TENS Added to Physical Therapy Lowers Fibromyalgia Pain

Adjunctive transcutaneous electrical nerve stimulation improves movement-evoked pain and fatigue in pragmatic trial

By
Andrea Surnit
April 3, 2026
5 min

Conexiant

Overview

The addition of transcutaneous electrical nerve stimulation (TENS) to physical therapy significantly reduced movement-evoked pain in fibromyalgia patients compared to physical therapy alone, with effects lasting for six months. This study highlights TENS as a beneficial nonpharmacologic option for managing fibromyalgia symptoms.

Background

Fibromyalgia is a chronic pain condition that presents significant challenges to patient mobility and quality of life, with movement-evoked pain being a major barrier to exercise. Exercise is considered a first-line treatment, yet many patients experience inadequate relief from traditional physical therapy alone. Understanding effective adjunct therapies like TENS is crucial for improving patient outcomes.

Data Highlights

Outcome	PT + TENS	PT Alone
Mean reduction in movement-evoked pain (0-10 scale)	1.2	-
Patients achieving ≥30% pain reduction	41%	13%
Reported improvement on Patient Global Impression of Change	72%	51%

Key Findings

Movement-evoked pain decreased significantly more in the TENS group at 60 days.
41% of patients receiving TENS achieved at least a 30% reduction in pain compared to 13% in the control group.
Improvements were sustained through 180 days post-treatment.
Secondary outcomes favored TENS, including reductions in resting pain and fatigue.
No serious adverse events related to TENS were reported, with minor events occurring in about 30% of patients.

Clinical Implications

The findings support the integration of TENS into physical therapy regimens for fibromyalgia patients to enhance pain management and improve exercise participation. Clinicians should consider TENS as a safe adjunct therapy, particularly for patients who do not respond adequately to standard physical therapy alone.

Conclusion

TENS appears to provide meaningful improvements in pain and related symptoms for fibromyalgia patients, representing a valuable addition to nonpharmacologic treatment options. Further research may help refine its use in clinical practice.