Fibromyalgia

Condition

Fibromyalgia, also known as fibromyalgia syndrome (FMS) is a long-term rheumatic condition which causes widespread pain and stiffness all over the body. It was previously known as muscular rheumatism or fibrositis.

Fibromyalgia is surprisingly common, affecting around 1 in every 20 people and is significantly more common in women (affecting 7 times more women than men). It can occur at any age but typically develops around 30-50 years of age.

Signs and Symptoms of Fibromyalgia

  • Widespread pain and discomfort
  • Muscle stiffness
  • Morning stiffness
  • Fatigue/tiredness and difficulty sleeping
  • Headaches
  • “Fibro-fog” – difficulty concentrating/remembering
  • IBS (irritable bowel syndrome)
  • Anxiety and/or depression

Causes/Triggers

The exact cause of fibromyalgia is not clear – there are a number of theories or potential causes, including:

  • Physical factors – a trauma or injury to muscle which leads to ongoing pain and fatigue
  • Chemical factors – abnormal levels of certain chemicals in the brain/nervous system
  • Genetic factors – an inherited condition
  • Psychological factors – such as the breakdown of a relationship, redundancy or bereavement

The circumstances for each patient are often complex and it is not always possible to identify a cause.

Conventional Treatments

There is no known cure for fibromyalgia, so treatment is focused on relieving the symptoms rather than the condition itself. Treatment routes are:

  • Medication – painkillers and/or antidepressants
  • Counselling/talking therapy – e.g. CBT (Cognitive Behavioural Therapy)
  • Lifestyle – e.g. relaxation, exercise

rTMS at The Smart Clinics in London

Transcranial Magnetic Stimulation therapy treatment is available at Smart TMS, based at The Smart Clinics, Brompton Cross, London. Smart TMS was the first UK clinic to offer treatments for fibromyalgia using rTMS.

On the basis of research, we believe that rTMS – Repetitive Transcranial Magnetic Stimulation could offer sufferers of fibromyalgia an alternative treatment option using transcranial magnetic stimulation to work directly on the associated areas of the brain. It would also offer the benefit of being a non-medication approach, avoiding potentially unpleasant side-effects associated with drugs.

To discuss this further, please contact us.

Fibromyalgia and TMS Treatment

Evidence, Research and Studies

Research Studies

There is evidence that fibromyalgia is associated with excitability in some parts of the cortex of the brain associated with the deeper pain control systems.

A randomized controlled study was conducted with patients with chronic widespread pain due to Fibromyalgia.  Fifteen patients were given rTMS in 10 daily sessions and followed up for 2 months and compared with a control group.  rTMS significantly reduced pain and improved sleep, fatigue and activity levels in the rTMS treatment group compared to the control group.  There were a few mild and transitory side effects: 4 had a transient headache and one had transient nausea (Passard et al, 2007).

A randomized controlled study was conducted with patients with chronic widespread pain due to Fibromyalgia to determine how long the treatment effects of rTMS could be maintained.  Sixteen patients were treated with rTMS firstly over 5 consecutive days and then with a total of 14 sessions spread out over 6 months weeks and compared with a control group.  The group who received rTMS improved with respect to measures of pain, fatigue, sleep and activity levels.  It was considered that top-up sessions every 2 to 3 weeks was likely to be the most effective spacing to maintain the treatment improvements (Mhalla et al, 2011).

A randomized controlled study was conducted with nineteen patients with chronic widespread pain due to Fibromyalgia who were treated with rTMS and compared with a control group.  They were first treated with 10 sessions over 2 weeks followed by 4 more sessions spread out over 10 weeks.  Compared with the control group the quality of life measurements were improved in the patients who received rTMS by the end of the study period.  There were no side-effects during the follow up study (Boyer et al, 2014)

A systematic review of rTMS treatment studies in Fibromyalgia was conducted. One hundred and sixty-three articles were screened, and five with moderate to high quality were included in the meta analysis.   rTMS was found to improve quality of life with a moderate effect and showed a trend toward reducing pain intensity.  In comparison with sham stimulation, rTMS demonstrated superior effects on the quality of life of patients with fibromyalgia 1 month after starting therapy (Knijnik, el al 2016).

References

References:

  • Boyer et al (2014) rTMS in Fibromyalgia.  A randomized trial evaluating QoL and its brain metabolic substrate.  Neurology. 82 (14) 1231-1238.
  • Knijnik et al (2016) Repetitive Transcranial Magnetic Stimulation for Fibromyalgia: Systematic Review and Meta-Analysis. Pain Pract. (3):294-304.
  • Mhalla et al (2011) Long term maintenance of the analgesic effects of TMS in fibromyalgia.  Pain.  Doi. 10.1016/j.pain.2011.01.034.
  • Passard et al (2007)  Effects of unilateral rTMS of the motor cortex on chronic widespread pain in fibromyalgia.  Brain.  130. 2661-2670.