Trial Report Transcutaneous electrical nerve stimulation for fibromyalgia-like syndrome in patients with Long-COVID (...), 2024, Zulbaran-Rojas et al

Full title: Transcutaneous electrical nerve stimulation for fibromyalgia-like syndrome in patients with Long-COVID: a pilot randomized clinical trial

Alejandro Zulbaran-Rojas, Rasha O. Bara, Myeounggon Lee, Miguel Bargas-Ochoa, Tina Phan, Manuel Pacheco, Areli Flores Camargo, Syed Murtaza Kazmi, Mohammad Dehghan Rouzi, Dipaben Modi, Fidaa Shaib & Bijan Najafi

Abstract

This study investigated the effect of Transcutaneous Electrical Nerve Stimulation (TENS) for fibromyalgia-like symptoms including chronic widespread musculoskeletal pain, fatigue, and/or gait impairment in twenty-five individuals with long-COVID. Participants were randomized to a high dose (intervention group, IG) or low dose (placebo group, PG) TENS device.

Both groups received daily 3–5 h of TENS therapy for 4-weeks. The Brief Pain Inventory assessed functional interference from pain (BPI-I), and pain severity (BPI-S). The global fatigue index (GFI) assessed functional interference from fatigue. Wearable technology measured gait parameters during three 30-feet consecutive walking tasks.

At 4-weeks, the IG exhibited a greater decrease in BPI-I compared to the PG (mean difference = 2.61, p = 0.008), and improved in gait parameters including stride time (4-8%, test condition dependent), cadence (4-10%, depending on condition), and double-support phase (12% in dual-task) when compared to baseline. A sub-group meeting the 2010 American College of Rheumatology Fibromyalgia diagnostic criteria undergoing high-dose TENS showed GFI improvement at 4-weeks from baseline (mean change = 6.08, p = 0.005).

Daily TENS therapy showed potential in reducing functional interference from pain, fatigue, and gait alterations in long-COVID individuals. The study’s limited power could affect the confirmation of certain observations. Extending the intervention period may improve treatment effectiveness.

Open access: https://www.nature.com/articles/s41598-024-78651-5

 

Main drawback in real life to using TENS chronically is the cost of the electrode pads.

ETA: The cost of a 3-month supply of electrodes (comes with a new leg band) is $600. This is for the prescription-only Quell for Fibromyalgia TENS device.

 

I have to assume from references to the above article that the prescription-only Quell for Fibromyalgia TENS unit was used or similar intensity of stimulation.The physician prescribing page has warnings. Here are some of them:

Also mentioned: do not place an electrode on the upper back.

This is precisely where I would need one to be.

• Do not apply stimulation over the neck because this could cause severe muscle spasms resulting in airway closure, difficulty in breathing, or adverse effects on heart rhythm or blood pressure.

• Do not apply stimulation across the chest, because the introduction of electrical current into the chest may cause heart rhythm disturbances, which could be lethal.

• Do not apply stimulation in the presence of electronic monitoring equipment (e.g., cardiac monitors, ECG alarms), which may not operate properly when the electrical stimulation device is in use.

• Use caution if patient has a tendency to bleed internally, such as following an injury or fracture.

 

I’ve been using a TENS for VNS (vagus nerve stimulation) and using a conductive gel comes out cheaper.

The VNS doesn’t actually improve my ME or anything but can tone down the wired/adrenaline rush response somewhat significantly for me.