The Influence of Opioids on Transcutaneous Electrical Nerve Stimulation Effects in Women With Fibromyalgia

被引:1
|
作者
Dailey, Dana L. [1 ,2 ]
Vance, Carol G. T. [1 ]
Chimenti, Ruth [1 ]
Rakel, Barbara A. [1 ,3 ]
Zimmerman, Miriam Bridget [4 ]
Williams, Jon M. [5 ]
Sluka, Kathleen A. [1 ]
Crofford, Leslie J. [5 ]
机构
[1] Univ Iowa, Dept Phys Therapy & Rehabil Sci, 1-252 Med Educ Bldg, Iowa City, IA 52242 USA
[2] St Ambrose Univ, Dept Phys Therapy, Davenport, IA USA
[3] Univ Iowa, Coll Nursing, Iowa City, IA 52242 USA
[4] Univ Iowa, Coll Publ Hlth, Iowa City, IA USA
[5] Vanderbilt Univ, Dept Med Rheumatol & Immunol, 221 Kirkland Hall, Nashville, TN 37235 USA
来源
JOURNAL OF PAIN | 2022年 / 23卷 / 07期
基金
美国国家卫生研究院;
关键词
Opioid; tramadol; TENS; fibromyalgia; pain; PAIN CATASTROPHIZING SCALE; QUALITY-OF-LIFE; DOUBLE-BLIND; INDUCED HYPERALGESIA; FREQUENCY TENS; TAMPA SCALE; GUIDELINES; PERFORMANCE; RECEPTORS; EFFICACY;
D O I
10.1016/j.jpain.2022.02.008
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Transcutaneous electrical nerve stimulation (TENS) uses endogenous opioids to produce analgesia, and effectiveness can be reduced in opioid-tolerant individuals'. We examined TENS effectiveness (primary aim), and differences in fibromyalgia symptoms (secondary aim), in women with fibromyalgia regularly taking opioid (RTO) medications compared with women not-regularly taking opioids (not-RTO). Women (RTO n = 79; not-RTO not-n= 222) with fibromyalgia with daily pain levels >= 4 were enrolled and categorized into RTO (taking opioids at least 5 of 7 days in last 30 days) or not-RTO groups. Participants were categorized into tramadol n = 52 (65.8%) and other opioids n = 27 (34.2%) for the RTO group. Participants were phenotyped across multiple domains including demo-graphics, fibromyalgia characteristics pain, fatigue, sleep, psychosocial factors, and activity. Participants were randomized to active TENS (n = 101), placebo TENS (n = 99), or no TENS (n = 99) for 1-month with randomization stratified by opioid use. Active TENS was equally effective in movement-evoked pain in those in the RTO and not-RTO groups. Women with fibromyalgia in the RTO group were older (P = .002), lower-income (P = .035), more likely to smoke (P = .014), and more likely to report depression (P = .013), hypertension (P = .005) or osteoarthritis (P = .027). The RTO group demonstrated greater bodily pain on SF-36 (P = .005), lower quality of life on the physical health component of the SF-36 (P = .040), and greater fatigue (MAF-ADL P = .047; fatigue with sit to stand test (P = .047) These differences were small of and unclear clinical significance. In summary, regular use of opioid analgesics does not interfere with the effectiveness of TENS for movement-evoked pain. Clinical Trial Registration Number: NCT01888640. Perspective: Individuals treated with mixed frequency TENS at a strong but comfortable intensity that was taking prescription opioid analgesics showed a significant reduction in movement-evoked pain and fatigue. These data support the use of TENS, using appropriate parameters of stimulation, as an intervention for individuals with fibromyalgia taking opioid analgesics. (C) Published by Elsevier Inc. on behalf of United States Association for the Study of Pain, Inc.
引用
收藏
页码:1268 / 1281
页数:14
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