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Fibromyalgia Basics

Cranial Electrical Stimulation (CES)

Home | Alternative Therapies

Woman using cranial electrical stimulation or CES therapy for treating brain function in fibromyalgia.

Preliminary studies are encouraging for CES’ ability to treat fibromyalgia and related symptoms. However, there are two downsides to CES: (1) the up-front cost of the device and (2) the lack of sufficient research to confirm the benefits. Before any therapy can be recommended, you need to know the odds that it will work and which symptoms it might relieve. Besides, doctors won’t prescribe a therapy unless they can provide this type of information to their patients with confidence.

What is CES?

CES is FDA-approved for treating insomnia, anxiety, depression, and pain. There are even several studies to suggest the device works for these indications. But how does a tiny current transmitted through the earlobe work to relieve these symptoms? No one knows for sure, but here are the likely mechanisms of CES:

  • Increases the brain’s alpha-waves to promote relaxation
  • Improves blood flow to brain areas that need it
  • Balances the communications between brain networks
  • Increases various neurotransmitters such as GABA and serotonin (they help relieve many symptoms)
  • Balances communication between the brain and the peripheral nervous system
  • Reduces brain inflammation (based on the findings of more potent brain stimulation devices)

Symptoms Treated  

Ten years ago, a two-month treatment trial showed CES reduced pain and sleep disturbance in fibromyalgia patients.1,2 Brain imaging revealed reduced pain processing activity in several areas. Less activity implies the brain is not spinning its wheels to fight incoming pain signals. In addition, fibromyalgia patients were less sensitive to painful stimuli at the end of the brain stimulation study.

Aside from looking at its role in reducing fibromyalgia pain, many studies show CES alleviates anxiety, improves sleep, and reduces depression.3 Unfortunately, not all treatment trials generate the same favorable results, and the data is less compelling for treating depression. On the upside, the side effects of CES are minor.

Although CES manufacturers claim the device helps with a variety of symptoms, it’s most likely to relieve anxiety.4 In fact, one study shows the device is just as effective as medications or counseling for anxiety.5

Richard Morriss, M.D., a psychiatrist at the University of Nottingham in the UK, has treated around 400 patients using CES. “About 40 to 50 percent show some benefit in anxiety,” says Morriss, adding that eight percent get side effects. “The most common are headache, dizziness, nausea, and skin irritation at the site of the ear clip. These are short-lived and mild.”

Morriss uses the Alpha-Stim brand of CES, which sells for $840. While this is a lot of money, the financial barriers are greatly reduced in the United Kingdom, compared to the United States. People can rent the device for three months for only $52, and if it works, they can elect to purchase it.

In the United States, some providers rent the device to patients, but usually patients must purchase it before knowing whether it works. Hopefully, more research and greater healthcare awareness of the device will change this situation.

CES for Fibro?
… a work in progress

CES shows tremendous promise for treating fibromyalgia because it’s safe to use at home. Treatments generally last one hour, but the therapy can be done while watching TV, reading a book, or getting ready for bed at night. It’s convenient and the side effects are mild.

CES sounds like an ideal therapy, so why is it that your doctor has not prescribed it for you? More studies are needed to show it effectively treats a significant portion of people with fibromyalgia. After all, physicians can’t prescribe a therapy without data to show its efficacy. Plus, patients living in the United States have another hurdle: insurance doesn’t cover the cost of CES devices. Insurers require more proof as well.

Fortunately, Anna Woodbury, M.D., fibromyalgia researcher at Emory University in Atlanta, GA, is working to provide the much-needed answers. She is evaluating CES for treating fibromyalgia. In addition to measuring the therapy’s efficacy, Woodbury is using elaborate brain imaging to determine how the device works. Part of the study is funded by AFSA and you can read more about it in the Projects Funded section.

Before shelling out money for any therapy, you deserve to know:

  • Is it effective for treating fibromyalgia?
  • What are the key symptoms it relieves?
  • What are the odds that CES will help fibromyalgia patients? Is it one out of ten or one out of three?

Woodbury’s research on CES lays the groundwork for answering these questions. In the meantime, keep in mind that the FDA approval of CES means it is safe; it just doesn’t guarantee it will work for you.

Patient Resources

The Alpha-Stim CES is available in two models and the manufacturer is Electromedical Products International. The Alpha-Stim M is much more expensive because it has a hand-held probe to treat regional areas. It costs $1,300 and is designed for treating joint arthritis. You probably do not need to pay extra for this. Alpha-Stim AID is the other model (costs $840) and it’s the one Woodbury is testing in fibromyalgia patients.

If you are eager to try an Alpha-Stim CES device for your fibromyalgia, check the following providers in your area: pain clinics, physical therapists, and chiropractors. A few might have the device available for short-term rental so you can test it out. But if it works for you, be prepared to purchase the unit for $840.

A licensed healthcare provider must prescribe the Alpha-Stim and other CES devices in the United States. Nurses and non-medical staff cannot prescribe the units.

Attention Active Military Members and Veterans: Roughly 50 percent of VA and DOD facilities cover the Alpha-Stim CES device. Contact the Government Services department (option 2) at Alpha-Stim for guidance. The number is (800) 367-7246.

To read about other fibro treatments:

TENS Units – info on how to use it and research studies in fibro patients

Heat Wraps – learn why a heat wrap placed on your most painful area tones down your body-wide pain

Alternative Therapies – this section contains several articles on nondrug approaches to treat your fibromyalgia

Medications – get advice from treatment experts on how to minimize side effects

Dietary Approaches – various dietary changes show promise for reducing fibromyalgia symptoms

Managing Fibromyalgia Pain – provides a variety of approaches to help you get a handle on your symptoms

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References for Fibromyalgia CES Brain Stimulation

  1. Taylor AG, et al. Pain Manag Nurs 14(4):327-335, 2013.
  2. Taylor AG, et al. EXPLORE 9(1):32-40, 2013.
  3. Brunye TT, et al. Front Hum Neurosci 15:625321, 2021. Free Article
  4. Chung FC, et al. Front Psychiatry 14:1157473, 2023. Free Article
  5. Royal S, Morriss R, at al. BMC Primary Care 23:97, 2022. Free Article