Cranial electrical stimulation (CES) is a non-invasive treatment that places electrodes on the head to stimulate the brain. Early results from a sham-controlled trial in 50 veterans with fibromyalgia point to it as a safe, effective way to turn down their pain. It fills a real gap: only one-third of veterans respond to common painkillers.
Fibromyalgia causes long-lasting pain and tender spots across the body. It is more common in women, but it is rising in men too. Veterans are far more likely than other people to live with chronic pain, and their pain runs stronger. So they are also quite likely to have fibromyalgia.
Fibromyalgia rarely shows up alone. People who have it are more likely to have mental health problems like depression, anxiety and PTSD. All of these are more common in veterans.
No one knows how many veterans have fibromyalgia, but it is likely missed often. An estimated 5-10 million people are living with the condition in the US.
The rules for diagnosing fibromyalgia have gotten better over the years. Still, it is often a diagnosis of exclusion. That means doctors name it only after they rule out other common causes of chronic pain.
In fibromyalgia, most lab tests come back normal or close to it. That does not mean nothing is wrong in the body. It means the changes are hard to find with today’s tests.
For example, people with fibromyalgia may have inflammation, immune changes, shifts in gut bacteria, mood problems and more. These changes can be found, and they may hint at fibromyalgia. But they also show up in many other conditions. So the diagnosis rests mostly on the exam and the story.
Treating the pain is another problem. No single drug works for everyone. Some people get relief from common drugs like NSAIDs, but most do not. And some groups, like veterans, are less likely to respond to standard pain care. Only one-third of veterans respond to common painkillers.
Opioids are a poor fit for fibromyalgia. The pain is made in the central nervous system, not by injured tissue. So an opioid treats the wrong problem. Keep taking it and you drive the receptor desensitization that makes pain worse over time. That gap is exactly why non-drug options matter here.
So there is a clear treatment gap. Doctors are testing other ways to manage chronic pain syndromes like fibromyalgia. One safe and effective option worth a look is cranial electrical stimulation (CES).
A study recently enrolled 50 veterans with fibromyalgia from the Atlanta Veterans Affairs Healthcare System (VAHCS). They were randomized (randomly assigned) to CES or a sham (fake) treatment. Both groups had their pain scored at 6 and 12 weeks. The study also scanned their brains with functional connectivity magnetic resonance imaging (rs-fcMRI).
The first results were shown at the recent ASRA Pain meeting. Early findings suggest CES could be a safe, effective way to turn down pain in veterans with chronic pain syndromes like fibromyalgia.
CES is quite safe. It just places electrodes on the head to stimulate the brain. Nothing goes into the body. It has already been shown to help mood disorders like depression and anxiety. Now a new study shows it may also help fibromyalgia.
Frequently asked questions
What is cranial electrical stimulation?
Cranial electrical stimulation, or CES, is a non-invasive treatment. It places electrodes on the head to stimulate the brain. Nothing is implanted and no drug is involved. It has already been shown to help mood disorders such as depression and anxiety. New research is testing it as a way to calm fibromyalgia pain.
Does cranial electrotherapy stimulation help fibromyalgia?
Early results say it does. The sham-controlled trial enrolled 50 veterans with fibromyalgia at the Atlanta Veterans Affairs Healthcare System. Each got either CES or a sham treatment. Pain scores were checked at 6 and 12 weeks, and brains were scanned with functional MRI. The first findings, shown at the ASRA Pain meeting, point to CES as a safe, effective way to turn down pain.
Why are opioids a poor choice for fibromyalgia?
Fibromyalgia pain is made centrally, in the nervous system, not by injured tissue. So an opioid treats the wrong problem. Staying on opioids also drives receptor desensitization (the receptors stop responding), which makes pain worse over time. That is why non-drug options like CES matter so much here. It counts most in veterans, where only one-third respond to common painkillers.
How is fibromyalgia diagnosed?
Fibromyalgia is still diagnosed mostly by exam and history. Lab tests are often normal or close to it. Changes like inflammation, immune shifts or gut bacteria changes also show up in many other conditions. In many cases it is still a diagnosis of exclusion. Doctors confirm it after ruling out other common causes of chronic pain.
Source:
Ree, A., Rapsas, B., Denmon, C., Vernon, M., Rauch, S. A., Guo, Y., Cui, X., Stevens, J. S., Krishnamurthy, V., Napadow, V., Turner, J. A., & Woodbury, A. (2024). A Randomized, Sham-Controlled Trial of Cranial Electrical Stimulation for Fibromyalgia Pain and Physical Function, Using Brain Imaging Biomarkers. Journal of Visualized Experiments: JoVE, 203. https://doi.org/10.3791/65790
Dr. Gurpreet Singh Padda, MD, MBA, MHP
