Health Problem: Fibromyalgia is a chronic condition characterized by widespread pain, fatigue, mood changes, and sleep disturbances.

Health Technology: Cranial electrical stimulation (CES) is a noninvasive therapeutic device that applies alternating pulsed current (< 1000 microamperes) transcutaneously to the head via electrodes placed on the earlobes, mastoid processes, zygomatic arches, or at the maxillo-occipital junction.

Controversy: Concerns regarding the opioid epidemic have fueled considerable interest in nonpharmacological strategies for pain management in recent years. Numerous federal regulatory agencies have advised or mandated that nonpharmacologic options for pain be offered by healthcare systems and providers. Although fibromyalgia is a relatively common condition, its pathology remains poorly defined and specific targeted treatments are not available. Controversies surrounding use of CES for the treatment of fibromyalgia include the regulatory status of the devices and demonstration of their efficacy for pain.

Key Questions:

  • Does CES reduce pain and improve function or quality-of-life impairments associated with fibromyalgia in adults?
  • How does CES compare with usual care?
  • Is CES safe for treating fibromyalgia in adults?
  • Have definitive patient selection criteria been identified for the use of CES in adults with fibromyalgia?

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