Treatment of fibromyalgia: when to use electrotherapy?

Diffuse pain, muscle tension, fatigue, stress… for almost half of patients with fibromyalgiathe pain is such that they are no longer able to work. Ailments that are barely relieved by analgesics. “Pharmacological treatments (opioids) are not very effective in the long term, or even not recommended. The management of fibromyalgia is based on different non-drug approaches,” indicates Dr Michel Guinot, rheumatologist at Grenoble University Hospital. Among them, electrotherapy – or transcutaneous electrical stimulation (TENS) – has pride of place.

This therapy consists of applying to painful regions 2 to 4 electrodes which deliver electrical impulses. The objective: to block the transmission of painful messages to the brain. The patient feels slight tingling which mask painful sensations.

Five years ago, Sandrine, 58, discovered this device: “It was a small revolution,” she confides. Thanks to TENS, I was able to reduce the painkillers that I had been taking for almost 10 years, without success. It also allowed me to go for walks again, or window shop. Activities that I had abandoned because walking had become too difficult.”

Very discreetthe electrotherapy box can be hidden under clothing. An advantage that Sandrine greatly appreciates and never parts with it. “Usually, I install the electrodes before leaving the house, and I hang the device on my belt. That way I can use it whenever I need it.”

The relief has been demonstrated by various scientific studies. The latest, carried out with 300 women, suggests that after a month of electrotherapy, almost half of the patients have less pain, at rest and in movement, and as many are less tired than those on placebo (or who did not use TENS).

Always presentthe pains are less intense. “Some respond very well, while others feel no benefit. However, patients become sensitive to it a few months or years later, without it being explained. You should not hesitate to repeat the test “, recommends Dr. Christian Gov, pain specialist. “We associate TENS with physical activity, meditationof theself-hypnosisof the music therapyof the sophrologyto live better on a daily basis,” adds Dr. Guinot.

Each patient must make this technology their own.

At first, Sandrine’s doctor advised her to use it for 30 minutes to 1 hour, 4 to 6 times a day, but she quickly realized that this was insufficient. “In case of intense pain, my sessions last 2 hours or more. This was not forbidden to me, because it exists few side effects. I tested all the programs on the device, and the most effective for me was not the one prescribed by my doctor.” An autonomy that she acquired thanks to therapeutic education workshops led by a specialist nurse. Mandatory if TENS is prescribed.

Electrotherapy devices require optional medical prescription. You can find them in pharmacies or on the internet. To be covered by Social Securitythe device must be prescribed by a pain doctor working in a pain center or privately, stipulates the High Authority of Health (HAS).

Therapists have the choice between three different devices :

The prices of these medical devices vary from 230 to 350 €.

Typically, the doctor first prescribes TENS to 1 or 2 months in order to become familiar with, and evaluate the effectiveness of this approach. The prescription can be extended of 6 months. During this phase, the device can be rented and will then be reimbursed €12 per month. If the test is successful, it can be purchased. Health insurance then covers €112 and some mutual insurance companies cover the rest. Each year, approximately 25,000 patients experience it, and nearly 15,000 purchase the device.