Abstract
Purpose of the Study: This case report describes the management of a fibromyalgia patient using Periodic Transcranial Direct Current Stimulation (tDCS) and Manual Therapy (MT). Materials and Methods: A 41-year-old woman presented with a complaint of generalized body pain and fatigue which started 10 years ago. The pain was associated with mood changes and insomnia among other symptoms, and was not responsive to analgesics and traditional herbal medicine. The patient was diagnosed as having FMS. Three sets of anodal tDCS for 20 minutes each with an interval of 10 minutes between successive stimulations followed by 30 minutes of MT were administered on each treatment day. The treatment was given 2 times per week for 8 weeks, totaling 16 hours of tDCS and 8 hours of MT. Outcomes were assessed at baseline (T0), at 1 (T1) and 2 months (T2) of intervention, and then at 4 (T3), 6 (T4) and 12 months (T5) of follow-up. Results: At 12 month follow-up (T5), outcomes indicated improvement in all symptoms (WPI=0, SS=0, FIQ=0, BPI=0, MFI-20=20, MOS=0, MASQ=38, SF-36=87, HADS=3). Conclusion: Periodic tDCS followed by MT may be used to enhance long-term remission of symptoms in a patient with FMS.