to skin that is broken, irritated, or infected
  • Avoid placing electrodes near the eyes, mouth, front or side of the neck, head, genitals, or reproductive organs

There are some people for whom TENS therapy is not recommended. If you have a pacemaker or other implantable device, TENS is not a good treatment option for you. Deep vein thrombosis is another condition that should not be treated with TENS therapy, as is any area where cancer has been diagnosed or is suspected.

Similarly, those who have epilepsy or are pregnant should not use a TENS unit without the supervision of their doctor.

When it comes to placement of the electrodes, do not place them on the chest if you have a history of heart disease.

Caring for your TENS unit

Taking good care of your TENS unit will ensure its proper function. Clean the unit regularly with a soft cloth. Do not use chemicals or rubbing alcohol to clean it, and do not submerge in water.

Store the unit in the case it comes in at room temperature. If you will not use your TENS unit for a long time, remove the batteries.

If you find that your electrodes are losing their stickiness, it may be time to replace them. Alternately, you can try to bring back the stickiness by washing gently under cold water. Allow them to air dry before reattaching to clean, lotion-free skin. Store unused patches in a sealed plastic baggie so they do not dry out.

Learn more

Fibromyalgia is one of the most challenging pain conditions to treat. The time to diagnosis is long, and it can be hard to find a treatment that works.

Most pain specialists agree that a combination of treatments offers the best chance for success. These treatments include lifestyle changes, comfort measures, and treatments like TENS therapy. Learn more about our full fibromyalgia treatment protocol here.

Arizona Pain takes an integrated care approach for all people who suffer from chronic pain. If you’d like to learn more about how a TENS unit for fibromyalgia can help you, call to schedule an appointment today.

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