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PHYSICAL DISORDERS

FIBROMYALGIA

43. Romano, Thomas. The usefulness of cranial electrotherapy in the management of headache in fibromyalgia patients. American Journal of Pain Management. 3(1):15-19, 1993.

Device: Pain Supressor, 12,000 to 20,000 Hz, 35µS, <4 mA, electrodes across temples

100 consecutive fibromyalgia syndrome (FS) pts (23 males ages 22 - 58, mean = 45, and 77 females ages 18 - 65, mean = 46) in a rheumatology practice with severe chronic headache unresponsive to outpatient treatments of medications (NSAIDS, beta blockers, tricyclics, and ergots), biofeedback, low tyramine diet, local injections, and physical therapy were given CES units and instructed to use them for 20 minutes, 4 times daily while continuing their medications. 75 completed the study. Dolimetry using a pressure algometer was performed at 6 active typical "tender" sites just before CES and 1 - 2 months after. Pts were also asked to rate their headache severity on a 1 - 10 scale (1 = no effect, 10 = totally effective in relieving headaches) before CES, at a subsequent visit, and at follow-up. CES proved to be effective in FS-related headache pts. Approximately 50% of FS Pts using CES regularly reported a significant decrease in the frequency and intensity of their headaches. The mean pretreatment headache intensity score was 8.1 (7.8 for males, 8.4 for females). After 1 - 2 months of CES treatment, the mean score was 4.7 (4.5 for males, 4.8 for females). The difference in the mean scores was 3.4 (3.3 for males, 3.6 for females) and there was definite subjective improvement. Dolimetric testing of 450 sites ( 6 per pt) revealed that 42% (189) were improved (had values increased > 1 kg/1.54 cm), 19% (86) were worse, and 39% (175) were unchanged. 8 pts reported absolutely no benefit, 6 stated they were entirely free of headaches, while 15 (20%) reported CES efficacy as a "7", indicating moderate improvement in both frequency and severity of headaches. 38 (51%) rated improvement as a "7" or greater. The author concluded that CES is a helpful adjunct in the treatment of FS pts with headache previously unresponsive to more conventional techniques. No side effects were reported.

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