Cranial Electrotherapy Stimulation (CES) as a Treatment for Fibromyalgia


What is fibromyalgia?

Fibromyalgia is a chronic pain syndrome that involves widespread muscle pain (myalgias) and joint pain (arthralgias). Fibromyalgia is thought to be due to central sensitization (CS), which causes chronic pain and pain amplification due to a dysfunction in the way the brain and spinal cord process painful and non-painful signals. In addition to pain, fibromyalgia is frequently accompanied by additional symptoms, including fatigue, cognitive impairment/brain fog, headaches, depression, anxiety, and insomnia.

The goal of fibromyalgia treatment is to reduce pain and other symptoms of the condition, thereby improving quality of life. Cranial electrotherapy stimulation (CES) is one such treatment that may help reduce pain and other symptoms of fibromyalgia.

What is cranial electrotherapy stimulation (CES)?

Cranial electrotherapy stimulation is a form of electrotherapy. Electrodes are clipped to each ear and a low level of electricity is sent back and forth through the head. The electrical current is quite low, so it is not felt. CES is not the same as transcutaneous electrical nerve stimulation (TENS); TENS is much stronger and uses a different waveform.

CES treatments range from 20 to 60 minutes in duration and, at the beginning of treatment, are typically done daily or every other day. As treatment progresses, they can be done on an as-needed basis. CES can be performed at a doctor’s office or at home (after learning how to use the device).

How does CES work?

CES is often prescribed long-term for use on a daily basis or near-daily basis for 3-6 weeks, followed by 2-3 times per week thereafter. CES works by stimulating the brain’s neuromatrix and limbic system (the emotion center of the brain). The stimulation of these areas is thought to alter pain thresholds.

What are the potential benefits of CES?

Studies show various benefits of CES:

  • Decreased activity in the cortex of the brain
  • Increased serotonin and endorphins in the central nervous system
  • Increased alpha waves (associated with a calm, relaxed state)
  • Neutralizing effect on somatic pain generators

Studies also show that some individuals who use CES report the following benefits:

  • Improved quality of life
  • Decreased sleep disturbances
  • Better quality of sleep
  • Reduced pain and tender spots