May 1, 2001 -- As many as six million Americans are living with fibromyalgia, and in most cases they are living with the constant, unrelenting symptoms of the condition: widespread pain in muscles and joints, sleep disturbances, irritable bowel syndrome, and anxiety, to name a few. But very positive results from a new study suggest that sending mini-currents of electricity through the brain -- a procedure called cranial electrotherapy stimulation --may provide relief from some of these symptoms.
Alan S. Lichtbroun, MD, says he learned about the electrotherapy technique while searching for better treatments for his many fibromyalgia patients.
"This technique is gaining wide acceptance at chronic pain treatment centers," says Lichtbroun, assistant professor at Robert Wood Johnson Medical School, in East Brunswick, N.J. "At first I looked at this device very skeptically -- and even now I am beginning to see some patients who had a marked response at the beginning are gradually beginning to deteriorate -- so again I wondered if the machine had lost its power. But what I've found is that patients eventually lose their incentive to use the machine, and less frequent use appears to mean a return of symptoms."
The machine Lichtbroun refers to is the Alpha-Stim CES device made by Electromedical Products International Inc., of Mineral Wells, Texas. Patients using the device clip electrodes to their earlobes, which transmit low levels of electricity back and forth, through the head.
In the study, published in the April issue of the Journal of Clinical Rheumatology, 20 patients were assigned to two groups, one that got cranial electrotherapy stimulation and another that got fake devices clipped to their ears that didn't transmit electricity. Because the electric currents are so low they cannot be felt as they pass through the brain, participants didn't know whether or not they received active stimulation.
Both groups were told to use the devices for an hour a day for three weeks.
For therapeutic use, patients are taught how to use the devices so that "they can undergo the treatment in their own homes, at a time that is convenient for them," says Lichtbroun.
That's a big advantage over some other approaches, such as massage, because it doesn't require "special appointments or a trip outside the home," he points out.
The results of the electrotherapy treatment were "very surprising," says Lichtbroun.
Physicians determine how severe a case of fibromyalgia is by testing "tender points" -- areas of highly localized pain. The study participants who had real electrotherapy treatment had a 28% improvement in tender-point scores and a 27% improvement in the amount of general pain they felt.
But most surprising, says Lichtbroun, was that only 5% of the treated patients reported having sleep disturbances after treatment, compared with 60% who had sleep problems before beginning electrotherapy treatments.
And 90% of the treated patients reported that their quality of life had improved as a result of treatment, while 20% of the patients who were in the fake treatment group said their quality of life had declined.
These results are almost too good, says Robert S. Katz, MD.
"Fibromyalgia is a very challenging condition from the standpoint of treatment," says Katz, associate professor of medicine at Rush Medical School, in Chicago. "I would be very impressed with a treatment that had a 50% improvement, but 90% makes me very skeptical."
Some other treatments have claimed equally impressive initial results, Katz says, but the improvement is seldom long-lasting.
"I would like to see some findings on the long-term results of this treatment," he says. Even in the short term, Lichtbroun's findings "need to be reproduced by other investigators before we can consider recommending this treatment," he adds.
Lichtbroun says he, too, would like to see the findings replicated in another study. Until then, he says, he is offering all his fibromyalgia patients "one free treatment with the devices."
Offering a freebie treatment is important because the electrotherapy devices range in price from $400 to $700, he says. "Some insurance companies will pay for the device, but many won't, and so the patient has to pay for it."