Woman grabbing shoulder in discomfort illustrating fibromyalgia

Using TMS Therapy For Fibromyalgia

by | May 30, 2024 | Blog

Fibromyalgia affects about 4 million adults in the United States. Living with fibromyalgia can be a daily challenge, with widespread pain, fatigue, and cognitive difficulties impacting work, family, and social life. 

The exact cause of fibromyalgia is unknown and traditional treatments can only do so much to manage its multifaceted nature. For those seeking alternative or complementary treatments to fibromyalgia, transcranial magnetic stimulation (TMS) therapy is emerging as a promising option. Originally developed as a treatment for major depression, TMS is now gaining attention as more research uncovers its potential for managing chronic pain and symptoms associated with fibromyalgia. 

In this article, we explore everything you need to know about using TMS therapy for fibromyalgia. We start by examining the condition, including what is fibromyalgia, its causes, symptoms, and traditional treatment options. We then discuss TMS therapy, what it involves, its benefits for treating fibromyalgia, and how you can start receiving treatment.

What is fibromyalgia?

Fibromyalgia is a chronic condition characterized by widespread musculoskeletal pain as well as fatigue, sleep, memory, and mood issues. Pain intensity may vary and is often likened to a burn or itch. It can be experienced all over the body or in localized areas.

While the exact cause of fibromyalgia is unknown, researchers believe it affects how the brain and spinal cord process pain signals, leading to amplified pain sensations. Symptoms are often triggered by an event, such as physical trauma, surgery, infection, or psychological stress, however they can also appear gradually over time with no obvious trigger. 

Fibromyalgia often coexists with other disorders like migraines, irritable bowel syndrome, anxiety, and depression. This can make the condition difficult to diagnose and treat. For many people, fibromyalgia significantly impacts daily functioning and quality of life due to constant pain and fatigue. 

There is no cure for fibromyalgia, but treatment typically involves medications (such as pain medications or antidepressants) as well as physical therapy, counseling, and stress-reduction techniques. These treatments aim to keep symptoms under control and improve overall well-being. While they do provide some relief, they do not address the multifaceted nature of fibromyalgia and many patients search for more effective and long-lasting relief. 

Fibromyalgia pain can feel similar to that of chronic myofascial pain syndrome. The difference is that myofascial pain tends to occur in one specific area of the body (e.g. just one side of the body) while fibromyalgia pain occurs all over, on both sides of the body. 

What causes fibromyalgia?

The exact causes of fibromyalgia aren’t fully understood, but researchers believe it may involve a combination of factors, including genetics, infections, and abnormalities in the nervous system. 

  • Abnormalities in the nervous system: One theory suggests that fibromyalgia is related to abnormalities in how the central nervous system processes pain signals. This research indicates that people with fibromyalgia may have heightened sensitivity to pain due to changes in neurotransmitter levels or changes in how the brain processes pain signals. 
  • Genetics: Another area of research focuses on the role of genetics in fibromyalgia. These studies show that fibromyalgia tends to run in families, suggesting a genetic predisposition to the condition. Researchers are working to identify specific genes that may be associated with a heightened risk of developing fibromyalgia.
  • Infections: Some researchers are investigating the role of infections or other environmental factors in triggering fibromyalgia symptoms. For example, viral or bacterial infections may trigger an immune response that leads to inflammation and changes in the nervous system, leading to fibromyalgia in susceptible individuals.

There’s still a lot to learn about the causes of fibromyalgia, however ongoing research is helping to improve our understanding of this complex condition. 

Fibromyalgia symptoms

Symptoms of fibromyalgia can vary in intensity and fluctuate over time. The primary symptoms are:

  • Widespread musculoskeletal pain: Often described as a constant dull ache or burning, fibromyalgia pain occurs on both sides of the body from head to toe, for at least three months. The pain can be accompanied by tenderness in specific areas known as tender points, often located around the neck, shoulders, chest, lower back, hips, and knees. 
  • Fatigue: Fibromyalgia fatigue is severe exhaustion that is not relieved by rest, which can interfere with daily activities. People will wake up tired even after sleeping for long periods of time and feel as though they are drained of all energy. 
  • Cognitive difficulties: Also known as ‘fibro fog’, this involves difficulty concentrating, memory lapses, and trouble processing information. 

As well as these three main symptoms, fibromyalgia can also involve: 

  • Difficulty falling or staying asleep 
  • Symptoms of depression and anxiety 
  • Tension headaches or migraines 
  • Irritable bowel syndrome (IBS) 
  • Temporomandibular joint (TMJ) disorders 
  • Heightened sensitivity to light, noise, smoke, and other environmental changes
  • Clumsiness
  • Allergies
  • Muscle stiffness
  • Dizziness.

Traditional treatments for fibromyalgia

Fibromyalgia is usually treated with a combination of approaches that aim to relieve symptoms and improve quality of life. These include medications, physical therapy, and psychotherapy. 

Medications for fibromyalgia

Different medications are used to treat fibromyalgia, including pain relievers, antidepressants, and anti-seizure medications:

  • Pain relievers: In most cases, over-the-counter pain medications are prescribed to alleviate fibromyalgia pain. These include Non-Steroidal Anti-Inflammatory Drugs (NSAIDs), such as ibuprofen, or acetaminophen (i.e. Tylenol). For more severe pain, opioids may be prescribed, however they are generally not recommended for long-term use as they can cause dependency and side effects.
  • Antidepressants: Certain antidepressant medications, such as duloxetine and milnacipran, can help reduce fibromyalgia pain and fatigue while also alleviating symptoms of depression and anxiety. 
  • Anti-seizure medications: Some anti-seizure medications, such as pregabalin and gabapentin, can be prescribed to help manage pain and reduce nerve-related symptoms of fibromyalgia.

Physical therapy

Physical therapy can help manage the effects of fibromyalgia by improving flexibility, strength, and endurance. This might include low-impact aerobics, water therapy, and muscle strengthening exercise as well as massage and heat therapies for pain relief. 

Psychotherapy

Psychotherapy and counseling can help address the psychological aspects of fibromyalgia, such as stress and mood disorders. It can also help patients develop healthy coping strategies by understanding the relationship between their thoughts, feelings, and pain.

While these traditional treatments for fibromyalgia help relieve symptoms and improve quality of life, some patients seek alternative or complementary therapies for additional relief. One such treatment is transcranial magnetic stimulation (TMS) therapy, which targets the brain’s neural circuits and shows promise in managing fibromyalgia symptoms.

What is Transcranial Magnetic Stimulation (TMS) therapy?

TMS therapy is a non-invasive procedure that uses magnetic pulses to stimulate nerve cells in the brain. It is sometimes called repetitive transcranial magnetic stimulation (rTMS). While originally used to treat depression, the treatment is gaining attention for its potential to manage chronic pain in conditions such as fibromyalgia. 

During a TMS session, an electromagnetic coil is placed against the scalp near the forehead and repetitive magnetic pulses are delivered to parts of the brain that are underactive due to chronic pain. These pulses activate these regions of the brain, helping rebalance pain processing pathways to offer relief from persistent pain symptoms.

TMS is typically administered five days a week for several weeks, with each session lasting around 20 minutes. The number of sessions and intensity of stimulation may vary depending on a person’s condition and response to the treatment. The procedure is painless and patients can resume daily activities as normal afterwards. 

TMS therapy has already been FDA-approved for the treatment of major depressive disorder and treatment-resistant depression. It is also being used to manage mental health conditions like PTSD, anxiety, and OCD. 

TMS therapy for fibromyalgia

Research and clinical trials are showing that TMS has the potential to relieve pain and enhance the quality of life for patients with chronic pain conditions such as fibromyalgia. One study even found that TMS therapy provided similar pain reduction compared to medications, but with fewer side effects. 

People with chronic pain who have been treated with TMS report both pain reduction and improved physical functioning as well as enhanced mood, sleep, and cognitive function. These results highlight how TMS can address the various symptoms of fibromyalgia, offering relief in situations where traditional treatments may not be effective. 

How does TMS therapy help fibromyalgia?

Fibromyalgia is characterized by widespread pain and tenderness in specific areas of the body. Patients may also experience fatigue, cognitive difficulties, anxiety, and depression. Taking this into account, here’s how TMS can target these symptoms: 

  • Changing brain activity: TMS targets areas of the brain involved in pain perception and processing, helping to reduce pain signals. 
  • Neuroplasticity: Over time, TMS can stimulate the brain’s ability to alter neural pathways, leading to long-term pain relief. 
  • Boost pain-relieving chemicals: TMS can increase the production of natural pain-relieving chemicals in the brain, such as serotonin, dopamine, and endorphins. 

Benefits & risks of TMS for fibromyalgia

Before considering TMS therapy as a treatment option for fibromyalgia, it’s important to understand both the benefits and risks involved. We outline some of these below. 

Benefits of TMS for fibromyalgia

The benefits of TMS therapy for fibromyalgia include:

Non-invasive

One of the main benefits of TMS for fibromyalgia is its non-invasive nature. It does not require surgery or anesthesia and offers a safe alternative for those who are sensitive to pain medications, experience side effects, or have not found relief through traditional treatments. 

Personalization

TMS therapy is a targeted treatment, which means it can be personalized for each patient. This means that each individual can receive a treatment that is customized to their specific symptoms and responsiveness. 

Well-tolerated

Traditional fibromyalgia medications, such as NSAIDs or opioids, can include side effects like gastrointestinal stress, drowsiness, or risk of dependency. TMS, however, is generally well-tolerated with few reported side effects. In some cases, a patient might experience mild scalp discomfort or a headache during or after treatment, but these usually resolve quickly. 

Long-term relief

Unlike traditional treatments, which focus on temporary relief and increasing dosage over time, TMS has the potential to produce long-lasting pain relief. Studies have shown that TMS can change parts of the brain associated with pain processing, leading to reduced pain perception.

Risks of TMS for fibromyalgia

Despite the numerous benefits of treating fibromyalgia with TMS, there are some drawbacks to be aware of. 

Limited evidence

While preliminary studies and clinical trials show promising evidence on the benefits of TMS for fibromyalgia, research is still relatively limited. As more studies are done in the future, there will be more evidence on the effectiveness of TMS as a treatment for fibromyalgia.

Cost & accessibility

While not a risk per se, it’s important to note that TMS therapy may not be covered by insurance for the treatment of fibromyalgia. It’s also not as readily available as traditional treatment options, limiting access for some individuals. On top of that, TMS for fibromyalgia typically involves multiple sessions over several weeks to achieve best results. This may require a significant time commitment that isn’t possible for some patients.

Things to consider before getting TMS for fibromyalgia

Some things to be aware of before pursuing TMS therapy for fibromyalgia include: 

  • Length of treatment: In most cases, TMS for fibromyalgia involves multiple sessions a week for several weeks. The specific number and duration of treatments may vary depending on your needs and responsiveness. 
  • Potential side effects: While TMS is mostly well-tolerated, there is a small risk of side effects such as headaches or scalp discomfort. This is usually mild and resolves quickly.

Combining TMS with traditional fibromyalgia treatments

Managing fibromyalgia with a combination of TMS and traditional treatments can offer a comprehensive approach to relieving symptoms and improving overall well-being. While TMS has been shown to reduce pain and improve function, its results will be even more effective when combined with traditional treatments. Here’s how:

  • Pain relief: Traditionally, physical therapy and medications have been used to relieve fibromyalgia pain. TMS can complement these approaches by targeting brain regions associated with pain perception and further reducing pain signals.
  • Improved function & sleep: In many cases, a combination of exercise, psychotherapy, and relaxation techniques can help improve daily function and sleep. TMS has been shown to directly enhance sleep and reduce fatigue, boosting these results.
  • Long-term management: Traditional fibromyalgia treatments focus on managing symptoms and adjusting dosages as needed. While more research is needed, studies demonstrate that TMS has the potential to offer long-term pain relief. 

How to get TMS for fibromyalgia

If you have fibromyalgia and haven’t found relief with traditional treatments, you may be eligible for TMS therapy

While TMS is currently FDA-approved for the treatment of depression, it is still considered off-label for the treatment of fibromyalgia. This may change in the future as more research shows evidence for its effectiveness and it becomes approved by the FDA. 

There are certain criteria that make a person ineligible for receiving TMS therapy. These include: 

  • People with implanted metallic devices or non-removable objects in or around the head (excluding fillings)
  • People with implants activated by physiological signals, including pacemakers, implantable cardioverter defibrillators, and vagus nerve stimulators
  • People with a history of seizures, epilepsy, head injuries, or other neurologic conditions.

If you would like to see if TMS is an appropriate treatment option for you, book a consultation with one of our licensed professionals

Summary: TMS therapy for fibromyalgia

As a non-invasive and well-tolerated treatment option, TMS therapy is proving to be effective in treating fibromyalgia and other chronic pain conditions. 

If you’d like to learn more about TMS therapy or find out whether it’s appropriate for you, feel free to contact us or book a consultation at one of our Colorado clinics today. Our friendly team is here to support you on your journey to long-term well-being.