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Fibromyalgia pain reduced by electrical brain stimulation

Written by Matthew Hogg BSc

Recent research demonstrates that external stimulation of the brain with an electrical current reduces the severity of fibromyalgia pain.

As recent Canadian reports have highlighted, fibromyalgia affects a significant number of people in developed nations, around 2-4%, yet the condition remains poorly understood and treatment usually involves a lot of trial and error.

Fibromyalgia is described as a musculoskeletal pain disorder, but this is a little misleading as sufferers experience a whole host of other symptoms from fatigue, to gastrointestinal problems, to brain fog, or "fibrofog", which clouds thinking and makes it hard to concentrate and focus. Fibromyalgia shares many of its symptoms with that other poorly understood condition, chronic fatigue syndrome (CFS), in fact.

Having said that, pain is generally the predominant symptom that sufferers experience. The pain of fibromyalgia is often excruciating, and is present at various 'tender points' around the body. The pain comes from the soft tissues of the body, the muscles, ligaments, and tendons, and sufferers describe it as deep muscular aching, throbbing, shooting, and stabbing. Sensations of intense burning are also common.

Although many people may not even have heard of fibromyalgia, the pain can be so severe that sufferers are left severely disabled, often bedridden, and unable to carry out daily tasks and take care of themselves without assistance. As a result it is essential that patients are able to find treatments that effectively reduce their pain, reduce their suffering, and allow them to function a little more normally.

Traditional treatment of pain in fibromyalgia usually involves the use of pain medications, from over-the-counter varieties such as aspirin, acetaminophen,and ibuprofen, to prescription-strength pain pills like narcotics (opiates), codeine, Vicodin, Darvocet, Percocet, and Ultram. In addition, some doctors will also prescribe anti-inflammatory medicines and muscle-relaxants to help reduce the pain. These medicines are often very effective but as well all drugs, they have their side-effects. Fibromyalgia patients are also more likely to have conditions such as irritable bowel syndrome and multiple chemical sensitivity than the general population, so may not be able to tolerate drug therapies.

Recently there have been a number of drug-free treatment options appearing with the backing of scientific studies demonstrating their effectiveness. Just last week I reported on a special electromagnetic radiation blocking fabric known as Farabloc which had been shown to reduce pain in athletes and people with various pain conditions, and has now been proven effective in the treatment of fibromyalgia pain.

Now a new study, whose results are published in the December 2006 issue of the journal Arthritis and Rheumatism, has shown that electrical stimulation of a certain part of the brain can also reduce the severity of pain associated with fibromyalgia.

The actual technique used is called transcranial direct current stimulation (tDCS), and side-effects are said to be rare and minimal. Transcranial direct current stimulation involves applying a very weak current, in the range of 1-2 milliAmps (mA), to modulate the activity of neurons in the brain. Many years of research have demonstrated that brain cells respond to direct current stimulation by altering their firing rates.

By applying tDCS to different areas of the brain through accurate placement of electrodes on the skull, researchers have been able to show various effects on a patients condition, mood improvement, and pain reduction. What's more, it is well established that the benefits of tDCS last for weeks after the treatment is applied.

This new study into the effects of tDCS on fibromyalgia pain was conducted at the University of Sao Paulo, Brazil. The work was carried out by a team of researchers headed by Dr. Felipe Fregni of Beth Israel-Deaconess Hospital and Harvard Medical School in Boston.

The researchers divided 32 women with fibromyalgia and moderate to severe pain into three groups. One group received tDCS of the primary motor cortex, the main area of the brain that controls movement. Another group received tDCS of the dorsolateral prefrontal cortex, part of the frontal lobes involved in thinking, and the third acted as the placebo control group, receiving sham stimulation. Each group received a 20 minute treatment every day for 5 days.

The results of the study show that tDCS of the primary motor cortex was significantly more effective for pain relief than either tDCS of the dorsolateral prefrontal cortex or sham stimulation. The women in the last 2 groups showed only marginal improvements in their pain.

Consistent with previous knowledge of how transcranial direct current stimulation works, the study also showed that the beneficial pain relieving effects persisted for 21 days, only showing signs of diminishing after this point. The technique was also well tolerated with only "minimal and rare" side effects reported, which included mild skin redness at the site of stimulation, sleepiness during stimulation and dizziness afterward.

Dr. Fregni is quoted as telling Reuters Health, "The improvement that we have seen -- an average of almost 50 percent -- indicates a very significant reduction in pain, especially because these patients are very refractory to other types of medical treatment." He went on, "Furthermore, such improvement might motivate patients to resume usual daily activities that might enhance this improvement."

The research team did in fact notice an improvement in motor function in the study participants which could translate into an increased ability to carry out daily activities. They noted that this could be due either to a reduction of pain, or a direct result of motor cortex stimulation.

This study provides further validation of non-drug based therapies for treating fibromyalgia pain. Many people suffering from fibromyalgia have problems with medications due to unpleasant side-effects or are unable to tolerate them due to chemical sensitivity and allergies. In other cases pain medications just aren't effective, as Dr. Fregni points out when he says that the pain reduction seen with tDCS was especially significant given that many of the study participants hadn't seen relief from other medical treatments.

If other studies show similar results and validate what was found here tDCS could prove to be an excellent treatment for the pain of many thousands of people suffering from fibromyalgia. The benefits are numerous and include the requirement for treatment only every few weeks, absence of side-effects, and the potential for reducing reliance on pharmaceutical drugs.